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Tang SJ, Wei HL, Li CY, Huang MN. Management strategies of dental anxiety and uncooperative behaviors in children with Autism spectrum disorder. BMC Pediatr 2023; 23:612. [PMID: 38049774 PMCID: PMC10694959 DOI: 10.1186/s12887-023-04439-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 11/21/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Children with Autism spectrum disorder (ASD) was frequently experienced dental anxiety and uncooperative behaviors during dental treatment. Oral health care was necessary because of the poor oral hygiene and prevalent dental diseases in this population. AIM In this systematic review, we evaluated the effectiveness and feasibility for pediatric dentist to manage the dental anxiety in children with ASD. DESIGN PubMed, Embase, and Cochrane Library were systematically performed on the literature search. The date of eligible publications was from inception to January 2023. After that, the quality of eligible studies was assessed by the Newcastle Ottawa Scale (NOS). Review findings were summarized using the PRISMA Statement for reporting. RESULTS A total of six studies were systematically evaluated according to the inclusion and exclusion criteria. Five studies were conducted to evaluate ASD Children's anxiety and uncooperative performance in the progressive oral examination, oral disease prophylaxis and fluoride application. The other one study evaluated the success rate of treatment in decayed permanent tooth treatment. In the included studies, four studies indicated that it was extremely necessary to reduce dental anxiety of ASD children to increase the cooperation in sensory-adapted dental environment (SADE). CONCLUSION It is not always effective and feasible for pediatric dentist to manage the dental anxiety in children with autism during routine oral examination. Meanwhile, it is necessary for ASD children to conduct preoperative psychological assessment, to investigate parents' expectations and cooperation, and to determine whether to start corresponding dental treatment.
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Affiliation(s)
- Shi-Jun Tang
- Department of Pediatric Dentistry, Stomatological Hospital of Guizhou Medical University, Guiyang, China
| | - Hong-Lin Wei
- Department of Pediatric Dentistry, Stomatological Hospital of Guizhou Medical University, Guiyang, China
| | - Cai-Yu Li
- Department of Pediatric Dentistry, Stomatological Hospital of Guizhou Medical University, Guiyang, China
| | - Ming-Na Huang
- Department of Pediatric Dentistry, Stomatological Hospital of Guizhou Medical University, Guiyang, China.
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Reis D, Fricke O, Schulte AG, Schmidt P. Is examining children and adolescents with autism spectrum disorders a challenge?-Measurement of Stress Appraisal (SAM) in German dentists with key expertise in paediatric dentistry. PLoS One 2022; 17:e0271406. [PMID: 35921352 PMCID: PMC9348685 DOI: 10.1371/journal.pone.0271406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 06/29/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES This questionnaire-based validation study investigated if the dental examination of children and adolescents with autism spectrum disorder is viewed by dentists with key expertise in paediatric dentistry as a challenge or a threat in terms of transactional stress theory. The Stress Appraisal Measure (SAM) was used for this purpose and it's feasibility and validity was examined as a first part of a multi-stage process for validation in dentistry with a sample of German dentists. It has hardly been investigated how the treatment of children and adolescents with a disorder from the autism spectrum is perceived by dentists. METHODS An online-based survey (39 questions) plus the SAM as an add-on as well as a preceding short story of imagination on the topic (appointment for a dental check-up in a special school) were developed. Via e-mail members of the German Society of Paediatric Dentistry (DGKiZ) received a link which enabled interested members to participate. The majority of the members of the DGKiZ have additional qualifications in the treatment of children and adolescents and further training in the area of special needs care in dentistry. The data analysis was based on the SAM and its subscales. RESULTS Out of the 1.725 members of DGKiZ 92 participants (11 male, 81 female) fully completed the questionnaire and the SAM. All in all the dentists rated their own psychological and physical stress in course of treating children and adolescents with a disorder from the autism spectrum between less and partly stressful. Although the structure of the SAM could not be fully mapped by means of a factor analysis, the different ratings "challenge" or "threat" could be comprehensibly evaluated after reading the story. The participants rated the situation from the story in general as challenging but not as threatening. Intercorrelations between the subscales of the SAM (e.g threat and centrality) of r = .56 showed that the scales are not clearly independent of one another. According to the transactional stress model, the SAM bases on, stress (perceived stressfulness) arises from appraisal processes (e.g. threat, controllable-by-self) that bring about a comparison between the requirements for the described situation and one's own possibilities in terms of a person-environment-fit. In the hierarchical regression a variance of R2 = .48 could be explained with all six subscales (appraisal processes) to predict perceived stressfulness of the SAM within a sample of dentists. CONCLUSIONS Due to the response rate the results of the SAM are not representative for all German dentists, but it offers an insight into topics of special needs dentistry in Germany that have not yet been examined. Overall, the feasibility and validity of the SAM in the context of mapping cognitive appraisal processes and stress could be confirmed. Taking into account the result that the treatment of children and adolescents with autism spectrum disorder is seen as a challenge, it is concluded that there is a need to improve the education of dental students and graduated dentists in Germany in the field of special needs dentistry.
