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da Silva GCB, Firmino RT, Nóbrega WFS, d'Ávila S. Oral habits, sociopsychological orthodontic needs, and sociodemographic factors perceived by caregivers impact oral health-related quality of life in children with and without autism? Int J Paediatr Dent 2024; 34:593-607. [PMID: 38229239 DOI: 10.1111/ipd.13160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/18/2023] [Accepted: 01/04/2024] [Indexed: 01/18/2024]
Abstract
BACKGROUND Caregivers play a crucial role in assessing the oral health-related quality of life (OHRQoL) of young individuals with autism spectrum disorder (ASD). AIM This study assessed the impact of sociodemographic and oral conditions on OHRQoL and family dynamics in young individuals with and without autism, as perceived by guardians. DESIGN This comparative cross-sectional study included young individuals aged 6 to 14 years and their guardians. Data were collected at a specialized institution and dental schools. Guardians completed the Parental-Caregiver Perceptions Questionnaire (P-CPQ), Family Impact Scale (FIS), and sociodemographic and oral habits questionnaires. The sociopsychological need for orthodontic treatment was assessed using the Index of Orthodontic Treatment Need (IOTN). RESULTS The sample included 144 youths and caregivers. The ASD group had higher P-CPQ and FIS scores. Factors associated with poorer perceived OHRQoL included higher youth age, lower caregiver education, higher IOTN scores, teeth clenching (RR = 1.20; 95% CI: 1.01-1.41), and lip sucking. Lower parental education (RR = 1.75; 95% CI: 1.10-2.80) and higher IOTN scores from the caregiver's perspective impacted family dynamics. CONCLUSION Caregivers of young individuals with ASD perceived a lower OHRQoL, and families in this group were more affected by sociodemographic and oral conditions.
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Affiliation(s)
| | - Ramon Targino Firmino
- Academic Unit of Biological Sciences, Federal University of Campina Grande, Patos, Brazil
| | | | - Sérgio d'Ávila
- Postgraduate Program in Dentistry, State University of Paraíba, Campina Grande, Brazil
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2
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Ming NR, Noble D, Chussid S, Ziegler A, Chung WK. Caregiver-reported dental manifestations in individuals with genetic neurodevelopmental disorders. Int J Paediatr Dent 2024; 34:145-152. [PMID: 37655712 DOI: 10.1111/ipd.13116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 07/04/2023] [Accepted: 07/18/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Children with neurodevelopmental disorders (NDDs) often have poor oral health and dental abnormalities. An increasing number of genes have been associated with neurodevelopmental conditions affecting the oral cavity, but the specific dental features associated with many genes remain unknown. AIM To report the types and frequencies of dental manifestations in children with neurodevelopmental conditions of known genetic cause. DESIGN A 30-question survey assesing ectodermal and dental features was administered through Simons Searchlight, with which formed a recontactable cohort of individuals with genetic NDDs often associated with autism spectrum disorder (ASD). RESULTS Data were collected from a largely paediatric population with 620 affected individuals across 39 genetic conditions and 145 unaffected siblings without NDDs for comparison. Drooling, difficulty accessing dental care, late primary teeth eruption, abnormal primary and permanent teeth formation, misshapen nails, and hair loss were more frequent in individuals with NDDs. Additionally, we evidenced an association between three new pathogenic gene variant/oral manifestation pairs: CSNK2A1/unusual primary teeth, DYRK1A/late primary teeth eruption, and PPP2R5D/sialorrhea. CONCLUSION Our results demonstrate that genetic NDDs caused by mutations in CSNK2A1, DYRK1A, and PP2R5D are associated with unique dental manifestations, and knowledge of these features can be helpful to personalize dental care.
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Affiliation(s)
- Neil R Ming
- College of Dental Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Deanna Noble
- College of Dental Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Steven Chussid
- Department of Paediatric Dentistry, Columbia University Irving Medical Center, New York, New York, USA
| | - Alban Ziegler
- Department of Paediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Wendy K Chung
- Department of Paediatrics, Columbia University Irving Medical Center, New York, New York, USA
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
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3
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Uliana JC, Del' Agnese CC, Antoniazzi RP, Kantorski KZ. Autistic individuals have worse oral status than neurotypical controls: a systematic review and meta-analysis of observational studies. Clin Oral Investig 2024; 28:137. [PMID: 38321186 DOI: 10.1007/s00784-024-05500-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 01/07/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVE To compare dental caries, oral hygiene, periodontal status, bruxism, malocclusion, tooth loss, and salivary alterations between autistic and typical developing individuals. MATERIAL AND METHODS Observational studies presenting clinical measures of oral outcomes between autism spectrum disorder (ASD) individuals and controls. EMBASE, LILACS, PubMed, PsycINFO, Scopus, Web of Science, Google Scholar, and ProQuest were searched up to June 26, 2023. Pairs of reviewers independently conducted study selection, data extraction, and assessments of methodological quality and certainty of evidence. Meta-analyses of standardized mean differences (SMD) and risk ratio (RR) were performed. RESULTS A total of 47 studies comprising 6885 autistic individuals were included in the review. Autistic individuals had significantly higher severity of dental-caries experience in primary teeth (SMD 0.29, 95%CI 0.02, 0.56), of dental plaque presence (SMD 0.59, 95%CI 0.24, 0.94), and of gingivitis (SMD 0.45, 95%CI 0.02, 0.88). Autistic individuals showed higher probability of occurrence of gingivitis (RR 1.34, 95%CI 1.08, 1.66,), bruxism (RR 4.23, 95%CI 2.32, 7.74), overjet (RR 2.16, 95%CI 1.28, 3.64), overbite (RR 1.62, 95%CI 1.02, 2.59), crossbite (RR 1.48, 95%CI 1.02, 2.13), and openbite (RR 2.37, 95%CI 1.46, 3.85), when compared to neurotypical individuals. Most estimates showed a small effect size with very low certainty of evidence. CONCLUSION Autistic individuals show worse oral health status than controls. CLINICAL RELEVANCE The findings reported herein can help to build health policies to better serve autistic individuals including prevention actions and access to specialized dental care.
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Affiliation(s)
- Jaíne C Uliana
- Oral Science, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Catiusse C Del' Agnese
- Oral Science, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Raquel P Antoniazzi
- Oral Science, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Karla Z Kantorski
- Oral Science, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil.
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Valdez-Zambrano VE, Romo-Cardoso A. [Preventive treatment alternatives in pediatric patients with autism spectrum disorder in the dental practice. literature review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2024; 12:e189. [PMID: 39015312 PMCID: PMC11247464 DOI: 10.21142/2523-2754-1201-2024-189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 02/01/2024] [Indexed: 07/18/2024] Open
Abstract
Autism comes from the Greek word auto, which means "self." Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social interaction and communication. Dental treatment in patients with ASD can be challenging due to their behavior. Therefore, this review discusses preventive treatment techniques for pediatric patients with ASD at the dental office, as the prevalence of children with autism is growing. Thus, dentists would face more patients with autism in their daily practice. Regarding treatment protocols, they would require specialized attention in dental management. Information was searched in the following databases: PubMed, SciELO, Redalyc, Elsevier, and the International Association of Paediatric Dentistry (IAPD). The descriptors used were: Pediatric Dentistry, Autism, ASD, Autism Spectrum Disorder, and Management of the autistic patient.
