Lai Chun-Cheng, Wu Chia-Chan
Department of Pediatric Dentistry, Far Eastern Memorial Hospital, Taipei, Taiwan.
Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.
Medicine (Baltimore). 2025 Mar 21;104(12):e41867. doi: 10.1097/MD.0000000000041867.
Difficulty in the cooperation of children with autism spectrum disorder (ASD) leads to a poor diagnosis of caries patterns and poor clinical and radiographic findings. This study aimed to investigate the association between caries patterns and treatment characteristics in children with ASD and compare these variables with those in healthy children treated under general anesthesia. The medical records of children with ASD undergoing dental treatment under general anesthesia (n = 40) were analyzed in this study. The collected data included demographic profile, medical status (ASD severity and associated comorbidities), dental history (behavior, care approach, past dental treatment, and follow-up period), caries pattern (surface and depth), and clinical and radiographic findings (e.g., percussion/palpation pain, fistula, furcation involvement, and pathologic resorption). We compared the caries patterns and treatment of children with ASD to those of their healthy counterparts (n = 40). In children with ASD, age and severity were significantly associated with presentation behavior (P = .03 and P = .04) and the chosen care approach (P = .03). Clinical and radiographic examinations revealed that furcation involvement or pathological resorption was more frequent in children with ASD from families with lower average monthly income (P = .05) and in those with associated comorbidities (P = .02). Caries involving 1 or 2 surfaces were more prevalent in children with ASD, with a significant proportion extending to the dental pulp (P < .001). Dental caries characteristics and patterns among children with ASD differ from those of healthy children, which influences dental treatment decisions.
患有自闭症谱系障碍（ASD）的儿童在合作方面存在困难，这导致龋齿模式的诊断不佳以及临床和影像学检查结果不理想。本研究旨在调查ASD儿童的龋齿模式与治疗特征之间的关联，并将这些变量与在全身麻醉下接受治疗的健康儿童的变量进行比较。本研究分析了40例在全身麻醉下接受牙科治疗的ASD儿童的病历。收集的数据包括人口统计学资料、医疗状况（ASD严重程度和相关合并症）、牙科病史（行为、护理方式、既往牙科治疗和随访期）、龋齿模式（表面和深度）以及临床和影像学检查结果（如叩诊/触诊疼痛、瘘管、根分叉病变和病理性吸收）。我们将ASD儿童的龋齿模式和治疗情况与其健康对照儿童（40例）进行了比较。在ASD儿童中，年龄和严重程度与表现行为（P = 0.03和P = 0.04）以及所选择的护理方式（P = 0.03）显著相关。临床和影像学检查显示，平均月收入较低家庭的ASD儿童（P = 0.05）以及患有相关合并症的儿童（P = 0.02）根分叉病变或病理性吸收更为常见。涉及1个或2个表面的龋齿在ASD儿童中更为普遍，其中相当一部分扩展至牙髓（P < 0.001）。ASD儿童的龋齿特征和模式与健康儿童不同，这会影响牙科治疗决策。
