Department of Pedodontics and Preventive Dentistry, University College of Medical Sciences, Guru Teg Bahadur Hospital, University of Delhi, Delhi, India.
Spec Care Dentist. 2023 Nov-Dec;43(6):856-868. doi: 10.1111/scd.12867. Epub 2023 Apr 20.
Autism spectrum disorder is a neurodevelopmental condition which has posed a challenge to carers, pediatricians and dentists through the years. Over the last four decades, the disorder has been better understood and management techniques have evolved. In the field of dentistry, the autistic child presents difficulty in management, even for the simplest dental procedures. A comprehensive understanding of other psychoeducational and behavioral approaches to manage autism is very important. This article aims to introduce various important key techniques such as Applied Behavior Analysis, TEACCH, Sensory Adapted Dental Environment, Picture Exchange Communication System, and Animal Assisted Therapy and analyze their application in dentistry.
A search of literature was carried out in Clinicaltrials.gov, Medline and Scopus with the search terms "Applied Behavior Analysis," "TEACCH," "Sensory Adapted Dental Environment," "Picture Exchange Communication System," and "Animal Assisted Therapy" along with "autism OR autistic," "dental OR dentistry OR oral health." After the screening for inclusion and exclusion criteria, 10 eligible articles were included, in English, published within the last 10 years.
Limited research was available regarding these lesser-known behavioral approaches in dentistry. The few that were available showed encouraging results. The different techniques proved useful in increasing acceptance of dental treatment and reducing behavioral disturbances. The patients experienced reduced dental anxiety, lesser discomfort, improved communication, and knowledge.
Pediatric and special care dentists are likely to benefit by incorporating the recommended comprehensive behavior management techniques in their practice. There is evidence that these techniques will reduce behavioral disturbances in autistic children thereby making primary dental care possible without the need for sedation or general anesthesia.
自闭症谱系障碍是一种神经发育障碍，多年来一直给护理人员、儿科医生和牙医带来挑战。在过去的四十年中，人们对这种疾病有了更好的理解，管理技术也在不断发展。在牙科领域，自闭症儿童的管理非常困难，即使是最简单的牙科手术也是如此。全面了解其他管理自闭症的心理教育和行为方法非常重要。本文旨在介绍各种重要的关键技术，如应用行为分析、TEACCH、感官适应的牙科环境、图片交换沟通系统和动物辅助治疗，并分析它们在牙科中的应用。
在 Clinicaltrials.gov、Medline 和 Scopus 中使用“应用行为分析”、“TEACCH”、“感官适应的牙科环境”、“图片交换沟通系统”和“动物辅助治疗”以及“自闭症或自闭症”、“牙科或口腔健康”等搜索词进行文献搜索。经过纳入和排除标准的筛选，纳入了 10 篇符合条件的英文文献，这些文献在过去 10 年内发表。
关于这些在牙科领域不太知名的行为方法的研究有限。现有的少数研究结果令人鼓舞。这些不同的技术在增加对牙科治疗的接受程度和减少行为障碍方面证明是有用的。患者经历了减少的牙科焦虑、较少的不适、改善的沟通和知识。
儿科和特殊护理牙医可能会受益于在实践中纳入推荐的综合行为管理技术。有证据表明，这些技术将减少自闭症儿童的行为障碍，从而使他们能够在不需要镇静或全身麻醉的情况下进行初级牙科护理。