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Affiliation(s)
- Vianca E Valdez-Zambrano
- Facultad de Odontología, Universidad Católica de Cuenca. Cuenca, Ecuador. , Universidad Católica de Cuenca Facultad de Odontología Universidad Católica de Cuenca Cuenca Ecuador
| | - Adriana Romo-Cardoso
- Facultad de Odontología, Universidad Católica de Cuenca. Cuenca, Ecuador. , Universidad Católica de Cuenca Facultad de Odontología Universidad Católica de Cuenca Cuenca Ecuador
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de Oliveira Marques V, Kort-Kamp LM, de Souza MAN, Portela MB, Castro GFBDA. Oral Health and Behavioral Management of Children with Autistic Spectrum Disorder: A 30-year Retrospective Study. J Autism Dev Disord 2023:10.1007/s10803-023-06209-x. [PMID: 38109033 DOI: 10.1007/s10803-023-06209-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE This article aims to determine the oral health status, the dental treatment, the behavioral management techniques, and the follow-up of pediatric autistic spectrum disorder (ASD) patients treated at the Clinic for Pediatric Patients with Disabilities (CPPD) at a public university in Brazil. METHODS The medical records of all the patients seen between 1990 and 2020 were evaluated. Data were collected on the autistic patients' medical and dental conditions, treatments, behavior during dental visits, behavioral management techniques used, and the entire follow-up period at the clinic. The Student's t-test and chi-square tests were used to perform the statistical analysis (α = 0.05%). RESULTS Sixty-six records of ASD children were analyzed from a total of 656 dental records. The majority were male (80.3%). The mean age was 7.39 ± 2.75 years. All the children had a cognitive deficit, and 62.5% used medication. Most of the children arrived with caries lesions (56.1%), and the mean number of decayed, missed and filled teeth in both the deciduous (dmft-d) and permanent dentition (DMFT) was 2.45 ± 3.13 and 0.87 ± 1.51, respectively. The restorative technique was the most commonly used procedure (54.5%), and protective stabilization was the most frequently used behavioral management technique (18.2%). Of the children who sought treatment, 86.4% were discharged, and 15.2% abandoned the procedure. The majority (those discharged) continued to undergo regular follow-up at the clinic (86%), and the incidence of new caries lesions observed was 33.33% Conclusions: Although our ASD patients had a high frequency of caries and dental treatment needs, we observed good adherence to the treatment, with a low dropout rate, and high discharge rate.
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Affiliation(s)
- Vivian de Oliveira Marques
- Pediatric Dentistry, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Luana Mota Kort-Kamp
- Pediatric Dentistry, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Maristela Barbosa Portela
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Fluminense, Rio de Janeiro, RJ, Brazil
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Alqahtani AS, Gufran K, Alsakr A, Alnufaiy B, Al Ghwainem A, Bin Khames YM, Althani RA, Almuthaybiri SM. Oral Healthcare Practices and Awareness among the Parents of Autism Spectrum Disorder Children: A Multi-Center Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:978. [PMID: 37371210 DOI: 10.3390/children10060978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/23/2023] [Accepted: 05/28/2023] [Indexed: 06/29/2023]
Abstract
This study aimed to evaluate the knowledge and attitudes of the parents of autistic children toward oral health and the practice of oral hygiene habits. A questionnaire was constructed, validated, and distributed to the parents of autistic children at different autistic centers. The questionnaire was divided into three parts: demographic information on the parents of autistic children, the knowledge and attitudes of parents toward oral health, and the practice of oral hygiene habits in the current population. A total of 206 responses were collected. Irrespective of the parents' educational and employment statuses, most second children were diagnosed with autism, and most of the parents have four or more children. In terms of knowledge and attitudes toward oral health, a total of 90.30% of the patients were aware of the oral healthcare of their child, and 55.80% of parents take them to the dentist for checkups. Moreover, the response to the practice of oral hygiene habits from the parents was positive, and most of the parents assist in the oral hygiene practices of their autistic children. This study showed that most of the parents appeared to have satisfactory knowledge about oral health practices for autistic children. However, additional studies should also be conducted.
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Affiliation(s)
- Abdullah Saad Alqahtani
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | - Khalid Gufran
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | - Abdulaziz Alsakr
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | - Banna Alnufaiy
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | - Abdulhamid Al Ghwainem
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | | | - Rakan Abdullah Althani
- College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia
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Martínez Pérez E, Adanero Velasco A, Gómez Clemente V, Miegimolle Herrero M, Planells Del Pozo P. Importance of Desensitization for Autistic Children in Dental Practice. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050796. [PMID: 37238344 DOI: 10.3390/children10050796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 04/19/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVES Dental treatment in special needs patients, including children with autism, can be accomplished by reducing the behaviors that can reduce fear, as it has been demonstrated in other studies. The present study aims to examine the influence of the latency time elapsing between desensitization and the real dental situation on facilitating the access of children with autism to dental treatment. STUDY DESIGN Nineteen patients with autism, who were aged 3-14 years and attended the Special Education Center in Madrid but were living with their parents at home, were selected for the study. All children in the sample were subjected to a desensitization process before attending the real dental office. Two study groups were established: the latency period between the last desensitization and the real situation was one day for the first group and seven days for the second group. An experimental study was conducted to assess the child's cooperation in the dental chair; the dental examination was divided into several steps and the highest step reached by each child was recorded. RESULTS There is a statistical difference in the number of steps reached between the children who received the information just before the examination date and the children who experienced a longer latency period between receiving the information and experiencing the examination. CONCLUSIONS We would like to emphasize the importance of providing information in advance when dealing with autistic children; this information should be as close as possible to the real situation. Additionally, we would like to stress the importance of inter-cooperation between parents, educators, and pediatric dentists in order to guarantee adequate oro-dental care for autistic children. Further studies with larger sample sizes and a control group are recommended.
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Affiliation(s)
- Eva Martínez Pérez
- Clinical Specialties Department, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain
| | - Alberto Adanero Velasco
- Clinical Dentistry Department, Biomedical and Sciences Faculty, European University of Madrid, 28670 Madrid, Spain
| | | | - Mónica Miegimolle Herrero
- Clinical Dentistry Department, Biomedical and Sciences Faculty, European University of Madrid, 28670 Madrid, Spain
| | - Paloma Planells Del Pozo
- Clinical Specialties Department, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain
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8
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Andonovski ME, Antonarakis GS. Autism spectrum disorder and dentoalveolar trauma: A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e858-e864. [PMID: 35777731 DOI: 10.1016/j.jormas.2022.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 06/26/2022] [Accepted: 06/27/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Patients with autism spectrum disorder (ASD) may be more predisposed to oral pathology, including dentoalveolar trauma. Our aim was to assess the risk of dentoalveolar trauma in patients with ASD. MATERIALS AND METHODS Meta-analysis methodology was used to compare the prevalence of dentoalveolar trauma in individuals with ASD compared to individuals without ASD. A literature search was carried out, with predefined inclusion and exclusion criteria, to identify controlled studies evaluating dentoalveolar trauma in individuals with ASD. Data were combined using the random-effects meta-analysis model. RESULTS Out of an initial 154 studies, 14 were selected for inclusion in the meta-analysis, resulting in a total of 1488 individuals with ASD. Meta-analysis results showed significant difference in the overall risk of dentoalveolar trauma between individuals with ASD versus a control group (RR = 1.45). Looking at specific types of dentoalveolar trauma, individuals with ASD were found to be more at risk for partial or total (avulsion) luxation injuries (RR = 3.02) than healthy individuals. CONCLUSIONS Individuals with ASD are more at risk for dentoalveolar trauma than those without ASD, especially for more severe dentoalveolar trauma such as luxation and avulsion injuries.
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Affiliation(s)
- Marie-Elisabette Andonovski
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva 1206, Switzerland
| | - Gregory S Antonarakis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva 1206, Switzerland.
