Autism Spectrum Disorder

Question 1

What is autism?

Answer 1

a lifelong neurodevelopment disorder?

Question 2

What are the 3 main challenges in autism?

Answer 2

1. difficulties with communication and language
2. difficulties in forming relationships with other people
3. a limited pattern of behaviour and resistance to small change in familiar surroundings

Question 3

Why might dentistry be challenging for children with autism?

Answer 3

• sensory overload
  
  • new environment
  • new people
  • missed school
  • changed routine
• new smells
  
  • ZOE
  • perfume
• auditory
  
  • suction
  • handpieces
  • waiting room
  • fire alarm
  • music
• tactile
  
  • cold metal instruments
  • taste of toothpaste/prophy
  • drying teeth with 3:1
  • ultrasonic scaling
  • invasion of personal space

Question 4

What healthcare teams may be involved in children with autism spectrum disorder?

Answer 4

• paediatrician
• dietician
• educational psychologist
• psychiatrist
• general medical practitioner
• occupational therapist
• social worker
• health visitor
• speech and language therapist
• play therapist
• community dentist or GDP

Question 5

What are potential dental features of autism spectrum disorder

Answer 5

• non-carious tooth surface loss
  
  • erosion
  • attrition
  • chipping of teeth
  • can be related to diet and grinding
• caries
  
  • dependent on risk factors
  • diet
    
    • depending on restrictions
  • toothbrushing
  • fluoride intake
• trauma/self-injurious behaviours
  
  • gingival trauma
  • dental trauma
  • ulceration
  • trauma to lips
  • accidents more common
• xerostomia
  
  • medications
    
    • e.g. for ADHD

Question 6

What considerations and modifications may be required for seeing children with autism spectrum disorder?

Answer 6

• preparation
  
  • ‘hello’ visit
  • minimise waiting
    
    • early appointment
  • wait in car
    
    • call in when ready
  • social story
• during appointment
  
  • timers
  • ASD friendly room
    
    • radio off
    • clutter free
  • comforters
    
    • ear defenders
    • weighted blanket
    • own toothbrush/sunglasses
  • plastic mirror
  • tell, show, do
  • examine outwit dental chair
  • avoid similes/metaphors
• after, at home
  
  • 3 monthly visits
    
    • gradual slow exposure
  • keep appointments short
  • appropriate setting
    
    • PDS
    • commn=unity
  • create routine
  • picture books/story board/social story
  • dietary advice
    
    • empathic
  • non-flavoured toothpaste
  • 2 brush technique
  • prevention
    
    • fluoride exposure