Introduction
Improving oral health for autistic children can sometimes challenge families and dental professionals. Autistic children have some kind of behavioural impairment which can lead to difficulties in dental care. Due to problematic behaviours, unusual oral habits, medications, and dietary preferences, this population appears to be at risk for developing oral diseases.
Common Oral Problems in Autism
Poor oral health hygiene
They tend to have large amounts of food debris around their teeth and pronounced plaque accumulation.Because they lack manual skills of brushing and flossing their teeth, resulting in inadequate oral hygiene.
Higher decayed, missing or filled teeth
Tooth decay is the breakdown of teeth due to acids produced by bacteria. A study showed that autistic children have lower salivary pH and buffering capacity, and this acid may be caused by the oral bacteria when they break down sugar.
Higher malocclusion rate
Malocclusion means the teeth are not aligned properly. Atypical oral habits and food preferences may contribute to this.
Gingivitis
A study provides a possible explanation of the presence of generalised gingivitis might be the side effects of medications used to control the manifestations of autism.
Damaging oral habits
Autistic children tend to have some detrimental oral habits such as bruxism, tongue thrusting, picking at the gingiva, and lip biting.
Self-injurious behaviour
The rate of dental injuries is higher among ASD children, and the most common dental injury is enamel fracture. Autistic children are prone to agitation and emotional dysregulation, which makes them prone to self-injurious behaviour.
Practical Strategies for Oral Care
Increased oral health promotion
For parents and caregivers both at primary school age and at the preschool stage to enable them to implement adequate preventive regimes for their children. Dental health education should include information/ guidance on reducing the frequency of sugary foods and drinks in the diet, good oral hygiene, use of fluoride toothpaste, and early attendance at the dentist or dental nurse for advice and care.
Improving access to dental care
Encouraging uptake of dental services should also form part of any health promotion strategy for autistic children. Government should address the problem of shortage and maldistribution of dentists and low economic status which may contribute to the difficulty of accessing dental services.
Use of Sedatives in the dental environment
In pediatric dentistry, when the behaviour of patients is difficult to manage, dental treatment is performed under sedation. During the preparatory steps, children with ASD sometimes refuse to wear inhalation masks, take pills, or receive intramuscular and intravenous injections due to fear. Some dentists will use sedation via the submucosal route to enable autistic children to undergo dental treatment.
Positive reinforcement such as verbal praising and token rewards
It’s a way to help autistic children to learn and maintain new, meaningful behavioural changes. For example, to encourage children to brush their teeth correctly, parents should identify children’s existing skill levels and the main areas of improvement to work on. And then use reinforcers like a specific toy or game after children do it in the right way.
Conclusion
Most children hate going for dental treatment. Children with ASD are exposed to similar challenges but may experience them differently and more profoundly. Examining the occurrence of dental problems in children with ASD may be an effective way to support public health policies for preventing and controlling their oral health problems.
References:
- https://www.nidcr.nih.gov/sites/default/files/2017-09/practical-oral-care-autism.pdf
- https://www.nature.com/articles/s41415-021-3376-2
- https://www.autismspeaks.org/tool-kit/dentist-for-kids-with-autism
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- https://hiddentalentsaba.com/positive-reinforcement-autism/