Revisión diagnóstica sobre el uso de las técnicas de orientación conductual para el manejo odontológico de niños con trastornos del espectro autista
Resumen
Introducción: El autismo es un trastorno del desarrollo cerebral que produceproblemas conductuales, sociales, cognitivos y en la comunicación. En la consulta odontológica, las conductas propias de estos pacientes afectan el cuidado de su salud bucal y dificultan su atención odontológica especializadapor falta de colaboración, impulsividad, agresividad y dificultad para expresar las emociones. Se han propuesto técnicas básicas y avanzadas de orientaciónconductual para manejar a estos pacientes enla consulta odontológica. Sin embargo, no se ha encontrado una revisiónsistemática,actualizada en español. Objetivo: analizar el comportamiento de las técnicas de manejo conductual de niños con trastornos del espectro autista (TEA) que acuden a la consulta odontológica. Métodos: Se realizó una revisión sistemática de estudios publicadosentre 2000 y 2020 en revistas especializadas indexadas en bases de datos (artículos ytesis). Resultados: se seleccionaron 64 estudios. La mayoría resalta la educación y la motivación de los padres como factores clave para lograr el éxito de la consulta odontológica. Todas las técnicas básicas de manejo conductual han sido exitosas: manejo de la conducta por medio de la comunicación, desensibilización, análisis aplicado de la conducta, pedagogía visual, adecuación sensorial del ambiente y capacitación parapadres. Las técnicas avanzadas, terapias farmacológicas, anestesia general y la estabilización protectora son el último recurso, válido solo cuando las otras no han logrado su propósito. Conclusiones: Las técnicas conductuales y ambientales combinadas pueden ser más afectivas para lograr el mejoramiento de la conducta, la comunicación y, en consecuencia, la atención odontológica.
Palabras clave
Texto completo:
PDFReferencias
Gómez B, Baldillo V, Martínez E.M, Planells P. Intervención odontológica actual en niños con autismo. La desensibilización sistemática. Cient Dent. 2009;6(3): 207-215.
Horruitiner L. Manejo del paciente autista en el consultorio odontológico. Odontopediatr. Rev.2008;7(2): 15-27.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5).Consultado el 20-03-2020. https://doi.org/10.1176/appi.books.9780890425596.
Mohamed A. Dental caries experience, oral health status and treatment needs of dental patients with autism. J. Appl Oral Sci. 2011;19(3). Disponible en: http://www.scielo.br/scielo.php?pid=S167877572011000300006&script=sci_arttext.
Morales M. Abordaje conductual del paciente autista en la consulta estomatopediátrica. Redoe. 2006;12(24-13). Disponible en: http://www.redoe.com/ver.php?id=37.
Weil T, Inglehart M. Dental Education and Dentists’ Attitudes and Behavior Concerning Patients with Autism. Journal of Dental Education. 2010; 74(12): 1294-1307 Disponible en: http://www.jdentaled.org/content/jde/74/12/1294.full.pdf
Akhila T, Ditto Sharmin D. Dental Management and Behavioural Modifications of Children with Autism Spectrum Disorders (ASD).EC Dental Science. 2015;1: 33-55. https://ecronicon.com/ecde/pdf/ECDE-01-00007.pdf
Loo C, Graham R, Hughes C. La experiencia de caries y conducta de pacientes dentales con trastornos del espectro autista. JADA.2009;4(1): 25-31.
Ramassamy E, Gajula-Shivashankarappa P, Adimoulame S, Meena R, Elangovan H, & Govindasamy E. Yoga therapy as an adjunct to traditional tooth brushing training methods in children with autism spectrum disorder.Special Care in Dentistry.2019;39(6): 551-556.
Mangione F, Bdeoui F, Monnier-Da Costa A, & Dursun E. Autistic patients: a retrospective study on their dental needs and the behavioural approach. Clinical Oral Investigations. 2019: 1-9. https://doi.org/10.1007/s00784-019-03023-7
Kuhaneck H, & Chisholm E. Improving dental visits for individuals with autism spectrum disorders through an understanding of sensory processing. Special Care in Dentistry. 2012;32(6): 229–233. https://doi.org/10.1111/j.1754-4505.2012.00283.x
Lefer G, Rouches A, Bourdon P, & Cazaux S. Training children with autism spectrum disorder to undergo oral assessment using a digital iPad® application. European Archives of Paediatric Dentistry. 2019;20(2): 113-121.
Marshall J, Sheller B, Williams,B, Mancl L, & Cowan C. Cooperation predictors for dental patients with autism. Pediatric Dentistry. 2017;29(5): 369-376.