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Affiliation(s)
- Daniela Reis
- Department of Child and Adolescent Psychiatry, Psychotherapy and Child Neurology Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany
- Faculty of Health, Child and Adolescent Psychiatry, Witten/Herdecke University, Witten, Germany
| | - Oliver Fricke
- Department of Child and Adolescent Psychiatry, Psychotherapy and Child Neurology Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany
- Faculty of Health, Child and Adolescent Psychiatry, Witten/Herdecke University, Witten, Germany
| | - Andreas G. Schulte
- Faculty of Health, Department of Special Care Dentistry, Dental School, Witten/Herdecke University, Witten, Germany
| | - Peter Schmidt
- Department of Child and Adolescent Psychiatry, Psychotherapy and Child Neurology Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany
- Faculty of Health, Child and Adolescent Psychiatry, Witten/Herdecke University, Witten, Germany
- Faculty of Health, Department of Special Care Dentistry, Dental School, Witten/Herdecke University, Witten, Germany
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Schmidt P, Reis D, Schulte AG, Fricke O. Self-Assessment of Knowledge on the Treatment of Children and Adolescents with Special Care Needs: Results of a Survey amongst German Dentists with Key Expertise in Paediatric Dentistry. J Pers Med 2022; 12:jpm12071173. [PMID: 35887670 PMCID: PMC9319936 DOI: 10.3390/jpm12071173] [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: 06/11/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 02/06/2023] Open
Abstract
Background: The treatment of children and adolescents with disabilities (CA-Dis) and psycho-emotional disorders (CA-Psy) places special demands on dentists. Aim: To explore German dentists’ (with key expertise in paediatric dentistry) perception of their competence and comfort levels in dealing with these patients, and implications for access to care. Methods: Online questionnaire surveying demographic information and self-assessment of training, knowledge, and comfort in dealing with CA-Dis and CA-Psy among 1725 members of the German Society of Paediatric Dentistry (DGKiZ). Results: Ninety-two participants (11 male, 81 female) completed the questionnaire: 17.4% (n = 16) treated CA-Dis once or more a day; CA-Psy were rarely treated on a daily basis (7.6%; n = 7). In regard to CA-Dis, 62% (n = 57) rated their level of expertise as “good” or “very good”; for CA-Psy this was 40.2% (n = 37). Overall, 76.1% (n = 70), respectively, 88.0% (n = 81) of the respondents felt they had been inadequately prepared to treat CA-Dis or CA-Psy. Although the physical burden of treating CA-Psy was rated as “not at all stressful” or only “slightly stressful” by 45.7% of the participants, 31.5% rated the psychological distress as “very stressful” or “extremely stressful”. The better their self-assessed expertise in treating CA-Dis was, the lower their own psychological distress was rated (r = −0.34). Training on this topic seems to have an impact on the perceived burden of treating such patients. Conclusions: A core curriculum in special care dentistry needs to be embedded in the German dental curriculum. The results permit the development of health programs for workplace health management in dentistry.
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Affiliation(s)
- Peter Schmidt
- Department of Special Care Dentistry, Witten/Herdecke University, 58455 Witten, Germany;
- Department of Child and Adolescent Psychiatry, Psychotherapy and Child Neurology, Gemeinschaftskrankenhaus Herdecke, 58313 Herdecke, Germany; (D.R.); (O.F.)
