Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia (The National University of Malaysia), Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
Department of Craniofacial Diagnostics and Biosciences, Faculty of Dentistry, Universiti Kebangsaan Malaysia (The National University of Malaysia), Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
BMC Oral Health. 2022 May 6;22(1):162. doi: 10.1186/s12903-022-02200-7.
A rise in the reported numbers of children with Autism Spectrum Disorder (ASD) highlights the need for dental practitioners to be more familiar with the treatment approaches for these special needs children to ensure comfortable, well-accepted and efficient management while in dental office.
This paper aimed to acquire a deeper understanding of some of the innovative and best approaches to managing children with ASD in dental settings.
A systematic literature search was performed in PubMed, Scopus, Web of Science, Cochrane databases, and grey literature based on the PRISMA 2020 statement, using main keywords such as: 'management', 'dental', 'children', and 'Autism Spectrum Disorder'. Original full-text papers including randomised controlled trials (RCT) and all other designs of non-randomised controlled studies (NRS) reporting relevant intervention studies in English were included without any publication time limit. The quality of the evidence found eligible for the review were then assessed using the ROB-2 and ROBINS-I tools. Subsequently, the details of management interventions and impact of treatment approaches were compared and discussed.
Out of the 204 articles found, 109 unrelated articles were excluded during the initial screening. The full papers of remaining 28 were retrieved and only 15 (7%) articles were eligible to be reviewed; eight RCTs with 'some concerns' and 'high risk' categories particularly concerning their randomisation design, and seven NSRs with 'serious' to 'critical' bias largely due to confounding factors.
Our review found inconclusive evidence on the strength of recent psychological and non-pharmacological approaches used to manage children with ASD in dental settings. Small sample size and lack of a control group in certain studies affected the strength of evidence and credibility of the findings. Nevertheless, this review shared informative details on some innovative approaches for better understanding of the management of children with ASD for dental professionals.
自闭症谱系障碍（ASD）患儿数量的报告增加，凸显出牙科医生需要更加熟悉这些特殊需求儿童的治疗方法，以确保在牙科诊室中进行舒适、被广泛接受且高效的管理。
本文旨在深入了解一些在牙科环境中管理 ASD 儿童的创新和最佳方法。
根据 PRISMA 2020 声明，在 PubMed、Scopus、Web of Science、Cochrane 数据库和灰色文献中进行了系统性文献检索，使用主要关键词如“管理”、“牙科”、“儿童”和“自闭症谱系障碍”。纳入的原始全文论文包括随机对照试验（RCT）和所有其他非随机对照研究（NRS）的设计，这些研究报告了英语相关干预研究。无任何出版时间限制。然后使用 ROB-2 和 ROBINS-I 工具评估符合审查条件的证据质量。随后，比较和讨论了管理干预措施的细节和治疗方法的影响。
在 204 篇文章中，有 109 篇在最初筛选时被排除。保留的 28 篇全文论文被检索，只有 15 篇（7%）文章符合审查条件；8 项 RCT 被评为“存在一些关注”和“高风险”类别，特别是关于它们的随机设计，7 项 NRS 被评为“严重”至“关键”偏倚，主要是由于混杂因素。
我们的综述发现，关于最近在牙科环境中用于管理 ASD 儿童的心理和非药物方法的强度的证据尚无定论。某些研究中样本量小且缺乏对照组，影响了证据的强度和发现的可信度。然而，本综述分享了一些创新方法的详细信息，以帮助牙科专业人员更好地理解 ASD 儿童的管理。