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Zerman N, Zotti F, Chirumbolo S, Zangani A, Mauro G, Zoccante L. Insights on dental care management and prevention in children with autism spectrum disorder (ASD). What is new? FRONTIERS IN ORAL HEALTH 2022; 3:998831. [PMID: 36238091 PMCID: PMC9551997 DOI: 10.3389/froh.2022.998831] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/09/2022] [Indexed: 11/26/2022] Open
Abstract
Autistic subjects represent a severe concern to dentistry due to the considerable difficulty in managing their oral health, maintaining routine toothbrushing, and preventing dental and periodontal problems. The social and economic burden of managing dental care in autism spectrum disorder (ASD) children is particularly cumbersome for families and public and private health expenditure, especially when children reach the dentist following a late diagnosis with evident oral health problems. An early diagnosis of ASD helps dentists better address these children's oral health. Unfortunately, insufficient attention is paid to the training and education of general pediatricians, dentists, and dental hygienists, allowing them to get to approach the different clinical aspects of ASD. Usually, children diagnosed with ASD are scheduled for dental appointments like their neurotypical peers, whereas their needs are typically complex and personalized. Scant attention is also devoted to these patients by commercial manufacturers of dental products and devices for oral hygiene and prevention of caries and periodontal diseases, leaving parents without the support and often failing when they address the oral health of autistic children. The difficulties of oral care do not derive simply from the behavior of ASD patients, as is commonly assumed, and therefore cannot be overcome solely by the patience and attention of parents and dentists. Genetics, dietary habits, sensory impairments, and cognition disorders are other causes contributing in various degrees to the impact on the mood and psychological reactions of autistic children towards dentists. How can we prevent teeth caries, periodontal disorders, and other oral health impairments by properly managing ASD children? This manuscript gives an up-to-date overview of these problems and helps to provide good remarks.
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Affiliation(s)
- Nicoletta Zerman
- Department of Surgery, Dentistry, Paediatrics and Gynecology, University of Verona, Verona, Italy
| | - Francesca Zotti
- Department of Surgery, Dentistry, Paediatrics and Gynecology, University of Verona, Verona, Italy
| | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Alessandro Zangani
- Department of Surgery, Dentistry, Paediatrics and Gynecology, University of Verona, Verona, Italy
| | | | - Leonardo Zoccante
- Autism Veneto Region Center, Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
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Khan I. Auto-extraction in special care patients. Br Dent J 2022; 232:132-133. [PMID: 35149786 PMCID: PMC8832433 DOI: 10.1038/s41415-022-3945-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- I Khan
- By email, West Midlands, UK
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11
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Meuffels SA, Kuijpers-Jagtman AM, Tjoa STH, Bonifacio CC, Carvajal Monroy PL. Malocclusion complexity and orthodontic treatment need in children with autism spectrum disorder. Clin Oral Investig 2022; 26:6265-6273. [PMID: 35701552 PMCID: PMC9525343 DOI: 10.1007/s00784-022-04578-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/07/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This study aimed to investigate the malocclusion complexity and orthodontic treatment need among children with and without autism spectrum disorder (ASD) referred for orthodontic treatment by quantifying the Discrepancy Index (DI) and Index of Orthodontic Treatment Need (IOTN). MATERIALS AND METHODS Dental records of 48 ASD and 49 non-ASD consecutive patients aged between 9 and 18 years (median age 13.0 years) referred for orthodontic treatment were reviewed and compared. The Discrepancy Index (DI) was quantified to determine the malocclusion complexity, and the Index of Orthodontic Treatment Need (IOTN), including the Dental Health Component (IOTN-DHC) and Aesthetic Component (IOTN-AC), was quantified to determine the orthodontic treatment need. Statistical analysis included descriptive analysis, Pearson chi-square tests, Fisher's exact test, Mann-Whitney U tests, and several univariate and multivariate regression analyses. The statistical analysis used descriptive analysis, Pearson chi-square test, Fisher's exact test, and multivariate logistic regression. RESULTS The results show that both malocclusion complexity (DI, p = 0.0010) and orthodontic treatment need (IOTN-DHC, p = 0.0025; IOTN-AC p = 0.0009) were significantly higher in children with ASD. Furthermore, children with ASD had a higher prevalence of increased overjet (p = .0016) and overbite (p = .031). CONCLUSIONS Malocclusion complexity and orthodontic treatment need are statistically significantly higher among children with ASD than children without ASD, independent of age and sex. CLINICAL RELEVANCE Children with autism may benefit from visits to a dental specialist (orthodontist) to prevent, to some extent, developing malocclusions from an early age.
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Affiliation(s)
- Stephanie A. Meuffels
- Department of Pediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands ,Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine/Medical Faculty, University of Bern, Bern, Switzerland ,Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Stephen T. H. Tjoa
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Clarissa C. Bonifacio
- Department of Pediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
| | - Paola L. Carvajal Monroy
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus Medical Center, Rotterdam, the Netherlands
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12
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Hong SJ, Chae YK, Lee C, Choi SC, Nam OH. A Digital Fabrication of Dental Prosthesis for Preventing Self-Injurious Behavior Related to Autism Spectrum Disorder: A Case Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179249. [PMID: 34501850 PMCID: PMC8430482 DOI: 10.3390/ijerph18179249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/23/2021] [Accepted: 08/30/2021] [Indexed: 12/02/2022]
Abstract
This case report aimed to demonstrate the prosthetic solution of an autism patient with self-injurious behavior using digital dentistry. A 24-year-old male visited our clinic with chief complaints of severe gingival recession associated with self-injurious behavior. Bilateral fixed prosthesis with denture flange were delivered using a digital workflow for the protection of the gingiva. The patient showed healed gingival tissue, behavioral modification, and acceptable oral hygiene during the follow-up period. Also, his caregivers reported no recurrence of the self-injurious behavior. Autism patients usually show self-injurious behavior, which can damage their oral tissue. With adoption of this prosthesis, behavior modification as well as healing of oral tissue was achieved.
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Affiliation(s)
- Seoung-Jin Hong
- Department of Prosthodontics, School of Dentistry, Kyung Hee University, Seoul 02447, Korea;
| | - Yong Kwon Chae
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul 02447, Korea; (Y.K.C.); (S.C.C.)
| | - Chunui Lee
- Department of Oral and Maxillofacial Surgery, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea;
| | - Sung Chul Choi
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul 02447, Korea; (Y.K.C.); (S.C.C.)
| | - Ok Hyung Nam
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul 02447, Korea; (Y.K.C.); (S.C.C.)
- Correspondence: ; Tel.: +82-2-958-9372; Fax: +82-2-965-7247
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13
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Lai YYL, Downs JA, Wong K, Zafar S, Walsh LJ, Leonard HM. Oral parafunction and bruxism in Rett syndrome and associated factors: An observational study. Oral Dis 2021; 29:220-231. [PMID: 34033206 DOI: 10.1111/odi.13924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To explore patterns of parafunction, and bruxism, and its relationships with genotype and snoring in individuals with Rett syndrome (RTT). METHODS Retrospective observational data of those with confirmed MECP2 mutations in the InterRett database (n = 216) were used to investigate experience of parafunctional habits, and bruxism and their relationships with genotype and snoring using multivariable linear regression. RESULTS The prevalence of parafunction was 98.2%. Bruxism was reported (66.2%) with the patterns mostly both diurnal and nocturnal (44.1%) and exclusively diurnal (42.7%). Compared to individuals with C-terminal deletion, individuals with p.Arg106Trp mutations were less likely to have bruxism reported (aOR = 0.15; 95% CI 0.02-0.98, p = 0.05) and those with p.Arg168* mutation were more likely to have frequent bruxism than none or occasional bruxism reported (aROR 3.4; 95% CI 1.1-10.7 p = 0.04). The relative odds of having nocturnal bruxism constantly, compared to none/occasionally, were higher among those 'always' snoring (aROR 6.24; 95% CI 2.1-18.2, p = 0.001) than those with no snoring. CONCLUSIONS There appeared to be genotypic association with bruxism in p.Arg168* and p.Arg106Trp mutations and association between nocturnal bruxism and frequent snoring in an international sample of individuals with RTT. Clinical significance of the high prevalence of bruxism should be highlighted in relation to difficulty communicating pain and increased dental treatment need in RTT.