- Department of Child and Adolescent Psychiatry, Witten/Herdecke University, 58455 Witten, Germany
- Correspondence: ; Tel.: +49-2302-926-655
| | - Daniela Reis
- Department of Child and Adolescent Psychiatry, Psychotherapy and Child Neurology, Gemeinschaftskrankenhaus Herdecke, 58313 Herdecke, Germany; (D.R.); (O.F.)
- Department of Child and Adolescent Psychiatry, Witten/Herdecke University, 58455 Witten, Germany
| | - Andreas G. Schulte
- Department of Special Care Dentistry, Witten/Herdecke University, 58455 Witten, Germany;
| | - Oliver Fricke
- Department of Child and Adolescent Psychiatry, Psychotherapy and Child Neurology, Gemeinschaftskrankenhaus Herdecke, 58313 Herdecke, Germany; (D.R.); (O.F.)
- Department of Child and Adolescent Psychiatry, Witten/Herdecke University, 58455 Witten, Germany
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Barbosa MA, Lotito MCF, Masterson D, Pastura G, de Souza IP, Tavares-Silva CM, Castro GFBDA. Autistic spectrum disorder children and adolescents' oral health characteristics - scoping review. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 70:329-342. [PMID: 38699508 PMCID: PMC11062281 DOI: 10.1080/20473869.2022.2092936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/14/2022] [Indexed: 05/05/2024]
Abstract
This study aimed to conduct a scoping review to know children and adolescents' main oral health concerns with Autism Spectrum Disorder (ASD) and thus identify any oral characteristic that stands out, aiming at preventive and interceptive clinical conduct. A search was performed in the three electronic databases and the gray literature; in September 2021. A total of 562 studies were identified, and after applying the eligibility criteria, 73 articles were included in the synthesis of this scoping review. The mean decayed, lost, and restored teeth index (DMFT/dfmt) ranged from 0 to 12.37; the mean DMFT index (permanent dentition) from 0.06 to 6.2; and the average dmft index (deciduous dentition) ranged from 0.29 to 9.91. The mean simplified oral hygiene index (OHIS) ranged from 0 to 3.4; gingival index (GI) from 0.29 to 2; and plaque index (PI) from 0.005 to 3.15. Plaque prevalence was 25.9% to 90%; dental calculus from 4.7% to 59.41%; gingivitis from 36.7% to 100%. Bruxism was 10.3% to 73%, and dental trauma was 4.7% to 100%. This disparity in the results shows the heterogeneity of this population, with different degrees of socio-behavioral impairment, which can directly influence oral hygiene and the consequent accumulation of biofilm.
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Affiliation(s)
- Mainara Alves Barbosa
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Do Rio De Janeiro, Rio De Janeiro, RJ, Brazil
| | - Michelle Coelho Ferreira Lotito
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Do Rio De Janeiro, Rio De Janeiro, RJ, Brazil
| | - Daniele Masterson
- Central Library of the Health Science Center, Universidade Federal Do Rio De Janeiro, Rio De Janeiro, RJ, Brazil
| | - Giuseppe Pastura
- Department of Pediatrics, Faculty of Medicine, Universidade Federal Do Rio De Janeiro, Rio De Janeiro, RJ, Brazil
| | - Ivete Pomarico de Souza
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Do Rio De Janeiro, Rio De Janeiro, RJ, Brazil
| | - Claudia Maria Tavares-Silva
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal Do Rio De Janeiro, Rio De Janeiro, RJ, Brazil
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Erwin J, Paisi M, Neill S, Burns L, Vassallo I, Nelder A, Facenfield J, Devalia U, Vassallo T, Witton R. Factors influencing oral health behaviours, access and delivery of dental care for autistic children and adolescents: A mixed-methods systematic review. Health Expect 2022; 25:1269-1318. [PMID: 35716111 PMCID: PMC9327820 DOI: 10.1111/hex.13544] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/25/2022] [Accepted: 05/17/2022] [Indexed: 12/05/2022] Open
Abstract
Background Autistic children and young people (CYP) experience oral health (OH) inequalities. They are at high risk of dental disease and show significant levels of unmet need in relation to OH and access to dental care. Aim This study aimed to gather evidence on the factors that influence OH behaviours, access to and delivery of dental care for autistic CYP. Design This was a mixed‐methods narrative systematic review. Data Sources Embase, Web of Science, Dentistry & Oral Sciences Source, MEDLINE, Psychinfo, Scopus, CINAHL, SocINDEX and grey literature were the data sources for this study. Review Methods A systematic search was conducted for qualitative, quantitative and mixed‐methods research studies from countries with a High Development Index that related to OH behaviours, access to and delivery of dental care for autistic CYP. Results were analysed using narrative synthesis. Results From 