Hospital Dentist Case

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Recommended: Social interaction deficit of a child with autism

Hospital Dentistry
Autism
- Patient demographic:
. Patient initials: MR
. Age: 16 years old.
. Sex: Female.

- History of Present Illness:
. She presented to UH clinic for examination after many attempts without examination was possible.

- Past Medical History:
. Autism

- Past Surgical History:
. None

- Medication:
. Zoloft: Selective Serotonin Reuptake Inhibitors.

- Clinical Examination:
. Extra-oral Examination: -Within normal limits.
. Intra-oral Examination:
-Patient laid on floor in waiting area until she was assisted to a chair and rolled to operatory. Parents did very well once she was placed in immobilization.
-Generalized gingival edema and erythema. Moderate calculus accumulation especially in mandibular anterior teeth …show more content…

There is usually impairment in several additional domains integral to social functioning, including language and communication.

- Diagnostic Keys for Autism Spectrum Disorder:
1. Impairment in social interaction
a. Uses nonverbal behaviors
b. Poor peer relationships
c. Lack of interest in shared activities
d. Lack of social or emotional reciprocity
2. Impairments in communication
a. Delay in language
b. Stereotyped or repetitive language
c. Lack of age-appropriate social play
3. Repetitive behaviors
a. Inflexibility
b. Preoccupation with parts of objects

- Etiology: Majority of cases are not associated with a comorbid medical condition. However, two thirds of cases have a comorbid psychiatric feature (ADHD 29%, anxiety 22%, bipolar 20%, depression 20%).
- Treatment:
Nonpharmacologic Therapy: Consistent behavioral training program in both the home and school environments.
Acute General Rx: selective serotonin reuptake inhibitors (SSRIs), atypical antipsychotics, valproic acid.
Chronic Rx: Extended use of medications for acute management of comorbid psychiatric disorder.

Severity Levels:

Level 3: Requiring very substantial support.
Social …show more content…

Preventive oral hygiene procedures for patients who are not able to perform oral hygiene procedures, a family member or attendant should be instructed on the procedures.
• Oral hygiene may be the most influential caries risk indicator in children with autism and special attention should be given to the presence of visible plaque and gingivitis in patients with ASD.
• Orthodontic concerns in individuals with ASD compared to healthy individuals include an increased tendency toward anterior open bite and dental crowding.
• Flouride application is one of the method to limit the caries development due to poor oral hygiene to eliminate the caries development.
• Restorative treatment: Dental amalgam is characterized by excellent moisture tolerance and longevity making it a suitable choice for posterior teeth in patients where moisture control is more difficult to achieve.
• Most of the medications used to treat disorders contribute to increased dental problems in such patients because xerostomia is one of their primary adverse effects. This unfavorable oral environment may create conditions leading to an increased incidence of smooth-surface caries and

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