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Affiliation(s)
- Yvonne Yee Lok Lai
- The University of Queensland School of Dentistry, UQ Oral Health Centre, Herston, QLD, Australia
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Jenny Anne Downs
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Kingsley Wong
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Sobia Zafar
- The University of Queensland School of Dentistry, UQ Oral Health Centre, Herston, QLD, Australia
| | - Laurence James Walsh
- The University of Queensland School of Dentistry, UQ Oral Health Centre, Herston, QLD, Australia
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Verhaltensbedingte dentale und orale Befunde bei Menschen mit Autismus-Spektrum-Störung – eine ausgewählte Übersicht. Monatsschr Kinderheilkd 2020. [DOI: 10.1007/s00112-020-01078-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Zusammenfassung
Hintergrund
Charakteristisch für Menschen mit einer Störung aus dem Autismusspektrum (ASS) sind qualitative und quantitative Störungen der Kommunikation und sozialen Interaktion, stereotypes Verhalten und ggf. auch Sonderinteressen.
Ziel der Arbeit
Der vorliegende Artikel blickt auf unterschiedliche ASS-assoziierte Verhaltensmuster und deren Auswirkungen, die sich im Mundraum oder an den Zähnen darstellen.
Ergebnis
Im klinischen Alltag wird vermehrt ein Zusammenhang zum Mundraum festgestellt. Konkret sind Aspekte der einseitigen Ernährungsgewohnheiten, der Selbststimulation oder Selbstverletzung zu nennen, die einen Einfluss auf die Entstehung oraler und dentaler Erkrankungen wie Karies, Gingivitis haben können.
Diskussion
Mittel- und langfristig können sich abnorme, repetitive Verhaltensweisen in dentalen oder oralen Erkrankungen manifestieren. Der dadurch verursachte Krankheitswert kann letztlich die Lebensqualität der Person und des sozialen Umfelds negativ beeinflussen.
Schlussfolgerung
Folglich ist es wichtig zu wissen, dass eine orale Beteiligung einer individuellen Verhaltensauffälligkeit bei einem Menschen mit einer ASS häufig gegeben ist. Im klinischen Alltag der Kinder- und Jugendmedizin ist dieses Wissen für Diagnose und Therapie, aber auch für die interdisziplinäre Zusammenarbeit mit dem (Kinder‑)Zahnarzt hilfreich.
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Diekamp M, Jenter L, Schulte AG, Fricke O, Schmidt P. Restoration of an Upper Anterior Tooth in an Adolescent with Autism Spectrum Disorder-A Student Case Report. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E237. [PMID: 33227942 PMCID: PMC7699251 DOI: 10.3390/children7110237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/13/2020] [Accepted: 11/14/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Patients with autism spectrum disorder (ASD) or other mental or physical limitations experience an imbalance in the frequency of dental treatment as compared with the general patient population, in part, due to inadequate pre-graduate training of future dentists. CASE PRESENTATION This case report describes a successful anterior tooth restoration, in awake state, in a 15-year-old boy with early childhood autism. The procedure was carried out independently by students of dentistry within the scope of their integrated clinical training semesters. Desensitization sessions were used as a preparatory measure and elements of behavioral facilitation (tell-show-feel-feel-do) were applied during the treatment. CONCLUSIONS To avoid discrimination of this group of patients in the provision and quality of dental care, a structured approach to the transfer of theoretical and practical knowledge in the field of special care dentistry is indispensable. To this end, treatment strategies for special care patients should be taught to pre-graduate dental students as a fundamental part of their university curriculum.
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Affiliation(s)
- Max Diekamp
- Integrated Clinical Course, Dental School, Witten/Herdecke University, 58455 Witten, Germany; (M.D.); (L.J.)
| | - Leonie Jenter
- Integrated Clinical Course, Dental School, Witten/Herdecke University, 58455 Witten, Germany; (M.D.); (L.J.)
- Department of Special Care Dentistry, Dental School, Witten/Herdecke University, 58455 Witten, Germany;
| | - Andreas G. Schulte
- Department of Special Care Dentistry, Dental School, Witten/Herdecke University, 58455 Witten, Germany;
| | - Oliver Fricke
- Department of Child and Adolescent Psychiatry, Psychotherapy and Child Neurology, Gemeinschaftskrankenhaus Herdecke, 58313 Herdecke, Germany;
- Department of Child and Adolescent Psychiatry, Witten/Herdecke University, 58455 Witten, Germany
| | - Peter Schmidt
- Department of Special Care Dentistry, Dental School, Witten/Herdecke University, 58455 Witten, Germany;
- Department of Child and Adolescent Psychiatry, Psychotherapy and Child Neurology, Gemeinschaftskrankenhaus Herdecke, 58313 Herdecke, Germany;
- Department of Child and Adolescent Psychiatry, Witten/Herdecke University, 58455 Witten, Germany
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Farmani S, Ajami S, Babanouri N. Prevalence of Malocclusion and Occlusal Traits in Children with Autism Spectrum Disorders. Clin Cosmet Investig Dent 2020; 12:343-349. [PMID: 32904713 PMCID: PMC7457711 DOI: 10.2147/ccide.s262679] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/21/2020] [Indexed: 12/03/2022] Open
Abstract
Background The purpose of this cross-sectional study was to evaluate the prevalence of malocclusion in children with autism spectrum disorders (ASDs) and to determine the most common occlusal traits. Materials and Methods The present cross-sectional study was conducted among 7–15 years old children with ASDs and randomly selected healthy children with the same demographic characteristics. Molar relationship, lip incompetence, overbite, overjet, midline deviation, crossbite, and crowding/spacing were recorded. A descriptive analysis was performed for all variables. A comparison of the presence or absence of malocclusion traits between children with and without ASDs was assessed using the chi-square test. Univariate and multivariate logistic regressions were used to calculate odds ratio (OR) and 95% confidence intervals (95% CI) to assay various parameters between autism and non-autism group. Results A total of 96 patients were assessed, 47 patients in the ASD group, and 49 in the control (non-ASD) group. The results showed no significant difference between the ASD and control groups in terms of the overall prevalence of malocclusion (P>0.05). However, the prevalence of increased overjet and Class II molar relationship was significantly higher in the ASD group compared to the control group (P=0.03). Patients in the control group showed a higher prevalence of midline deviation (P=0.001). Conclusion Despite a higher prevalence of overjet and Class II molar relationship in children with ASDs, the prevalence of malocclusion was not higher in this group of patients.
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Affiliation(s)
- Somaye Farmani
- Department of Orthodontics, Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shabnam Ajami
- Department of Orthodontics, Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Babanouri
- Department of Orthodontics, Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Qiao Y, Shi H, Wang H, Wang M, Chen F. Oral Health Status of Chinese Children With Autism Spectrum Disorders. Front Psychiatry 2020; 11:398. [PMID: 32477184 PMCID: PMC7232536 DOI: 10.3389/fpsyt.2020.00398] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 04/20/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To assess and compare the oral health status of children with and without autism spectrum disorders (ASD) in China. METHODS This study recruited 144 children with ASD and 228 unrelated children with typical development (TD) aged 3-16 years from China. Data were collected using parent-reported questionnaires. Oral problems (oral symptoms and habits), oral health measures (oral hygiene practice and dental care experience), and the impact on the child's quality of life (based on a modified version of the Parental-Caregiver Perception Questionnaire) were assessed and compared between the two groups. RESULTS Children with ASD had worse oral health status than children with TD. Oral symptoms were more prevalent in the ASD group, especially halitosis (p < 0.001), food impaction (p < 0.001), and oral lesions (p < 0.001), than the TD group. The rate of damaging oral habits, including mouth breathing (p < 0.001) and object biting (p < 0.05), was also high in the ASD group. Compared with the TD group, more children with ASD did not brush their teeth independently and frequently (p < 0.001), had difficulty accessing dental care (p < 0.01), and reported unpleasant dental experiences (p < 0.001). The presence of ASD was associated with decreased oral health-related quality of life (p < 0.001) in these children and their families. CONCLUSION Oral problems such as halitosis and bad oral habits are more prevalent among children with ASD. These children also lack oral hygiene practice and dental visits. This situation negatively impacts their quality of life, and must be brought to the attention of their treating dentists.
