A scoping review on the management of adults and children with autism in the dental setting

Abstract

Objectives: Many studies have discussed the management of adults and children with autism in the dental setting. Most studies have focussed on evaluating the effectiveness of different behavioural approaches, however, the results were conflicting. Thus, the aim of this study was to scope the literature systematically, to untangle the definition and use of the term ‘patient management’ for adults and children with autism in dentistry.

Methods: A scoping review was conducted by applying the framework developed by Arksey and O’Malley (2005). A search was carried in four online databases to explore the literature on the management of adults and children with autism in the dental setting. Two reviewers independently conducted the study selection and characterisation.

Results: Nineteen studies were included in the review. The selected studies were summarised and categorised within one of the four themes identified in the methods chapter: applied behavioural management techniques; communication techniques; pharmacological and restraint management techniques; environmental changes. Nine included articles focused on the impact of the applied behavioural analysis (ABA) approach on the behaviour of children and adults with autism in the dental setting. Three included papers were about applying of communication techniques. Four included articles centred on the management of children and adults with autism in the dental setting by the means of pharmacological and restraint behaviour management techniques. And lastly, three included studies focused on the importance of the environment.

Conclusion: From the results of this review, there is no direct single approach that can be recommended for the management of children and adults with autism in the dental setting. However, applying a variety of approaches include the applied behavioural management techniques, communication techniques and environmental changes could mean a far-reaching positive impact while dealing with children/ adults with autism in the dental environment. Management approaches must be staged and individualized for each child/adult with autism. Using these considerations, dental attendance for this group of the population may effectively transformed from a frightening event into a more acceptable experience.