59 eligible studies, 9 themes were generated: (1) affordability and accessibility; (2) autism‐related factors and cognitive or motor skill differences; (3) the dental environment; (4) managing CYP's behaviour; (5) responding and adapting to the needs of the autistic CYP and their parent/carer; (6) attitude of dental health professionals (DHPs) towards autistic CYP and their parents/carers; (7) knowledge of how to care for and support CYP's OH; (8) empowerment of parents/carers and collaboration with DHPs; and (9) communication and building rapport. Conclusion The adoption of healthy OH behaviours and access to dental care by autistic CYP is impacted by a range of factors including those intrinsically related to a diagnosis of autism, for example, communication and those often associated with autism, for example, sensory sensitivities. Access to better OH and dental care can be facilitated by responding to the individual needs of autistic CYP through accommodation, education and adaptation. This necessitates greater awareness and knowledge of autism amongst DHPs and the provision of appropriate services. More methodologically robust intervention studies are needed to identify effective ways to support autistic CYP in achieving good OH and access to dental care. Patient and Public Contribution The review protocol was developed with members of the project patient and public involvement group who provided the autistic voice, contributing to the interpretation of the review findings and writing of the manuscript.
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Affiliation(s)
- Jo Erwin
- Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Martha Paisi
- Peninsula Dental School, University of Plymouth, Plymouth, UK.,School of Nursing and Midwifery, University of Plymouth, Plymouth, UK.,Peninsula Dental Social Enterprise, Plymouth, UK
| | - Sarah Neill
- School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
| | - Lorna Burns
- Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Isaac Vassallo
- School of Engineering, Computing and Mathematics, University of Plymouth, Plymouth, UK
| | | | | | - Urshla Devalia
- Royal National ENT and Eastman Dental Hospital, University College London Hospitals NHS Foundation Trust, London, UK
| | - Tara Vassallo
- Plymouth Institute of Education, University of Plymouth, Plymouth, UK.,National Autistic Society-Plymouth & District Branch, Plymouth, UK
| | - Robert Witton
- Peninsula Dental School, University of Plymouth, Plymouth, UK.,Peninsula Dental Social Enterprise, Plymouth, UK
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AlHumaid J. Dental experiences related to oral care of children with autism spectrum disorders in Saudi Arabia: A literature review. Saudi Dent J 2022; 34:1-10. [PMID: 35068893 PMCID: PMC8767258 DOI: 10.1016/j.sdentj.2021.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 11/30/2022] Open
Abstract
The burden of autism spectrum disorder (ASD) in Saudi Arabia remains unclear with a dearth of literature, which focus on risk factors, prevalence, or interventions. This study is a review of the published literature related to dental experiences of children with ASD in Saudi Arabia. Twenty-two studies were included in this review, based on the predefined inclusion criteria which examined dental disease prevalence in children with ASD, identified the risk factors and the potential barriers to oral care. Results uncovered a lack of systematically published studies from Saudi Arabia which might have led to the limited development of effective oral health policies in the Kingdom. Identification of research gaps and potential intervention policies are needed to improve the oral health and quality of life of children with ASD in Saudi Arabia.
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What Happens at a Dental Surgery When the Patient is a Child with Autism Spectrum Disorder? An Italian Study. J Autism Dev Disord 2021; 51:1939-1952. [PMID: 32880788 PMCID: PMC8124035 DOI: 10.1007/s10803-020-04684-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Oral health care can be a difficult experience for a child with Autism Spectrum Disorder (ASD), for their family and for the dentist. The purpose of this study is to provide an understanding of the challenges experienced by the three aforementioned figures during oral care treatment. A cohort of 275 parents of typical development children (TD), 57 parents of children with ASD (3–15 years old) and by 61 dentists, completed two different multiple choices questionnaires. The data obtained show a great difficulty in the treatment of children with ASD as seen by the dentists and by the parents. This is due to: caregivers’ demographic issues; difficulties encountered before and during the dental examination; scarce presence of experts in ASD treatment.
