Oral health status and management of autistic patients in the dental setting

Aim Dental treatment of patients with Autism Spectrum Disorders (ASD) is challenging due to difficulties in social interactions, hypersensitivity to sensory stimuli, various degrees of cognitive and developmental issues, poor collaboration, limited capacity to manage emotions, stereotyped movements, hyperactivity, limited adaptation to new situations and environments. Data on the type of treatment required are scarce. This study investigates the oral health status of ASD patients, the possibilities of chair treatment and the need for dental treatments under general anaesthesia (GA).Methods One hundred sixty-nine medical records, from 2005 to 2018, of patients with ASD were examined. Patients undergoing chair or general anaesthesia were assigned to two groups according age (younger or older than 14 years old). The level of cooperation was classified into four categories: none, poor, fair, good.Results For most patients chair treatment was not sufficient. At the first appointment older patients were less cooperative than younger. Adults needed general anaesthesia more than younger persons for urgent dental procedures, already scheduled at the first visit. Conclusions Primary prevention, setting up a routine oral hygiene at home and regular dental examinations, internalised like a habit by patients, are the main instruments to maintain oral health in ASD patients. When non-cooperative patients need urgent treatment, safe and high-level dental therapies should be performed under GA.