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Affiliation(s)
- Yanan Qiao
- Department of Orthodontics, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Han Shi
- Department of Orthodontics, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Hui Wang
- Department of Pediatrics, Xiamen Branch of Children's Hospital of Fudan University (Xiamen Children's Hospital), Xiamen, China
| | - Mingbang Wang
- Shanghai Key Laboratory of Birth Defects, Division of Neonatology, Xiamen Branch of Children's Hospital of Fudan University (Xiamen Children's Hospital), Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China
| | - Fengshan Chen
- Department of Orthodontics, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
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Büyükbayraktar ZÇ, Doruk C. Orthodontic Approach to Patients with Autism: A Review. Turk J Orthod 2019; 32:172-175. [PMID: 31565693 PMCID: PMC6756565 DOI: 10.5152/turkjorthod.2019.18078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 01/07/2019] [Indexed: 11/22/2022]
Abstract
Autism is a complex neurobehavioral disorder that causes problems in thinking, feeling, language, and the ability to communicate with other people. Over the past two decades, there has been a great deal of interest in autism disorder. This problem is recognized worldwide, and various measures are taken both nationally and internationally to improve the lives of affected individuals and families. The oral health care of such patients can be complicated since they cannot express their problems and can show unpredictable behaviors during treatment. The aim of the literature review was to collect information about the general oral health status of patients with autism, the difficulties that may be encountered during treatment, and the precautions that can be taken and the treatment approaches. This article reviews the dental literature from 1943 to the present.
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Affiliation(s)
| | - Cenk Doruk
- Department of Orthodontics, Cumhuriyet University School of Dentistry, Sivas, Turkey
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19
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Naidoo M, Singh S. The Oral health status of children with autism Spectrum disorder in KwaZulu-Nata, South Africa. BMC Oral Health 2018; 18:165. [PMID: 30314501 PMCID: PMC6186069 DOI: 10.1186/s12903-018-0632-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 10/05/2018] [Indexed: 12/20/2022] Open
Abstract
Background Echoing the sentiments of the Sixty-seventh World Health Assembly of May 2014, mandating the all-inclusive and synchronized efforts for the management of autism spectrum disorder (ASD), the aim of this current study was to investigate the oral health status of children with ASD aged between 7 to 14 years in KwaZulu-Natal, South Africa. Methods An investigative cross-sectional quantitative design employing non-probability purposeful sampling was conducted on 149 children with ASD attending special needs schools in KwaZulu-Natal. An intra-oral examination to investigate decayed, missing and filled teeth (DMFT/dmft), gingival index (GI), and plaque index (PI), attrition and soft tissue trauma using the World Oral Health Survey Form for Children, (2013) was implemented during data collection. Results Average DMFT/dmft scores of 3, 42 and 0, 97 were recorded respectively. Molars dominated the decayed component of the DMFT/dmft with an average caries prevalence of (51, 7% and 40, 8%) respectively. These results displayed zero fillings indicative of unmet treatment needs. The gingival index revealed mild gingival inflammation, (46, 3%) and the plaque index demonstrated visible plaque at (43, 6%).Attrition scores revealed mild loss of dental enamel (47%). The most prevalent soft tissue trauma recorded was lip biting (37, 25%). Conclusion Restorative or preventative treatment measures were not evident in this study. Unmet dental needs are therefore an important concern in this population. Health care planners should develop preventive programs targeted at high risk groups such as this study population.
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Affiliation(s)
- Magandhree Naidoo
- School of Health Sciences, Discipline of Dentistry, University of KwaZulu-Natal, Westville Campus, South Africa.
| | - Shenuka Singh
- School of Health Sciences, Discipline of Dentistry, University of KwaZulu-Natal, Westville Campus, South Africa
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Chandrashekhar S, S Bommangoudar J. Management of Autistic Patients in Dental Office: A Clinical Update. Int J Clin Pediatr Dent 2018; 11:219-227. [PMID: 30131645 PMCID: PMC6102426 DOI: 10.5005/jp-journals-10005-1515] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 02/17/2018] [Indexed: 12/29/2022] Open
Abstract
Autism is an intellectual developmental disorder characterized by insidious disability in communication, social interaction, and using language and abstract concepts. This organic disorder is known to have deformities in brain, i.e., cerebellum and limbic system, showing wide spectrum of systemic and behavioral symptoms. The oral health care of such patients can be complicated as they cannot verbalize complaints about any dental problems they may be experiencing and can display a variety of behaviors and reactions to small changes also. This study summarizes etiology and diagnosis of this disorder with the special emphasis on the issues encountered while coping with children with autistic spectrum. How to cite this article: Chandrashekhar S, Bommangoudar JS. Management of Autistic Patients in Dental Office: A Clinical Update. Int J Clin Pediatr Dent 2018;11(3):219-227.
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Affiliation(s)
- Shashidhar Chandrashekhar
- Professor, Department of Conservative Dentistry and Endodontics S.M.B.T. Dental College & Hospital, Ahmednagar, Maharashtra India
| | - Jyothi S Bommangoudar
- Reader, Department of Pedodontics and Preventive Dentistry, S.M.B.T Dental College & Hospital, Ahmednagar, Maharashtra, India
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21
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Harris JC, Kirby J, Brierley C, Dyer FMV. Orthodontics: Hammer horror. Br Dent J 2018; 224:59. [DOI: 10.1038/sj.bdj.2018.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Al-Sehaibany FS. Occurrence of oral habits among preschool children with Autism Spectrum Disorder. Pak J Med Sci 2017; 33:1156-1160. [PMID: 29142556 PMCID: PMC5673725 DOI: 10.12669/pjms.335.13554] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To determine occurrence of oral habits among Saudi preschool children with autism spectrum disorder (ASD) and compare it with healthy preschool children. Methods: This study was conducted over a 14-months period in Riyadh, Saudi Arabia. The sample consisted of two groups; a study group (SG) of 150 ASD children, and a control group (CG) of age- and gender-matched 150 healthy children. The parents of the children in both the groups were administered a questionnaire that included questions about the children’s demographic information and previous or persistent oral habits. Results: The prevalence of oral habits was higher (87.3%) among the SG children as compared to CG children (49.3%). The most prevalent oral habit among the SG was bruxism (n = 82; 54.7%), followed by object biting (n = 67; 44.7%) and mouth breathing (n = 40; 26.7 %). Among the CG; the most prevalent oral habit was mouth breathing (n = 40; 26.7%) followed by nail biting (n=18; 12%) and object biting (n = 7; 4.7%). The prevalence of bruxism, object biting, thumb sucking and tongue biting was significantly (p<0.05) higher in the SG than the CG. Conclusions: The prevalence of oral habits was higher in the ASD group children than the healthy children.
