Rouches A, Lefer G, Dajean-Trutaud S, Lopez-Cazaux S
Département de pédodontie, UFR odontologie, université de Nantes, 1, place Alexis-Ricordeau, 44042 Nantes cedex 1, France.
Centre de recherche en éducation de Nantes (CREN) EA, UFR lettres et langage, université de Nantes, chemin de la Censive-du-Tertre, BP 81227, 44312 Nantes cedex 3, France.
Arch Pediatr. 2018 Feb;25(2):145-149. doi: 10.1016/j.arcped.2017.11.013.
Autism spectrum disorder (ASD) is a life-long heterogeneous psychiatric disorder, characterized by impaired social interaction and communication, and the presence of repetitive and stereotyped behaviors as well as restricted interests. These features have an impact on the oral health of these individuals: high risk of dental caries, poorer periodontal status, and bruxism are often described. Children with ASD often provide limited collaboration with medical procedures, particularly those considered invasive such as dental care. Children with ASD are prone to agitation, self-injury, and emotional dysregulation; they can also present hypersensitivity to sensory input. These features make it difficult for professionals to examine and treat children with ASD; they interfere with dental care and constitute a barrier to it. Most of them are treated under general anesthesia or sedation. Therefore, children with ASD present a challenge for the dental community. Adapted and specific strategies are required to allow individuals with ASD to go beyond the barriers of dental care. Different tools and techniques of evidence-based practice can be considered: visual pedagogy, behavioral approaches, and numeric devices can be used. Pediatricians have a key role in the oral care of children with autism. The aim of this article is to present the oral health associated with ASD, to set out the possible ways to improve oral health, to enable the practitioner to detect problems, to raise awareness, and to help patients and their families in their care pathway.
自闭症谱系障碍(ASD)是一种终身性的异质性精神疾病,其特征为社交互动和沟通受损,以及存在重复刻板行为和兴趣受限。这些特征会对这些个体的口腔健康产生影响:经常被描述为患龋齿风险高、牙周状况较差以及磨牙症。患有ASD的儿童在接受医疗程序时往往配合度有限,尤其是那些被认为具有侵入性的程序,如牙科护理。患有ASD的儿童容易激动、自我伤害和情绪失调;他们还可能对感官输入表现出超敏反应。这些特征使得专业人员难以对患有ASD的儿童进行检查和治疗;它们干扰牙科护理并构成障碍。他们中的大多数是在全身麻醉或镇静下接受治疗的。因此,患有ASD的儿童对牙科界来说是一个挑战。需要采用适应性的特定策略,以使患有ASD的个体跨越牙科护理的障碍。可以考虑不同的循证实践工具和技术:可以使用视觉教学法、行为方法和数字设备。儿科医生在自闭症儿童的口腔护理中起着关键作用。本文的目的是介绍与ASD相关的口腔健康,阐述改善口腔健康的可能方法,使从业者能够发现问题,提高认识,并在护理过程中帮助患者及其家属。