Marion I, Nelson T, Sheller B, McKinney C, & Scott J. Dental stories for children with autism. Special Care in Dentistry. 2016;36(4): 181–186. https://doi.org/10.1111/scd.12167
Zink A, Molina E, Diniz M, Santos M. T, & Guaré R. Communication application for use during the first dental visit for children and adolescents with autism spectrum disorders. Pediatric Dentistry. 2018;40(1): 18-22.
Zink A, Diniz M, Rodrigues dos Santos M, & Guaré R. Use of a Picture Exchange Communication System for preventive procedures in individuals with autism spectrum disorder: pilot study. Special Care in Dentistry. 2016;36(5): 254–259. https://doi.org/10.1111/scd.12183
Weil T, Bagramian R, & Inglehart M. Treating patients with Autism Spectrum Disorder—SCDA members’ attitudes and behavior. Special Care in Dentistry. 2011;31(1): 8-17. https://deepblue.lib.umich.edu/bitstream/handle/2027.42/79116/j.1754-4505.2010.00173.x.pdf?sequence=1
Marshall J, Sheller B, Mancl L, & Williams B. Parental attitudes regarding behavior guidance of dental patients with autism.Pediatric Dentistry.2008;30(5): 400-407.
Slayton R. Autism Spectrum Disorder (ASD) May Lead to Lower Prevalence and Severity of Dental Caries than in Children without ASD. Journal of Evidence Based Dental Practice.2010;10(2): 105–106. https://doi.org/10.1016/j.jebdp.2010.02.008.
Málaga I, Blanco R, Hedrera A, Álvarez N, Oreña V, & Baeza M. Prevalencia de los trastornos del espectro autista en niños en Estados Unidos, Europa y España: coincidencias y discrepancias. Revista Medicina.2019;79(1): 4-9.http://www.medicinabuenosaires.com/PMID/30776272.pdf
Stein Duker L, Floríndez L, Como, D, Tran C, Henwood B, Polido J, & Cermak S. Strategies for success: A qualitative study of caregiver and dentist approaches to improving oral care for children with autism. Pediatric Dentistry. 2019;41(1): 4E-12E. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6391730/
Elsabbagh M, Divan G, Koh YJ, Kim YS, Kauchali S, Marcín C, Montiel-Nava C, Patel V, Paula CS, Wang C, Yasamy MT, Fombonne E. Global prevalence of autism and other pervasive developmental disorders. Autism Res.2012;5: 160–179. https://doi. org/10.1002/aur.239
Stein LI, Polido JC, Maillaux Z et al. Oral care and sensory sensitivities in children with autism spectrum disorder. Spec Care Dentist31: 102–110. https://doi.org/10.1111/j.1754-4505.2011.00187.x
Stein, L. I., Polido, J. C., & Cermak, S.A. (2012). Oral care and sensory concerns in autism. American Journal of Occupational Therapy. 2011;66: e73–e76. https://doi.org/10.5014/ajot.2012.004085
Blomqvist M, Dahllöf G, Bejerot S. Experiences of dental care and dental anxiety in adults with autism spectrum disorder. Autism Res Treat.2014: 238764. https://doi.org/10.1155/2014/ 238764 9.
Limeres-Posse J, Castaño-Novoa P, Abeleira-Pazos M et al. Behavioural aspects of patients with autism spectrum disorders (ASD) that affect their dental management. Med Oral Patol Oral Cir Bucal.2014;19: e467–e472. https://doi.org/10.4317/medoral.19566 10.
Cermak S, Stein Duker L, Williams M, Lane C, Dawson M, Borreson A, & Polido J. Feasibility of a sensory-adapted dental environment for children withautism. American Journal of Occupational Therapy. 2015;69: 1-10. http://dx.doi.org/10.5014/ajot.2015.013714
Gandhi RP, Klein U. Autism spectrum disorders: an update on oral health management. J Evid Based Dent Pract. 2014;14: 115–26. https://doi.org/10.1016/j.jebdp.2014.03.002
Brown J, Brown J, & Woodburn J. Dental services for children with autism spectrum disorder. Learning Disability Practice. 2014;17(3): 20–25. https://doi.org/10.7748/ldp2014.03.17.3.20.e1527
Cagetti M, Mastroberardino S, Campus G, Olivari B, Faggioli R, Lenti C, & Strohmenger L. Dental care protocol based on visual supports for children with autism spectrum disorders.Medicina Oral, Patología Oral y Cirugía Bucal. 2015;20(5), e598-604. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4598930/
Cermak SA, Stein Duker LI, Williams ME, Dawson ME, Lane CJ, Polido JC. Sensory adapted dental environments to enhance oral care for children with autism spectrum disorders: a randomized controlled pilot study. J Autism Dev Disord2015;45(9): 2876-88.