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Como DH, Stein Duker LI, Polido JC, Cermak SA. Oral Health and Autism Spectrum Disorders: A Unique Collaboration between Dentistry and Occupational Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E135. [PMID: 33375475 PMCID: PMC7795681 DOI: 10.3390/ijerph18010135] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/17/2020] [Accepted: 12/23/2020] [Indexed: 12/16/2022]
Abstract
Children with autism spectrum disorders (ASD) are at risk for oral health disparities. With the dramatic rise in ASD prevalence to 1 in 54 children, it is likely that an increasing number of dental practitioners will encounter or be asked to treat children with ASD. This paper reviews explanations related to the increasing prevalence of ASD, provides reasons why children with ASD are at increased risk for poor oral health, and discusses unique interprofessional collaborations between dental practitioners and occupational therapists. Occupational therapists and dentists can work together to plan modifications to the dental environment or adapt dental protocols to reduce some of the barriers encountered by those with ASD, provide desensitization strategies before the clinic visit, or help a child with emotional regulation during clinical treatments.
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Affiliation(s)
- Dominique H. Como
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (L.I.S.D.); (S.A.C.)
| | - Leah I. Stein Duker
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (L.I.S.D.); (S.A.C.)
| | - José C. Polido
- Children’s Hospital Los Angeles and Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA;
| | - Sharon A. Cermak
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (L.I.S.D.); (S.A.C.)
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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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Oral Health of Children with Autism: The Influence of Parental Attitudes and Willingness in Providing Care. ScientificWorldJournal 2020; 2020:8329426. [PMID: 33082718 PMCID: PMC7558776 DOI: 10.1155/2020/8329426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/05/2020] [Accepted: 09/20/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives Parents play a crucial role in health-related practices of children with autism spectrum disorder (ASD). This study assessed the association between oral health status and oral health practices of children with ASD in relation to their parental attitudes and comfort in providing oral care. Methods This cross-sectional study included 75 children with ASD attending the special needs schools in Eastern Saudi Arabia from 2015-2018. Parents responded to a self-administered questionnaire assessing their attitudes toward oral health and comfort in providing oral care for children. The clinical examination assessed dental caries (decayed, extracted, and filled: (DMF and def)), gingival disease, and plaque accumulation. The Pearson correlation coefficient was used to assess the relationship between the study variables, while ANOVA followed by post hoc was used to assess the differences. Results Prevalence of dental caries in primary teeth was 76% and 68% in the permanent dentition with a mean of 0.85 ± 1.9 and 1.03 ± 2.9, respectively. Thirty-one participants had gingival problems, mean gingival index was 1.03 ± 0.88, and mean plaque index was 0.95 ± 0.43. Half of the parents supervised their children's brushing, which was significantly associated with plaque accumulation (p = 0.004), gingival disease (p < 0.0001), and def (p = 0.02). Parental attitudes and comfort in providing oral health care were not associated with oral health status of ASD children; however, positive parental attitudes were associated with lower sugar consumption (p = 0.043). An inverse correlation was observed between comfort in providing oral health care with gingival and plaque scores r = -0.18 and -0.23, respectively. Conclusions The data are indicative of poor oral health practices and status among ASD children. Parents' oral health care practices seem to be reactive rather than proactive. Positive parental attitudes were associated with lower sugar consumption. Greater comfort in providing care was negatively correlated with plaque accumulation and gingival problems.
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Morris R, Greenblatt A, Saini M. Healthcare Providers’ Experiences with Autism: A Scoping Review. J Autism Dev Disord 2019; 49:2374-2388. [DOI: 10.1007/s10803-019-03912-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Thomas N, Blake S, Morris C, Moles DR. Autism and primary care dentistry: parents' experiences of taking children with autism or working diagnosis of autism for dental examinations. Int J Paediatr Dent 2018; 28:226-238. [PMID: 29073339 DOI: 10.1111/ipd.12345] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Accessing and receiving preventative dental treatment can be difficult for children with autism due to sensory processing disorders and/or challenging behaviours coupled with a reported reluctance by dentists to treat these children. AIM To gather dental experiences of UK parents of children with autism or working diagnosis of autism and explore how they feel primary care dental services can be improved. DESIGN A total of 17 parents of children with a diagnosis or working diagnosis of autism took part in semi-structured interviews. Data were analysed thematically. RESULTS Key themes identified were flexibility of the dental team and environment, confidence of the parents to advocate for their children's needs, continuity of services and clear referral pathways to specialist services. Cross-cutting all themes was the value of clear communication. The experiences provide greater understanding of issues such as hyper-empathy, the dental chair, challenges of the waiting room, perceived medical authority, and the importance of continuation of care. CONCLUSION In line with previous research about the importance of family-centred care, a strong relationship between parents and the whole dental team is essential for children with autism to access dental examinations and have satisfactory experience of care.
