Oral Pathology and Surgery Department & Orofacial Pathologies, Imaging and Biotherapies (EA2496), Faculty of Dental Surgery, Paris Descartes University, 1 rue Maurice Arnoux, 92120, Montrouge, France.
Oral Pathology and Surgery Department, Henri Mondor Hospital, 2 rue Gustave Eiffel, 94000, Créteil, France.
Clin Oral Investig. 2020 May;24(5):1677-1685. doi: 10.1007/s00784-019-03023-7. Epub 2019 Jul 22.
Autism spectrum disorder (ASD) is a lifelong heterogeneous psychiatric disorder that represents a challenge for dentists. The aim of this retrospective study was to analyse ASD patients' dental needs and to investigate key factors influencing the behavioural management.
One hundred eighteen ASD subjects (levels 2 and 3 of the DSM-5), adults and children, treated at university dental hospital, were included. For each of them, an index card was created to record general and medical information, dental care progress and treatment management. Data were analysed to characterize this specific population in terms of dental needs, technical approach and follow-up. The relationships between care approach and age (ANOVA test), care approach and concomitant pathologies as well as care approach and required treatment (chi-square test) were evaluated.
Almost all patients required oral care. No treatment could be provided under conscious conditions. Oral premedication and/or nitrous oxide/oxygen inhalation was significantly more efficient in children and allowed conservative procedures. In adults, general anaesthesia was significantly more employed. Few patients were followed up over a long period.
The variety of autism spectrum disorders complicates the statement of guidelines for dental care. The development of the collaboration between psychiatrics and dentists emerges as a key factor to improve the quality and the success of oral outpatient treatment.
Oral premedication and/or nitrous oxide/oxygen inhalation at high dose represented a good way to carry out conservative dental cares, with a significant efficiency in children. Nevertheless, in a considerable number of ASD patients, especially in adults, general anaesthesia could not be avoided.
自闭症谱系障碍（ASD）是一种终生异质性的精神障碍，对牙医来说是一个挑战。本回顾性研究旨在分析 ASD 患者的牙科需求，并研究影响行为管理的关键因素。
本研究纳入了 118 名在大学口腔医院接受治疗的 ASD 患者（DSM-5 水平 2 和 3），包括成人和儿童。为每位患者创建了一张索引卡，以记录一般和医疗信息、口腔保健进展和治疗管理。分析数据以描述该特定人群的牙科需求、技术方法和随访情况。评估了治疗方法与年龄（方差分析）、治疗方法与伴随疾病以及治疗方法与所需治疗之间的关系（卡方检验）。
几乎所有患者都需要口腔护理。在清醒状态下无法进行任何治疗。口腔预治疗和/或氧化亚氮/氧气吸入在儿童中更有效，可以进行保守治疗。在成人中，全身麻醉的应用更为广泛。只有少数患者接受了长期随访。
自闭症谱系障碍的多样性使得制定牙科护理指南变得复杂。精神病学和牙科医生之间的合作发展成为提高口腔门诊治疗质量和成功率的关键因素。
高剂量的口腔预治疗和/或氧化亚氮/氧气吸入是进行保守性牙科治疗的一种有效方法，在儿童中效果显著。然而，在相当一部分 ASD 患者中，尤其是成人，全身麻醉是不可避免的。