Cermak S, Duker L, Williams M, Dawson M, Lane C, & Polido J. Sensory adapted dental environments to enhance oral care for children with autism spectrum disorders: a randomized controlled pilot study.Journal of Autism and Developmental Disorders. 2015;45(9): 2876-2888.
Cermak S, Stein Duker L, Williams M, Lane C, Dawson M, Borreson A, & Polido J. Feasibility of a sensory-adapted dental environment for children with autism. American Journal of Occupational Therapy. 2015;69: 1-10. http://dx.doi.org/10.5014/ajot.2015.013714
Pilebro C, Bäckman B. Teaching oral hygiene to children with autism. International Journal of Paediatric Dentistry. 2005;15: 1–9.
Mulas F, Ros-Cervera G, Milla M. Modelos de intervención en niños con autismo. Rev Neurol. 2010;50(3): S77-84.
Hidayatullah T, Agustiani H, & Setiawan A. Behavior management-based applied behaviour analysis within dental examination of children with autism spectrum disorder.Dental Journal (Majalah Kedokteran Gigi).2018;51(2): 71-75.
Al Mochamant I, Fotopoulos I, & Zouloumis L. Dental management of patients with autism spectrum disorders.Balkan Journal of Dental Medicine.2015;9(3), 124-127.
Herrera-Moncada M, Campos-Lara P, Hernández-Cabanillas J, Bermeo-Escalona J, Pozos-Guillén A, Pozos-Guillén F, & Garrocho-Rangel J. Autism and Paediatric Dentistry: A Scoping Review.Oral Health and Preventive Dentistry. 201);17(3): 203-210. http://www.quintpub.com/userhome/ohpd/ohpd_17_3_herreramoncada_p203.pdf
Pisalchaiyong T, Trairatvorakul C, Jirakijja J, Yuktarnonda W. Comparison of the effectiveness of oral diazepam and midazolam for the sedation of autistic patients during dental treatment. Pediatr Dent.2005;27: 198-206.
Chandrashekhar S, & Bommangoudar J. Management of autistic patients in dental office: a clinical update.International Journal of Clinical Pediatric Dentistry. 2018;11(3): 219-227.
Chew L, King N, & O’Donnell D. Autism: the Aetiology, Management and Implications for Treatment Modalities from the Dental Perspective. Dental Update. 2006;33(2): 70–83. doi:10.12968/denu.2006.33.2.70
Isong IA, Rao SR, Holifield C, et al. Addressing dental fear in children with autism spectrum disorders: a randomized controlled pilot study using electronic screen media. Clin Pediatr.2014;53(3): 230-7.
Cuvo A, Godard A, Huckfeldt R, & DeMattei R. Training children with autism spectrum disorders to be compliant with an oral assessment. Research in Autism Spectrum Disorders. 2010;4(4), 681–696. https://doi.org/10.1016/j.rasd.2010.01.007
Delli K, Reichart P, Bornstein M, & Livas C. Management of children with autism spectrum disorder in the dental setting: concerns, behavioural approaches and recommendations.Medicina Oral, Patología Oral y Cirugía Bucal. 2013;18(6): e862-e869.
AbdAllah E, Metwalli N, & Badran A. Effectiveness of a one-year oral health educational and preventive program in improving oral health knowledge and oral hygiene practices of a group of Autistic Egyptian children and their caregivers. Future Dental Journal. 2018;4(1): 23–29. https://doi.org/10.1016/j.fdj.2018.02.001
Elmore J, Bruhn A, & Bobzien J. Interventions for the reduction of dental anxiety and corresponding behavioral deficits in children with autism spectrum disorder.American Dental Hygienists' Association. 2016;90(2): 111-120.
Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, & Chipponi J. Methodological index for non‐randomized studies (MINORS): development and validation of a new instrument. ANZ Journal of Surgery. 2003;73(9): 712-716.https://doi.org/10.1046/j.1445-2197.2003.02748.x
Von Elm E, Altman D, Egger M, Pocock S, Gøtzsche P, Vandenbroucke J, & Strobe Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. International Journal of Surgery. 2014;12(12): 1495-1499. https://doi.org/10.1016/j.ijsu.2014.07.013
Schulz K, Altman D, & Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMC Medicine. 2010;8(1): 18-27. https://annals.org/data/journals/aim/20207/0000605-201006010-00007.pdf
Moher D, Liberati A, Tetzlaff J, & Altman D. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of Internal Medicine. 2009;151(4): 264-269. https://doi.org/10.7326/0003-4819-151-4-200908180-00135
Al-Batayneh O, Nazer T, Khader Y, & Owai A. Effectiveness of a tooth-brushing programme using the picture exchange communication system (PECS) on gingival health of children with autism spectrum disorders. European Archives of Paediatric Dentistry. 2019. https://doi.org/10.1007/s40368-019-00485-x
Gupta M. Oral health status and dental management considerations in autism.International Journal of Contemporary Dental & Medical Reviews. 2014: 1-6.http://ijcdmr.com/index.php/ijcdmr/article/view/19
Hernandez P, & Ikkanda Z. Applied behavior analysis: behavior management of children with autism spectrum disorders in dental environments. The Journal of the American Dental Association. 2011;142(3): 281-287. https://doi.org/10.14219/jada.archive.2011.0167
Katta N, & Mani S. Autism Spectrum Disorders-A Review on the Recent Advances in the Dental Management of Autistic Children.Annals of International Medical and Dental Research. 2019;4(5): 31-40.
