Procedures for reducing dental fear in children with autism

Abstract

Children with autism are often unable to tolerate dental examinations because of fear associated with sights and sounds in the dental operatory. This study applies procedures commonly used to reduce phobic behavior in otherwise normal persons and individuals with mental retardation, to dental fear in children with autism. Three male subjects were desensitized to a dental exam by the experimenter who paired the anxiety-causing event with stronger stimuli that elicited anxiety-antagonistic responses. Application of the treatment package resulted in successful completion of the steps in a dental exam in an analog setting, and a clinically significant increase in the number of steps completed in vivo. This study demonstrates that children with autism can be trained to cooperate during a dental exam.

Comorbid psychopathology with autism spectrum disorder in children: An overview

“…Luiselli (1978) treated an autistic child who feared riding a bus. Love, Matson, and West (1990) trained mothers to effectively deal with their autistic children's fears of going outside and of bathroom showers, and Luscre and Center (1996) developed a treatment for ASD children who had dental fears. Most recently, Rapp, Vollmer, and Hovanetz (2005) treated swimming pool avoidance in an autistic adolescent girl.…”

Training Adults and Children with an Autism Spectrum Disorder to be Compliant with a Clinical Dental Assessment Using a TEACCH-Based Approach

“…Furthermore, they may even feel it is an aggressive intrusion and thus look for all possible mechanisms to protect this area. The probability of disruptive behavior is high, complicating, impairing or even preventing the dental intervention (Bäckman and Pilebro 1999a;Dávila and Jensen 1988;Friedlander et al 2006;Green and Flanagan 2008;Klein and Nowak 1998;Luscre and Center 1996;Namal et al 2007;Pilebro and Bäckman 2005;Shapira et al 1989). Thus, the use of habitual dentistry material and techniques becomes extremely difficult and complex due to the existence of communication deficits, sensory modulation alterations and the attachment to invariable environments.…”

“…Only a few works have employed protocols with different communicative strategies in children and toddlers to facilitate dental exploration and interventions (Bäckman and Pilebro 1999a, b;Cuvo et al 2010;Luscre and Center 1996;Pilebro and Bäckman 2005;Yepes et al 1998). In the past, to provide appropriate dental treatment, trials of clinical actions to be performed at home and in educational institutions have been suggested in order to anticipate and to familiarize patients with the tools and basic dental procedures (Kopel 1977;Swallow 1969).…”

“…In the past, to provide appropriate dental treatment, trials of clinical actions to be performed at home and in educational institutions have been suggested in order to anticipate and to familiarize patients with the tools and basic dental procedures (Kopel 1977;Swallow 1969). The use of modeling with in vivo models or via audio-visual methods has also been described to anticipate and improve the performance of clinical dental examination in these children (Luscre and Center 1996;Yepes et al 1998). In Sweden, through the use of images and visual pedagogy based on the TEACCH model, they anticipate certain actions to facilitate oral hygiene (Pilebro and Bäckman 2005), dental examination and preventive dental treatment (Bäckman and Pilebro 1999a).…”

People with learning disabilities and specialist services

“…A visit to the dentist can be especially traumatic because of different factors such as anxiety related to change in environment: lights, different noises, people, ways of dressing, 16 tactile and sensory issues, 17 a lack of understanding about the purpose of the visit and importance of oral health, 17 and because of the nature of dental treatment (even if it is only a check up) as an invasion of body space. 17 Once these factors have been successfully addressed there are few reasons why dental treatment cannot proceed as for patients without autism spectrum disorders and in a general practice setting.…”