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Affiliation(s)
- Fares S Al-Sehaibany
- Fares S. Al-Sehaibany, BDS, DMSc, Associate Professor, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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da Silva SN, Gimenez T, Souza RC, Mello-Moura ACV, Raggio DP, Morimoto S, Lara JS, Soares GC, Tedesco TK. Oral health status of children and young adults with autism spectrum disorders: systematic review and meta-analysis. Int J Paediatr Dent 2017; 27:388-398. [PMID: 27796062 DOI: 10.1111/ipd.12274] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Individuals with special needs are often affected by oral disorders such as dental caries and periodontal disease. Current data regarding prevalence of these conditions in individuals with autism spectrum disorders (ASD) are controversial. AIM To conduct a systematic review and meta-analysis to verify the prevalence of dental caries and periodontal disease in individuals with ASD, especially children and young adults. DESIGN Searches were conducted through MEDLINE/PubMed, Web of Science, and Scopus databases in December 2015. Studies were included if fulfilled the following eligibility criteria: to evaluate the oral health status of individuals with ASD; to be an observational study; and to assess the prevalence of dental caries and/or periodontal disease. Meta-analyses were conducted considering prevalence of dental caries and periodontal disease in individuals as outcome. RESULTS Search strategy identified 928 potentially relevant articles and seven of them were included in this review. All included studies reported dental caries prevalence, and the pooled prevalence was 60.6% (95% CI: 44.0-75.1). Moreover, only three studies showed prevalence of periodontal disease, resulting in pooled prevalence of 69.4% (95% CI: 47.6-85.0). CONCLUSION Prevalence of dental caries and periodontal disease in children and young adults with ASD can be considered as high, pointing to the need for oral health policies focused on these individuals.
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Affiliation(s)
| | - Thais Gimenez
- Graduation Program, School of Dentistry, Ibirapuera University, Sao Paulo, Brazil.,University of São Paulo, Sao Paulo, Brazil
| | - Rafael Celestino Souza
- Pediatric Dentistry for Special Need Patients Course, São Leolpodo Mandic College, Sao Paulo, Brazil
| | | | | | - Susana Morimoto
- Graduation Program, School of Dentistry, Ibirapuera University, Sao Paulo, Brazil
| | | | | | - Tamara Kerber Tedesco
- Graduation Program, School of Dentistry, Ibirapuera University, Sao Paulo, Brazil.,University of São Paulo, Sao Paulo, Brazil
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Murshid EZ. Dental knowledge of educators and healthcare providers working with children with autism spectrum disorders. Saudi Med J 2016; 36:1477-85. [PMID: 26620991 PMCID: PMC4707405 DOI: 10.15537/smj.2015.12.12622] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To evaluate dental knowledge and attitudes toward oral health care among healthcare providers and educators working with children with autism spectrum disorders (ASD) in central Saudi Arabia. METHODS There were 305 questionnaires distributed to 7 special-needs centers between September and November 2014. A total of 217 questionnaires were collected with a response rate of 71.1%. The study took place in the College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. RESULTS Approximately 50.2% of the participants did not offer any toothbrushing advice, and 73.3% never recommended dental checkup visits to parents, and 75.6% never performed dental examinations to children under their care. Ten percent thought that children should have their first dental visit after 6 years of age. Almost all participants agreed that children should practice oral hygiene, and 60.4% think they should brush twice per day. In general, the participants choose toothbrushes and toothpaste as the main tools to perform oral hygiene. There were 35% of participants who believed that parents should be responsible for the children's oral hygiene, and a few participants mentioned teachers and therapists to be responsible. Most of the participants (71.4%) did not receive any dental information from dental professional resources, only 14.3% of participants believed bacteria to be the cause of dental cavities. CONCLUSION There is a clear lack of dental knowledge and attitudes, and its practical application among the participating group of healthcare providers working with children with ASD in Riyadh.
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Affiliation(s)
- Ebtissam Z Murshid
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Chandna P, Srivastava N, Adlakha VK, Panthri P. Non suicidal self injury resulting in dental trauma in an adolescent. Dent Traumatol 2016; 32:510-513. [PMID: 27126959 DOI: 10.1111/edt.12280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIM Non-suicidal self injury may be a possible etiologic factor for dental trauma in adolescents. The aim of this case report is to present a case of non-suicidal self injury resulting in dental trauma in a 16 year old adolescent boy. CASE REPORT This report illustrates a case of non-suicidal self injury in a 16 year old healthy boy with resultant trauma to the maxillary central incisors and the left lateral incisor (teeth 11, 21, and 22). Three tests were applied; Wechsler Abbreviated Scale of Intelligence™ (WASI), Inventory of Statements about Self Injury (ISAS), and UPPS Impulsive Behavior Scale (UPPS); to assess the patient's intellectual and behavioral functioning. Dental treatment was rendered in the form of composite restorations on teeth 11, 21, and 22. RESULTS AND DISCUSSION The patient had a general intelligence quotient (IQ) of 92 (SD = 10.9), verbal score of 86.6 (SD = 14.6), and performance IQ of 93.4 (SD = 23.66) which implied that the intelligence levels were well within the normal range. The patient demonstrated self hitting behavior and predominantly intrapersonal functions of his NSSI on testing with the ISAS scale and elevated urgency scores on the UPPS scale. The total UPPS score was 115.9 and urgency score was 35.9. NSSI was an outlet for negative emotions and to release self directed anger. This resulted in dental trauma to teeth 11, 21, and 22. CONCLUSION NSSI may be an etiologic or risk factor for dental trauma in intellectually normal adolescents as seen in the present case. Self hitting, intrapersonal factors or self directed factors and impulsivity are more likely to predispose an adolescent toward performance of such behavior.
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Affiliation(s)
- Preetika Chandna
- Paedodontics and Preventive Dentistry, Applied Psychology, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, India
| | - Nikhil Srivastava
- Paedodontics and Preventive Dentistry, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, India
| | - Vivek Kumar Adlakha
- Paedodontics and Preventive Dentistry, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, India
| | - Prerna Panthri
- Paedodontics and Preventive Dentistry, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, India
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Cannavale R, Itro A, Campisi G, Compilato D, Colella G. Oral self-injuries: clinical findings in a series of 19 patients. Med Oral Patol Oral Cir Bucal 2015; 20:e123-9. [PMID: 25475766 PMCID: PMC4393972 DOI: 10.4317/medoral.19643] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 05/10/2014] [Indexed: 11/13/2022] Open
Abstract
Objectives: Self-injury (SI) is defined as a behavioral disturbance consisting of a deliberate harm to one’s own body without suicidal intent, it is not uncommon and ranges in severity from simple nail-biting to more extreme forms of self-mutilation. The head neck region may be the target of such lesions. SI is associated with several medical conditions, of which it can represent the first clinical sign. Aim of this paper is to describe a series of oral SI, giving special emphasis to the clinical findings, etiology and the management of lesions.
Material and Methods: A total of 19 patients with oral SI were prospectively examined; attention was paid to the occurrence and characterization of oral lesions. The management of the lesion also varied depending on the patient medical history, on the etiology of the psychiatric behavior, and on the severity, frequency, and method of inflicting injury. Periodic examinations were performed (after two weeks, three months and six months) and registered.
Results: All the patients healed gradually and healing was conditioned by the disease underlying. The treatment consisted of behavior modification in 11 cases, pharmacological treatment in 11 cases, psychotherapy in 2 cases, mouth guard in 9 cases, surgery in 2 cases, extractions in 1 case.
Conclusions: Oral SI are uncommon in the clinical practice. They may be associated with a known disease or may be the consequence of this, but often they may be the first sign of a psychiatric disorder.
Key words:Oral self-mutilation, self-inflicted lesions, self-injurious behavior, ulcers, Obsessive-Compulsive Disorder, mental retardation.
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Affiliation(s)
- Rosangela Cannavale
- Head and Neck Surgery Dept, 2nd University of Naples, Piazza Miraglia 80100 Naples, Italy,
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Gandhi RP, Klein U. Autism spectrum disorders: an update on oral health management. J Evid Based Dent Pract 2014; 14 Suppl:115-26. [PMID: 24929596 DOI: 10.1016/j.jebdp.2014.03.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
UNLABELLED Dental professionals caring for patients with a diagnosis of autism spectrum disorder (ASD) will need to provide oral health care based on a family-centered approach that involves a comprehensive understanding of parental concerns and preferences, as well as the unique medical management, behaviors, and needs of the individual patient. BACKGROUND With the rising prevalence of autism spectrum disorders (ASD), oral health providers will find themselves increasingly likely to care for these patients in their daily practice. The purpose of this article is to provide a comprehensive update on the medical and oral health management of patients with autism spectrum disorders. METHODS The authors conducted a literature review by searching for relevant articles written in English in the PubMed database pertaining to the medical and oral health management of autism, including caries status, preventive, behavioral, trauma, and restorative considerations. CONCLUSIONS A detailed family centered approach based on parental preferences and concerns, the patient's challenging behaviors, and related comorbidities can serve to improve the treatment planning and oral health management of dental patients with ASD.