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Affiliation(s)
- Nicole Thomas
- Plymouth University Peninsula School of Dentistry, Plymouth, UK.,Peninsula Cerebra Research Unit (PenCRU), University of Exeter Medical School, Exeter, UK
| | - Sharon Blake
- Peninsula Cerebra Research Unit (PenCRU), University of Exeter Medical School, Exeter, UK
| | - Christopher Morris
- Peninsula Cerebra Research Unit (PenCRU), University of Exeter Medical School, Exeter, UK
| | - David R Moles
- Plymouth University Peninsula School of Dentistry, Plymouth, UK
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Williamson HJ, Contreras GM, Rodriguez ES, Smith JM, Perkins EA. Health Care Access for Adults With Intellectual and Developmental Disabilities: A Scoping Review. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2017; 37:227-236. [PMID: 28703641 DOI: 10.1177/1539449217714148] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Adults with intellectual and/or developmental disabilities (IDD) often experience health disparities. To address disparities, Healthy People 2020 includes specific disability and health goals focused on improving health care access. The study's purpose was to review the literature exploring health care access for adults with IDD to identify opportunities for occupational therapy research and practice. A scoping review was completed of articles discussing health care access among adults with IDD in the United States. Thirty-seven articles met the inclusion criteria. Results are framed using the ecology of human performance theory identifying person and environmental issues affecting health care access of adults with IDD. Opportunities exist for occupational therapy to improve participation and health of adults with IDD through engaging in research and practice efforts addressing health care access. Occupational therapy could develop interventions to establish skills and abilities and recommend changes to the health care environment.
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Tong HJ, Lee HY, Lee YT, Low Y, Lim CR, Nair R. Factors influencing the inclusion of oral health education in individualized education plans of children with autism spectrum disorders in Singapore. Int J Paediatr Dent 2017; 27:255-263. [PMID: 27478971 DOI: 10.1111/ipd.12257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Prevention of oral diseases in children with autism spectrum disorder (ASD) is possible via incorporation of oral health education (OHE) into individualized education plans. OBJECTIVES To assess (i) whether training can improve teachers' oral heath knowledge, (ii) whether OHE is taught to children with ASD, and (iii) factors associated with teachers' perceived barriers to the implementation of OHE. DESIGN Teachers working in special schools were recruited. Two pre-tested questionnaires were administered, before and after a training session. The effectiveness of the intervention was evaluated. Teachers were also surveyed on their teaching of caries prevention and perceived barriers of teaching OHE. RESULTS There was a significant increase in knowledge scores post-intervention (P < 0.001). Teachers were more likely to incorporate OHE into their teaching if trained by dental professionals (P = 0.022) and provided teaching materials (P = 0.001). Teachers' level of baseline OHE knowledge was a predictor and significantly negatively associated with levels of perceived overall and personal barriers (both P < 0.001). CONCLUSION OHE is included in the curriculum of the schools surveyed, but this is very limited. The training programme increased teachers' oral health knowledge competence scores. Levels of knowledge, lack of training, and teaching materials are barriers to incorporating OHE in their teaching curriculum.
