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Background
: Subjects with Autism Spectrum Disorders (ASDs) have often difficulties to accept dental treatments.
The aim of this study is to propose a dental care protocol based on visual supports to facilitate children with ASDs
to undergo to oral examination and treatments.
Material and Methods
: 83 children (age range 6-12 years) with a signed consent form were enrolled; intellectual
level, verbal fluency and cooperation grade were evaluated. Children were introduced into a four stages path in or
der to undergo: an oral examination (stage 1), a professional oral hygiene session (stage 2), sealants (stage 3), and,
if necessary, a restorative treatment (stage 4). Each stage came after a visual training, performed by a psychologist
(stage 1) and by parents at home (stages 2, 3 and 4). Association between acceptance rates at each stage and gender,
intellectual level, verbal fluency and cooperation grade was tested with chi-square test if appropriate.
Results: Seventy-seven (92.8%) subjects overcame both stage 1 and 2. Six (7.2%) refused stage 3 and among the 44
subjects who need restorative treatments, only three refused it. The acceptance rate at each stage was statistically
significant associated to the verbal fluency (
p
=0.02;
p
=0.04;
p
=0.01, respectively for stage 1, 3 and 4). In stage 2 all
subjects accepted to move to the next stage. The verbal/intellectual/cooperation dummy variable was statistically
associated to the acceptance rate (
p
<0.01).
Conclusions: The use of visual supports has shown to be able to facilitate children with ASDs to undergo dental treatments even in non-verbal children with a low intellectual level, underlining that behavioural approach should be used
as the first strategy to treat patients with ASDs in dental setting.
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