Restoration of an Upper Anterior Tooth in an Adolescent with Autism Spectrum Disorder—A Student Case Report

Abstract

Background: Patients with autism spectrum disorder (ASD) or other mental or physical limitations experience an imbalance in the frequency of dental treatment as compared with the general patient population, in part, due to inadequate pre-graduate training of future dentists. Case presentation: This case report describes a successful anterior tooth restoration, in awake state, in a 15-year-old boy with early childhood autism. The procedure was carried out independently by students of dentistry within the scope of their integrated clinical training semesters. Desensitization sessions were used as a preparatory measure and elements of behavioral facilitation (tell-show-feel-feel-do) were applied during the treatment. Conclusions: To avoid discrimination of this group of patients in the provision and quality of dental care, a structured approach to the transfer of theoretical and practical knowledge in the field of special care dentistry is indispensable. To this end, treatment strategies for special care patients should be taught to pre-graduate dental students as a fundamental part of their university curriculum.

Self-Assessment of Knowledge on the Treatment of Children and Adolescents with Special Care Needs: Results of a Survey amongst German Dentists with Key Expertise in Paediatric Dentistry

“…This choice of focus was guided by the existing literature on the topic: on the one hand, there are various articles that call attention to the fact that the treatment of persons with disabilities or psycho-emotional disorders may be challenging for the entire dental team [ 13 , 14 ]; on the other hand, there are also articles that point out that the treatment of patients with “special needs” requires a special set of knowledge and practical skills. The latter publications underscore the need for advanced dental training and education in this regard [ 15 , 21 , 22 , 23 , 24 ].…”

“…Dental teams can, for example, experience an increased physical burden in treating CA-Dis with restricted mobility who need to be treated in their wheelchairs. In addition, the behavioural particularities of children and adolescents with “special needs” are challenges with which the dental team need to deal [ 24 ]. Moreover, the daily work in this field is also determined by numerous administrative tasks that need to be fulfilled, such as scheduling appointments for patients requiring general anaesthesia or for out-of-office treatment of patients in residential facilities (visiting dental treatment).…”

Is examining children and adolescents with autism spectrum disorders a challenge?—Measurement of Stress Appraisal (SAM) in German dentists with key expertise in paediatric dentistry

“…Previous studies dealt with the question of how challenging the treatment of children and adolescents with ASD is for dentists. These were either concrete challenges such as the behavior of children [ 42 ] or the need for information or further training on the subject or practical recommendations for action [ 11 , 14 , 15 ].…”

“…Previous studies dealt with the question of how challenging the treatment of children and adolescents with ASD is for dentists. These were either concrete challenges such as the behavior of children [42] or the need for information or further training on the subject or practical recommendations for action [11,14,15]. Studies about psychological and physical stress and the resulting stress experience of dentists when treating children and adolescents without disabilities showed that there is an association between the stress or stress experience and the practical experience of dentists, the procedures used and the age of the patient [43][44][45].…”

“…A study among dentists from Germany found that their subjective strain was significantly higher, the more insufficient and incomplete their own specialist knowledge on the treatment of children with disabilities was stated [13]. Alongside the treatment of children and adolescents with disabilities, treating individuals with mental health disorders and neurodevelopmental conditions such as autism spectrum disorders (ASD) [9,[14][15][16] are mostly seen and described as a challenge [10,13,15,16]. However, there is sparse scientific data based on whether the perception of dentists actually corresponds to a challenge from a psychological point of view.…”