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Affiliation(s)
- Huei Jinn Tong
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Hei Yi Lee
- Ministry of Health Holdings, Singapore, Singapore
| | | | - Yuxuan Low
- Ministry of Health Holdings, Singapore, Singapore
| | | | - Rahul Nair
- ARCPOH, School of Dentistry, University of Adelaide, Adelaide, SA, Australia
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15
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Duker LIS, Henwood BF, Bluthenthal RN, Juhlin E, Polido JC, Cermak SA. Parents' perceptions of dental care challenges in male children with autism spectrum disorder: An initial qualitative exploration. RESEARCH IN AUTISM SPECTRUM DISORDERS 2017; 39:63-72. [PMID: 29098015 PMCID: PMC5662021 DOI: 10.1016/j.rasd.2017.03.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Many children with autism spectrum disorders (ASD) experience barriers to oral care in the dental office setting. The purpose of this study was to provide an increased understanding of these challenges experienced during oral care in the dental office by children with ASD. METHOD This study was part of a larger mixed methods design and builds on quantitative results from a survey of parents of children with ASD ages 2-18 in which parents reported difficulties with access to care, sensory processing, and uncooperative behaviors. For this study, we conducted two, three hour, focus groups of parents of male children with ASD age 5-18 years in order to explore the survey results in greater depth. Focus group transcripts were analyzed using a template coding approach based on the three domains of office-based oral care challenges identified in the first phase (survey). RESULTS Several related themes emerged including: (1) Access: "Difficult to find the right dentist", (2) Sensory sensitivities: "All the sensory devices just make him so uncomfortable", (3) Restraint: "It looked like they were torturing him", and (4) Drugs: "A mixed bag". CONCLUSIONS The qualitative findings from this study both confirmed our previous survey findings and expanded upon them. These findings can help professionals better understand the challenges experienced by children with ASD and their parents as well as help identify priorities for planning efforts to address the oral health-related needs of this population.
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Affiliation(s)
- Leah I Stein Duker
- University of Southern California, Division of Occupational Science and Occupational Therapy at the Herman Ostrow School of Dentistry, 1540 Alcazar St, CHP 133, Los Angeles, CA 90089, United States
| | - Benjamin F Henwood
- University of Southern California, School of Social Work, 1150 S. Olive St, 1429, Los Angeles, CA 90015-2211, United States
| | - Ricky N Bluthenthal
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, 2001 N. Soto St, MC 9239, Los Angeles, CA 90032-3638, United States
| | - Emma Juhlin
- University of Southern California, Division of Occupational Science and Occupational Therapy at the Herman Ostrow School of Dentistry, 1540 Alcazar St, CHP 133, Los Angeles, CA 90089, United States
| | - José C Polido
- Children's Hospital Los Angeles, Division of Dentistry, 4650 Sunset Blvd, MS #116, Los Angeles, CA, 90027, United States
| | - Sharon A Cermak
- University of Southern California, Division of Occupational Science and Occupational Therapy at the Herman Ostrow School of Dentistry, 1540 Alcazar St, CHP 133, Los Angeles, CA 90089, United States
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16
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Watters AL, Stabulas-Savage J, Toppin JD, Janal MN, Robbins MR. Incorporating Experiential Learning Techniques to Improve Self-Efficacy in Clinical Special Care Dentistry Education. J Dent Educ 2015. [DOI: 10.1002/j.0022-0337.2015.79.9.tb05994.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Amber L. Watters
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine; New York University College of Dentistry, and Oral, Head, and Neck Cancer Clinic; Providence Cancer Center; Providence Portland Medical Center; Portland OR
| | - Jeanine Stabulas-Savage
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine; New York University College of Dentistry
| | - James D. Toppin
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine; New York University College of Dentistry and Director of Dental Services; Damian Family Care Centers; Queens NY
| | - Malvin N. Janal
- Department of Epidemiology and Health Promotion; New York University College of Dentistry
| | - Miriam R. Robbins
- Special Needs Clinic, Department of Oral and Maxillofacial Pathology, Radiology, and Medicine; New York University College of Dentistry
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17
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Nelson TM, Sheller B, Friedman CS, Bernier R. Educational and therapeutic behavioral approaches to providing dental care for patients with Autism Spectrum Disorder. SPECIAL CARE IN DENTISTRY 2015; 35:105-13. [PMID: 25470557 DOI: 10.1111/scd.12101] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE Autism Spectrum Disorder (ASD) is a condition which most dentists will encounter in their practices. Contemporary educational and behavioral approaches may facilitate successful dental care. METHODS A literature review was conducted for relevant information on dental care for children with ASD. RESULTS Educational principles used for children with ASD can be applied in the dental setting. Examples include: parent involvement in identifying strengths, sensitivities, and goal setting; using stories or video modeling in advance of the appointment; dividing dental treatment into sequential components; and modification of the environment to minimize sensory triggers. Patients with ASD are more capable of tolerating procedures that they are familiar with, and therefore should be exposed to new environments and stimuli in small incremental steps. CONCLUSIONS By taking time to understand children with ASD as individuals and employing principles of learning, clinicians can provide high quality dental care for the majority of patients with ASD.
