Children with Autism Spectrum Disorder Are Able to Maintain Dental Skills: A Two-Year Case Review of Desensitization Treatment.

Purpose: The purposes of this study of children with autism spectrum disorder (ASD), who had successfully accepted a dental examination seated in a dental chair following desensitization interventions, were to: (1) determine if ability to accept an examination was maintained two years following initial success; (2) quantify new dental skills acquired; and (3) analyze the use of advanced behavior guidance techniques. Methods: This retrospective two-year case series included 138 ASD children. Data were obtained from dental records. Descriptive statistics were calculated, and Fisher's exact test was used for comparisons of interest. Results: Most children (92 percent) maintained the ability to receive minimum threshold examinations once the initial exam had been achieved. New basic dental skills attained by most children included receiving toothbrush prophylaxis (83 percent) and accepting fluoride varnish (77 percent). Few children required oral sedation or protective stabilization, but 22 percent received general anesthesia. Conclusions: Most children with autism spectrum disorder who learned to accept an examination maintained that skill over time, and many accepted toothbrush prophylaxis and fluoride varnish. Sensory-invasive skills, such as radiographs and rubber cup prophylaxis, were acquired with lower frequency. Therefore, when treating ASD patients, it is important to consider that some will require advanced behavior guidance techniques. (Pediatr Dent 2019;41(5):397-403).

Predicting successful dental examinations for children with autism spectrum disorder in the context of a dental desensitization program.

BACKGROUND: The authors evaluated the effectiveness of a dental desensitization program for children with autism spectrum disorder (ASD) and determined characteristics associated with a successful dental examination. METHODS: The authors performed a retrospective review of clinical behavioral data and previsit questionnaires for 168 children with ASD who attended a university-based dental desensitization program. Data elements included demographic, treatment, and behavioral characteristics. The primary outcome was receiving a minimal threshold examination (MTE) while seated in a dental chair. RESULTS: An MTE was achieved for 77.4% of all children within 1 to 2 visits and 87.5% in 5 visits or less. Several factors predicted a successful dental examination: ability to be involved in group activities (relative risk [RR], 1.18; P = .02), ability to communicate verbally (RR, 1.17; P < .01), understanding of most language (RR, 1.14; P = .02), moderate versus severe caregiver-rated ASD severity (RR, 1.24; P = .04), and ability to dress self (RR, 1.27; P = .04). CONCLUSIONS: Desensitization was effective in achieving an MTE for most children. Those with characteristics consistent of a milder presentation of ASD were more likely to be successful. PRACTICAL IMPLICATIONS: Desensitization can be a successful approach to providing dental care for children with ASD.