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自闭症谱系障碍儿童的牙齿适应策略——随机试验的系统评价

Dental Adaptation Strategies for Children with Autism Spectrum Disorder-A Systematic Review of Randomized Trials.

作者信息

Prynda Magdalena, Pawlik Agnieszka Anna, Niemczyk Wojciech, Wiench Rafał

机构信息

Orthodontic Specialist, M-Dent Center for Esthetic Dentistry and Implantology, 34a/7 Sienkiewicza St., 50-335 Wrocław, Poland.

Specialist DentalClinic dr n.med.Agnieszka Anna Pawlik ul, Strumieńskiego 12/4, 41-400 Mysłowice, Poland.

出版信息

J Clin Med. 2024 Nov 26;13(23):7144. doi: 10.3390/jcm13237144.

DOI:10.3390/jcm13237144
PMID:39685603
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11641856/
Abstract

Children with Autism Spectrum Disorder (ASD) often struggle with dental care due to sensory sensitivities and behavioral issues, increasing their risk for oral health problems. Adaptation strategies such as visual aids, video modeling, and sensory-adapted environments aim to improve their dental experiences. A systematic review of randomized controlled trials (RCTs) was conducted according to PRISMA 2020 guidelines using the PubMed, Scopus, Embase, and Cochrane databases. Of the 1072 records screened, nine RCTs were included in the analysis. Studies included children with ASD under 18 years and compared dental adaptation techniques with traditional care. The risk of bias and study quality were assessed. The quality of evidence for the results was determined using the GRADE tool. Nine RCTs with sample sizes ranging from 25 to 138 participants showed significant improvements in oral hygiene, reduced anxiety, and increased cooperation. Video modeling and sensory-adapted environments were particularly effective in lowering distress during dental visits. Dental adaptation strategies, especially video modeling and sensory-adapted environments, effectively improve oral health outcomes and reduce anxiety in children with ASD. More research is needed to explore the long-term effects and include children with severe ASD.

摘要

患有自闭症谱系障碍(ASD)的儿童由于感官敏感和行为问题,在牙科护理方面常常面临困难,这增加了他们出现口腔健康问题的风险。视觉辅助工具、视频示范和感官适应环境等适应策略旨在改善他们的牙科体验。根据PRISMA 2020指南,使用PubMed、Scopus、Embase和Cochrane数据库对随机对照试验(RCT)进行了系统评价。在筛选的1072条记录中,有9项RCT纳入了分析。研究纳入了18岁以下的ASD儿童,并将牙科适应技术与传统护理进行了比较。评估了偏倚风险和研究质量。使用GRADE工具确定结果的证据质量。9项样本量从25至138名参与者不等的RCT显示,在口腔卫生、减轻焦虑和增加合作方面有显著改善。视频示范和感官适应环境在降低牙科就诊期间的痛苦方面特别有效。牙科适应策略,尤其是视频示范和感官适应环境,能有效改善ASD儿童的口腔健康状况并减轻焦虑。需要更多研究来探索长期效果,并纳入重度ASD儿童。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f83/11641856/f3acc389f923/jcm-13-07144-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f83/11641856/f3acc389f923/jcm-13-07144-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f83/11641856/f3acc389f923/jcm-13-07144-g001.jpg

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本文引用的文献

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Sensory over-responsivity and atypical neural responses to socially relevant stimuli in autism.自闭症中对社会相关刺激的感觉过度反应和非典型神经反应。
Autism Res. 2024 Jul;17(7):1328-1343. doi: 10.1002/aur.3179. Epub 2024 Jul 1.
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Factors Influencing Peri-Extraction Anxiety: A Cross-Sectional Study.影响拔牙周围焦虑的因素:一项横断面研究。
自闭症谱系障碍儿童口腔护理的意义——一项叙述性文献综述
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Oral Hygiene Status in Children on the Autism Spectrum Disorder.自闭症谱系障碍儿童的口腔卫生状况
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Culturally Adapted Dental Visual Aids Effect on Behavior Management during Dental Visits in Children with Autism Spectrum Disorder.文化适应性牙科视觉辅助工具对自闭症谱系障碍儿童牙科就诊期间行为管理的影响。
J Contemp Dent Pract. 2024 Jan 1;25(1):20-28. doi: 10.5005/jp-journals-10024-3620.
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Optimizing Care for Autistic Patients in Health Care Settings: A Scoping Review and Call to Action.优化医疗保健环境中自闭症患者的护理:范围综述与行动呼吁。
Acad Pediatr. 2024 Apr;24(3):394-407. doi: 10.1016/j.acap.2023.11.006. Epub 2023 Nov 10.
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A comparative evaluation of video modeling and social stories for improving oral hygiene in children with autism spectrum disorder: A pilot study.视频建模与社会故事对改善自闭症谱系障碍儿童口腔卫生的比较评价:一项初步研究。
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Oral health-care practices and dental assistance management strategies for people with autism spectrum disorder: An integrative literature review.自闭症谱系障碍患者的口腔保健实践和牙科协助管理策略:综合文献回顾。
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