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Affiliation(s)
- Travis M Nelson
- Clinical Assistant Professor, Department of Pediatric Dentistry, University of Washington, Seattle, Washington
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18
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Fakroon S, Arheiam A, Omar S. Dental caries experience and periodontal treatment needs of children with autistic spectrum disorder. Eur Arch Paediatr Dent 2014; 16:205-9. [PMID: 25385711 DOI: 10.1007/s40368-014-0156-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 09/26/2014] [Indexed: 11/29/2022]
Abstract
AIM To assess dental caries experience and periodontal treatment needs among Libyan children diagnosed with autistic spectrum disorder (ASD). MATERIALS AND METHODS A cross-sectional, comparative case-control study was used, in which dental caries experience of 50 children with ASD was compared with that of 50 controls. The children with ASD were recruited from Benghazi Centre of Children with ASD, Libya. Controls were recruited from school children and matched for age, gender and socioeconomic status. DMFT, dmft for dental caries experience and CPITN for periodontal treatment needs were calculated according to WHO criteria by a calibrated examiner. Scores for DMFT as well as CPITN indices were compared using bivariate analysis. RESULTS The data analysed for this study comprised observations from a group of children (cases = 50) diagnosed with ASD matched with healthy children (controls = 50). Consequently, each group consisted of 40 males and 10 females aged between 3 and 14 years (mean 7.29 ± 3.11). The ASD children showed significantly lower means for DMFT and dmft teeth as well as higher periodontal treatment needs (p > 0.05). CONCLUSION Children with ASD were found to be more likely caries-free and have lower DMFT scores and higher unmet periodontal treatment needs than did the unaffected control children.
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Affiliation(s)
- S Fakroon
- Department of Paediatric, Community and Preventive Dentistry, Faculty of Dentistry, Benghazi University, Benghazi, Libya
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19
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Alkahtani ZM, Stark PC, Loo CY, Wright WG, Morgan JP. Saudi and U.S. Dental Student Attitudes Toward Treating Individuals with Developmental Disabilities. J Dent Educ 2014. [DOI: 10.1002/j.0022-0337.2014.78.8.tb05785.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | | | - Cheen Y. Loo
- Department of Pediatric Dentistry; Tufts University School of Dental Medicine
| | - Wanda G. Wright
- Department of Public Health and Community Service; Tufts University School of Dental Medicine
| | - John P. Morgan
- Department of Public Health and Community Service; Tufts University School of Dental Medicine
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20
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Physiological and behavioral stress and anxiety in children with autism spectrum disorders during routine oral care. BIOMED RESEARCH INTERNATIONAL 2014; 2014:694876. [PMID: 25114916 PMCID: PMC4119730 DOI: 10.1155/2014/694876] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 06/03/2014] [Indexed: 12/28/2022]
Abstract
BACKGROUND Children with autism spectrum disorders (ASD) commonly exhibit uncooperative behaviors which impede oral care. Previous studies have utilized dentist-report measures of uncooperative behaviors in children with ASD but none have utilized an objective measure of children's behavior or a physiological measure of distress. This study investigated behavioral and physiological distress in children with ASD during routine oral care and examined factors associated with this distress. METHODS Participants were 44 children (n=22 typical, n=22 ASD) aged 6-12 receiving routine dental cleanings. Behavioral and physiological measures of stress and anxiety were collected during dental cleanings. RESULTS Children with ASD exhibited greater distress, compared to the typical group, on dentist-report and researcher-coded measures of overt distress behaviors and on physiological measures. Correlations between physiological and behavioral measures of distress were found in the ASD but not in the typical group. Behavioral distress was correlated with age in the typical group and with expressive communication ability and sensory processing difficulties in the ASD group; physiological distress was correlated with parent-report of anxiety in the typical group and sensory processing difficulties in the ASD group. CONCLUSIONS Novel strategies may be required to decrease behavioral and physiological distress in children with ASD in the dental clinic.
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21
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Treating patients with autism spectrum disorder—SCDA members' attitudes and behavior. Br Dent J 2011. [DOI: 10.1038/sj.bdj.2011.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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