Common dental problems in patients with autism and how to treat them

Some dental problems are associated with autism. We tell you what are the most common pathologies in the mouth of these patients and how they are treated.

Last update: February 26, 2022

Patients with autism may have some dental problems associated with their condition. What’s more, this disorder makes it difficult to take care of the mouth, which increases the risk of suffering from cavities and pathologies in the gums.

Autism Spectrum Disorder (ASD) encompasses several developmental conditions, characterized by repetitive behaviors and limited interests. This interferes with social relationships and the ability to carry out some activities of daily life. Next, we will tell you more about it and detail the care that these people should have in terms of oral health.

autism spectrum disorder

As we anticipated, autism spectrum disorder (ASD) is the name that receives a group of developmental conditions. Repetitive behaviors, focused and limited interests and the inability of the person to relate socially are some of the aspects that characterize this problem.

In everyday language, patients who present them are called “autistic”. Each case manifests itself in a particular way and with different intensities. Below, we mention some of the symptoms that these patients may present:

  • Inability to relate or lack of social skills.
  • Difficulty understanding rules or social expectations.
  • Disinterest in other people.
  • lack of response when named.
  • Little eye contact.
  • repetitive behaviors and restricted.
  • Trouble communicating.
  • limited language or absence of verbal language.
  • Strange and own language.
  • Repetition of other people’s conversations.
  • Rigidity and inflexibility in the face of changes or unknown situations.
  • Different or inappropriate use of objects.
  • Intense interest in specific topics.
  • Excessive reaction to sensory stimuli.
  • literal thought and difficulty understanding abstract concepts.
  • Little security awareness.
  • Difficulty following multi-step instructions.
The behaviors of autism spectrum disorder make proper oral hygiene difficult.


The most common dental problems in patients with autism

There are no oral manifestations or dental problems specific to autism in the mouth. The pathologies that occur can occur in any patient. But the fact of suffering from ASD increases the chances of suffering from certain oral conditions.

For example, caries and periodontal disease are common disorders in these patients. Preference for high-carbohydrate diets and sweet rewards for certain behaviors increase the risk of these conditions.

What’s more, Poor oral hygiene habits also affect or the inability to perform them autonomously. Other common oral problems in people with autism include the following:

  • Non-nutritive chewing.
  • tongue protrusion.
  • Grinding of the teeth.
  • Bruxism, which occurs in 20 to 25% of these patients.
  • Self-harm and trauma. These patients are used to biting their lips and tongue and scratching their gums. With this, they develop ulcerations in the mucous membranes.

According to a study of children with autism spectrum disorder in KwaZulu-Natal, South Africa, lip biting was the most prevalent soft tissue trauma, observed in 56.3% of the cases.

Causes of dental problems in patients with autism

Many of the dental problems present in patients with autism are related to situations typical of this disorder. Risk factors include the following:

  • Poor oral hygiene: ASD patients or their caregivers may have difficulty cleaning their mouths adequately. This causes the accumulation of bacterial plaque and tartar, which means a greater risk of suffering from cavities, gingivitis and periodontal disease.
  • Oral habits: repetitive behaviors typical of autism can affect oral health. Grinding your teeth, hurting your gums, and biting your lips or tongue are some examples. Also eat non-nutritive substances such as ice, earth, sand, clay or plastic.
  • Diet: some children with ASD have specific food preferences, consuming only some types of food and rejecting others (eating only carbohydrates and rejecting fruits, vegetables and meats; or eating pureed or mashed foods and not tolerating more textures). consistent). Other times, caregivers of patients with ASD, especially children, reward their good behavior with snacks and sweets. This type of diet increases the risk of caries and, in childhood, can affect the development of the jaws.
  • Medication: certain drugs used against this disorder can cause dry mouth. Some even have added sugar and cause an increase in the size of the gingival tissue. In this way, they increase the chances of suffering from cavities and gingivitis.
  • Seizures: seizures and frequent falls increase the risk of trauma and dental fractures.
  • Tooth anxiety: fear and lack of acceptance or collaboration in the dental office can lead to a lack of regular check-ups. This predisposes to the suffering of oral pathologies.

How to address dental problems in patients with autism?