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Affiliation(s)
- Roopa P Gandhi
- Department of Pediatric Dentistry, Children's Hospital Colorado and University of Colorado School of Dental Medicine, Aurora, CO, USA.
| | - Ulrich Klein
- Department of Pediatric Dentistry, Children's Hospital Colorado and University of Colorado School of Dental Medicine, Aurora, CO, USA
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Vajawat M, Deepika PC. Comparative evaluation of oral hygiene practices and oral health status in autistic and normal individuals. J Int Soc Prev Community Dent 2014; 2:58-63. [PMID: 24478969 PMCID: PMC3894080 DOI: 10.4103/2231-0762.109369] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim: The present study attempts to explore the oral hygiene practices and oral health status in autistic patients as compared to nonaffected, same aged healthy individuals. Materials and Methods: The oral hygiene practices, prevalence of caries and periodontal status were evaluated in 117 autistic patients and 126 healthy individuals. The test and control groups were divided into three categories, based on the type of dentition as Primary dentition (Category 1), Mixed dentition (Category 2) and Permanent dentition (Category 3). Plaque and gingival status was recorded by plaque index (Loe, 1967) and gingival index (Loe, 1967), periodontal status by community periodontal index of treatment needs and dental caries by DMFT/DEF index. Statistical analysis was done using descriptive statistics, independent sample t-test, contingency coefficient test and one-way ANOVA test by SPSS 14 software. Results: There was no statistically significant difference in the brushing habits between autistics and controls (P = 0.573); however, Autistics required assistance in brushing. Prevalence of caries was significantly lower in autistic patients (P = 0.000). Plaque and gingival scores were significantly higher in autistic patients (P = 0.000) and prevalence of periodontal disease was significantly higher in autistic patients (P = 0.000). Greater number of autistic patients required professional scaling and root planing (P = 0.000). Conclusion: The present study suggests that autistic patients have a higher rate of periodontal disease and lower caries compared to controls. Attempts should be made by parents, general dentists and periodontists to teach oral hygiene methods to these patients by constant repetition and patience, as autistic individuals can develop skills over a period of time and lead a more productive and independent life.
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Affiliation(s)
- M Vajawat
- Department of Periodontology, JSS Dental College and Hospital, JSS University, Mysore, Karnataka, India
| | - P C Deepika
- Department of Periodontology, JSS Dental College and Hospital, JSS University, Mysore, Karnataka, India
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Self-injurious behaviours are associated with alterations in the somatosensory system in children with autism spectrum disorder. Brain Struct Funct 2013; 219:1251-61. [PMID: 23644587 DOI: 10.1007/s00429-013-0562-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 04/19/2013] [Indexed: 10/26/2022]
Abstract
Children with autism spectrum disorder (ASD) frequently engage in self-injurious behaviours, often in the absence of reporting pain. Previous research suggests that altered pain sensitivity and repeated exposure to noxious stimuli are associated with morphological changes in somatosensory and limbic cortices. Further evidence from postmortem studies with self-injurious adults has indicated alterations in the structure and organization of the temporal lobes; however, the effect of self-injurious behaviour on cortical development in children with ASD has not yet been determined. Thirty children and adolescents (mean age = 10.6 ± 2.5 years; range 7-15 years; 29 males) with a clinical diagnosis of ASD and 30 typically developing children (N = 30, mean age = 10.7 ± 2.5 years; range 7-15 years, 26 males) underwent T1-weighted magnetic resonance and diffusion tensor imaging. No between-group differences were seen in cerebral volume, surface area or cortical thickness. Within the ASD group, self-injury scores negatively correlated with thickness in the right superior parietal lobule t = 6.3, p < 0.0001, bilateral primary somatosensory cortices (SI) (right: t = 4.4, p = 0.02; left: t = 4.48, p = 0.004) and the volume of the left ventroposterior (VP) nucleus of the thalamus (r = -0.52, p = 0.008). Based on these findings, we performed an atlas-based region-of-interest diffusion tensor imaging analysis between SI and the VP nucleus and found that children who engaged in self-injury had significantly lower fractional anisotropy (r = -0.4, p = 0.04) and higher mean diffusivity (r = 0.5, p = 0.03) values in the territory of the left posterior limb of the internal capsule. Additionally, greater incidence of self-injury was associated with increased radial diffusivity values in bilateral posterior limbs of the internal capsule (left: r = 0.5, p = 0.02; right: r = 0.5, p = 0.009) and corona radiata (left: r = 0.6, p = 0.005; right: r = 0.5, p = 0.009). Results indicate that self-injury is related to alterations in somatosensory cortical and subcortical regions and their supporting white-matter pathways. Findings could reflect use-dependent plasticity in the somatosensory system or disrupted brain development that could serve as a risk marker for self-injury.
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Abstract
AIM To assess the oral health status of autistic children in Chennai. DESIGN AND METHODS Oral health status was assessed for 483 children with autism, solicited from special education schools, autistic child centres and therapy centres. Conditions assessed were plaque accumulation, gingival health, dental caries, malocclusion, developmental anomalies, oral injuries and restorations. STATISTICS Chi-square and Fisher's exact tests of significance were used to compare groups. Proportions test was used to compare the significance of the parameters between boys and girls. RESULTS Autistic children with primary dentition showed significantly higher incidence of dental caries (24%), when compared to other oral conditions. Children with mixed dentition had more gingivitis (50%) and children with permanent dentition had more gingivitis (48.96%) and malocclusion (71.15%). All the oral conditions were seen more in boys than girls. CONCLUSION Autistic children have significantly poor oral hygiene and higher incidence of malocclusion and dental caries when compared to other oral conditions.
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Abstract
BACKGROUND Self-inflicted oral injuries of organic origin are particularly common in certain diseases, syndromes, and systemic disorders. In this article, we discuss the characteristics of these oral lesions and their treatment. LITERATURE SEARCH The authors have reviewed the most relevant literature relating to oral self-injury through a search in textbooks and published articles included in the Medline database for the years 1970-2010, and selected published cases from the last two decades. RESULTS The majority of the literature on oral self-injury is in the form of case reports. Self-injury is particularly prevalent in patients with Lesch-Nyhan syndrome, a heterogeneous group of neurological disorders, congenital insensitivity to pain with anhidrosis, and mental retardation. It is most common in males in the early years of life, and the sites most frequently involved are the lower lip and the tongue. Therapeutic approaches in these patients have included psychological and pharmacological treatment, intraoral devices, and surgical procedures. CLINICAL IMPLICATIONS Intraoral devices are the best therapeutic option for self-injury of organic origin, although this approach is not free of complications. The current lack of standardized treatment protocols for oral self-injury means that therapy must be individualized.