Oral health care for patients with autism it needs the accompaniment, the supervision and even the accomplishment on the part of other people. Having someone you trust to help you care for your mouth is essential to avoid problems.

Daily home care is essential. In addition, dental check-ups from an early age play a key role in maintaining health. Thus, the first step is to find a professional with the training, suitability and predisposition for this task.

Visit the dentist regularly, from the first years of life, it helps to create bonds of trust and become familiar with the dental environment. Incidentally, it allows the doctor to get to know his patient in order to offer personalized attention according to his particular needs.

A first interview of the dentist with the caregivers, without the patient, is also recommended. This allows him to know in advance about the behaviors, the rejections, the sensations and the stimuli that he should avoid or take advantage of.

Another good idea is to make a previous visit to the office so that the person with autism becomes familiar with the environment, the staff, the smells and the sounds. Anything that gives you security will be a good strategy to reduce anxiety about the consultation.

Ultimately, the patient must be encouraged to cooperate in the consultation. Positive reinforcements are helpful in some cases. Patience and trust in the professional are key for office visits to be effective.

Dental treatments in patients with autism

If prevention is adequate, the need for difficult, invasive or long dental treatments will be less. Therefore, it’s a good idea to focus on keeping your mouth healthy.

To carry out regular dental treatments such as cleaning, fluoride placement or fillings, it will be necessary to have the acceptance and collaboration of the patient. This is achieved with frequent visits that progressively build trust.

If there is a need for more complex treatments, immobilization techniques, sedation or even the use of general anesthesia may be necessary. If so, the dentist also requires consultation with the patient’s physicians.

In cases of severe bruxism or self-injury, the use of mouth guards may be convenient. It must be determined whether the patient will tolerate and accept this foreign body in the mouth.

To start a dental treatment in patients with autism it is necessary to create an environment of trust.

Prevention of dental problems in patients with autism

Prevention of dental problems is the best way to care for oral health in patients with autism. Learning and assuming the habit of dental hygiene will be similar to the establishment of other routines.

That is why previous experiences and known strategies are of great help here as well. Anyway, here are some tips that may be useful:

  • Choosing the toothbrush: try all the options of brushes that are necessary until you find the right one. The size, design and hardness of the bristles are important aspects for the sensitivity and comfort of these patients.
  • Use hygiene accessories: Choosing a paste and dental floss according to the patient’s preferences, with the appropriate textures, colors and flavors favors the acceptance of the hygiene routine.
  • Establish routines: the order and repetition of the same actions every day establish a routine that facilitates brushing. Doing it always in the same way, in the same place and with the same objects makes the task easier.
  • Give the example: Having caregivers brush in front of the patient and showing them how they do it is very helpful.
  • Teach technique: progressively, the need to open the mouth, present the brush, offer it to the patient’s hands and help him to perform the movements can be taught. If there is acceptance, the caregiver can do the task and then motivate its autonomous completion.
  • Use mouth supports: For cases of patients who suddenly close their mouths, a soft foam rubber support helps keep the mouth open during hygiene. This prevents bites or accidents.

Other strategies

Capitalizing on the patient’s interests during routine dental hygiene is also helpful. Caregivers know better than anyone what motivates them the most. Using pictures, characters, rewards (which shouldn’t be candy or unhealthy food), praise, or games can help incorporate brushing into everyday life.

For some patients with special sensitivity in the mouth, tooth brushing can be uncomfortable. In these cases, sensory modification can be used. Hugs or special costumes, for example, can generate a different sensory impact and reduce stress.

Oral cleaning with a cloth or small sponge also helps to get used to the sensations in the oral cavity. As the autistic person accepts these perceptions, You can progress to the use of brush, paste and dental floss.



Teamwork

In short, the appearance of dental problems in patients with autism can happen due to behaviors typical of this disorder, but also due to unhealthy practices that can be avoided.

The assistance of parents or caregivers to sanitize and keep the mouth healthy is a key point to prevent the most common oral diseases. The cooperation of occupational therapists and specialized dentists is also decisive.

Regular dental visits help monitor dental health and prevent difficult complications. Caregivers and health professionals working as a team find the best strategies to keep the oral cavity of patients with ASD as healthy as possible.

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