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Affiliation(s)
- Jacobo Limeres
- Special Needs Unit, School of Medicine and Dentistry, Santiago de Compostela University, Spain Department of Stomatology, School of Medicine and Dentistry, Santiago de Compostela University, Spain
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Jaber MA. Dental caries experience, oral health status and treatment needs of dental patients with autism. J Appl Oral Sci 2011; 19:212-7. [PMID: 21625735 PMCID: PMC4234331 DOI: 10.1590/s1678-77572011000300006] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2009] [Accepted: 02/16/2010] [Indexed: 12/24/2022] Open
Abstract
Objectives Autism is a lifelong neurodevelopmental disorder. The aims of this study were to
investigate whether children with autism have higher caries prevalence, higher
periodontal problems, or more treatment needs than children of a control group of
non-autistic patients, and to provide baseline data to enable comparison and
future planning of dental services to autistic children. Material and Methods 61 patients with autism aged 6-16 years (45 males and 16 females) attending Dubai
and Sharjah Autism Centers were selected for the study. The control group
consisted of 61 non-autistic patients chosen from relatives or friends of autistic
patients in an attempt to have matched age, sex and socioeconomic status. Each
patient received a complete oral and periodontal examination, assessment of caries
prevalence, and caries severity. Other conditions assessed were dental plaque,
gingivitis, restorations and treatment needs. Chi-square and Fisher's exact test
of significance were used to compare groups. Results The autism group had a male-tofemale ratio of 2.8:1. Compared to controls,
children with autism had significantly higher decayed, missing or filled teeth
than unaffected patients and significantly needed more restorative dental
treatment. The restorative index (RI) and Met Need Index (MNI) for the autistic
children were 0.02 and 0.3, respectively. The majority of the autistic children
either having poor 59.0% (36/61) or fair 37.8% (23/61) oral hygiene compared with
healthy control subjects. Likewise, 97.0% (59/61) of the autistic children had
gingivitis. Conclusions Children with autism exhibited a higher caries prevalence, poor oral hygiene and
extensive unmet needs for dental treatment than non-autistic healthy control
group. Thus oral health program that emphasizes prevention should be considered of
particular importance for children and young people with autism.
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Affiliation(s)
- Mohamed Abdullah Jaber
- Dental School, Ajman University of Science & Technology, Al Jurf campus, Ajman, United Arab Emirates.
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Characteristics and Dental Experiences of Autistic Children in Saudi Arabia: Cross-sectional Study. J Autism Dev Disord 2011; 41:1629-34. [DOI: 10.1007/s10803-011-1188-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Jaber MA, Sayyab M, Abu Fanas SH. Oral health status and dental needs of autistic children and young adults. ACTA ACUST UNITED AC 2010; 2:57-62. [DOI: 10.1111/j.2041-1626.2010.00030.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Case report of self-injurious behaviour (SIB) presenting as gingivitis artefacta major. Br Dent J 2009; 206:129-31. [PMID: 19218945 DOI: 10.1038/sj.bdj.2009.55] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2008] [Indexed: 11/09/2022]
Abstract
The case report described here discusses gingivitis artefacta major, an oral presentation of self-injurious behaviour, in an adolescent. On presentation, the patient knew well the ramifications of her gum scratching behaviour, however, was unable to stop. At further presentations new lesions had appeared with further bone loss. The cause of her behaviour seemed to be of psychological origin and therefore no interventive dental treatment was possible until this issue was resolved. A more preventive approach was adopted in the meantime. Referral to appropriate services from the dental profession also proved to be challenging. In conclusion, gingivitis artefacta, although rarely seen to this extent, is extremely challenging to diagnose and treat fully in a dental setting.
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Compilato D, Cirillo N, Termine N, Kerr AR, Paderni C, Ciavarella D, Campisi G. Long-standing oral ulcers: proposal for a new `S-C-D classification system’. J Oral Pathol Med 2008; 38:241-53. [PMID: 19141062 DOI: 10.1111/j.1600-0714.2008.00722.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Friedlander AH, Yagiela JA, Paterno VI, Mahler ME. The neuropathology, medical management and dental implications of autism. J Am Dent Assoc 2006; 137:1517-27. [PMID: 17082277 DOI: 10.14219/jada.archive.2006.0086] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND A paucity of information exists in the dental literature about autism and its dental implications. TYPES OF STUDIES REVIEWED The authors conducted a MEDLINE search for the period 2000 through 2006, using the term "autism," with the aim of defining the condition's clinical manifestations, dental and medical treatment and dental implications. RESULTS Autism is a severe developmental brain disorder that appears in infancy, persists throughout life, and is characterized by impaired social interaction, abnormalities in communication (both verbal and nonverbal) and restricted interests. Often accompanying the disorder are behavioral disturbances - such as self-mutilation, aggression, psychiatric symptoms and seizures - that necessitate the administration of multiple medications to help the affected person participate effectively in the educational and rehabilitative process. CLINICAL IMPLICATIONS Dentists caring for people with autism must be familiar with the manifestations of the disease and its associated features so that they can garner the maximum level of patient cooperation. They also must be familiar with the medications used to treat the associated features of the disorder because many of them cause untoward orofacial and systemic reactions and may precipitate adverse interactions with dental therapeutic agents.
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Affiliation(s)
- Arthur H Friedlander
- VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA 90073, USA.
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Abstract
Children with cerebral palsy are at greater risk of a whole range of oral conditions than their peers. These include bruxism (tooth grinding), oral skill dysfunction, gross malocclusion due to effects of the abnormal orofacial muscle tone on tooth eruption, drooling of saliva, and poor oral hygiene. A challenging case of a painful buccal lesion in a 2 year old girl with cerebral palsy (CP) that did not respond to antifungal, antiviral or antibiotic treatment is presented as a factitious lesion. The recognition and significance of self-injurious behaviour and factitious lesions in children are discussed.
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Affiliation(s)
- D Harris
- Department of Paediatric Emergency Medicine, St Mary's Hospital, London, UK.
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Abstract
Self-injurious behaviour (SIB) is deliberate harm to the body without suicidal intent, and the condition occurs in a number of psychiatric, behavioural and developmental disorders. This case report describes a 4-year-old female with SIB who presented to a paediatric dentist after the self-extraction of teeth as a result of oral motor tics. The girl repetitively ground her teeth in a monophasic lateral motion that resulted in luxation of her maxillary right primary canine, and produced generalized oral and facial pain. The parents consulted the dentist about their child's complaint of toothache. The oral findings were unexcephonable except for a mobile primary canine, but there was a history of unusual behaviour including hyperactivity, and after multidisciplinary consultation and exclusion of other systemic diseases, the subject was diagnosed as suffering from Tourette syndrome (TS). Preventive treatment using a dental splint was provided. Noncontingent reinforcement therapy was successfully used to diminish the subject's SIB.
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Affiliation(s)
- E Leksell
- Department of Paediatric Dentistry, Public Health Service, Eastman Dental Institute, Stockholm, Sweden.
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40
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Abstract
Oral and peri-oral structures can be traumatized by self-injurious behavior (SIB). Various articles have described prostheses used to prevent SIB-related injuries to the oral tissues of patients who have developmental or medical problems, such as psychological problems, congenital syndromes or mental retardation; however, reports of oral SIB in individuals unaffected by the above conditions are scarce. This case report describes the use of a removable prosthesis to prevent a stress-induced cheek biting habit in 15-year-old girl who did not have any of the commonly related conditions. The report discusses the importance of designing a prosthesis that protects tissues, while considering injury severity and the patient's healthas well as her ability to cooperate with treatment.
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Affiliation(s)
- Martin Romero
- Integral Pediatric Dentistry, Dental Clinic, University of Murcia, Spain
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41
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Ross-Russell M, Sloan P. Autoextraction in a child with autistic spectrum disorder. Br Dent J 2005; 198:473-4. [PMID: 15849575 DOI: 10.1038/sj.bdj.4812250] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2003] [Accepted: 05/10/2004] [Indexed: 11/09/2022]
Abstract
Many children with mild/moderate autistic spectrum disorder (ASD) receive care in general dental practice. We report a seven year old boy with ASD presenting with dental pain who auto-extracted one of his deciduous canines. Children with ASD may have hyposensitivity to pain and can exhibit unusual forms of self-injurious behaviour.
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Affiliation(s)
- M Ross-Russell
- Community Dental Department, Princess of Wales Hospital, Lynn Road, Ely.
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