Leiva-Villagra N, & Vergara-Silva, D. Protocolo de Atención Ortodóncica en Pacientes con Trastorno del Espectro Autista (TEA).International Journal of Odontostomatology. 2017;11(4): 399-404.https://dx.doi.org/10.4067/S0718-381X2017000400399
Limeres-Posse J, Castaño-Novoa P, Abeleira-Pazos M, & Ramos-Barbosa I. Behavioural aspects of patients with Autism Spectrum Disorders (ASD) that affect their dental management.Medicina Oral, Patología Oral y Cirugía Bucal. 2014;19(5): e467-e476.
Loo C, Graham R, & Hughes C. Behaviour guidance in dental treatment of patients with autism spectrum disorder. International Journal of Paediatric Dentistry. 2009;19(6): 390–398. https://doi.org/10.1111/j.1365-263x.2009.01011.x
López S, Lefer G, Rouches A, & Bourdon P. Toothbrushing training programme using an iPad® for children and adolescents with autism. European Archives of Paediatric Dentistry. 2019. https://doi.org/10.1007/s40368-018-0396-y
Marshall J, Sheller B, Mancl L, & Williams B. Parental attitudes regarding behavior guidance of dental patients with autism. Pediatric Dentistry.2008;30(5): 400-407.
Matton S, & Romeo G. Behavioral regression in 2 patients with autism spectrum disorder and attention-deficit/hyperactivity disorder after oral surgery performed with a general anesthetic. The Journal of the American Dental Association. 2017;148(7): 519–524. https://doi.org/10.1016/j.adaj.2017.05.006
Morales M. Abordaje conductual del paciente autista en la consulta estomatopediátrica Redoe. 2006;12(24-13). Disponible en: http://www.redoe.com/ver.php?id=37.
Muraru D, Ciuhodaru T, & Iorga M. Providing dental care for children with autism spectrum disorders.International Journal of Medical Dentistry. 2017;7(2): 124-30.
Musa Herranz S, Mourelle Martínez MR, Real Benlloch I, & Perea Gutiérrez I. Pacientes con trastorno del espectro autista en odontopediatría.Revista Científica de Formación Continuada. 2016;13(2): 43-48.
Muthu M, & Prathibha K. Management of a child with autism and severe bruxism: a case report.Journal of Indian Society of Pedodontics and Preventive Dentistry. 2008;26(2): 82-97.
Nagendra J, & Jayachandra S. Autism spectrum disorders: dental treatment considerations.Journal of International Dental and Medical Research. 2012;5(2): 118-125.
Nelson T, Sheller B, Friedman C, & Bernier R. Educational and therapeutic behavioral approaches to providing dental care for patients with Autism Spectrum Disorder. Special Care in Dentistry. 2014;35(3): 105–113. https://doi.org/10.1111/scd.12101
Nelson T, Chim A, Sheller B, McKinney C, & Scott J. Predicting successful dental examinations for children with autism spectrum disorder in the context of a dental desensitization program. The Journal of the American Dental Association. 2017;148(7): 485–492. https://doi.org/10.1016/j.adaj.2017.03.015
Orellana L. Intervención psicoeducativa para facilitar el exámenclínico odontológico en personas con trastornos del espectro autista. Tesis Doctoral, Universitat de València; 2013.
Santos V, Araujo T, Santos M, Rodrigues D, Silva L, Batista V. Conditioning strategies in the dental care of patients with autism spectrum disorders.Revista Brasileira de Odontologia. 2017;74(4): 294-9.
Udhya J, Varadharaja M, & Parthiban J. Autism disorder (AD): an updated review for paediatric dentists.Journal of clinical and diagnostic research: JCDR. 2014;8(2): 275-282.
Zafar S, Boyd D, & Siddiqi A. Dental management of a child with autism spectrum disorder and attention-deficit hyperactivity disorder.Oral Health and Dental Management. 2017;16(4): 1-7.
Magoo J, Shetty AK, Chandra P, Anandkrishna L, Kamath PS, & Iyengar U. Knowledge, attitude and practice towards oral health care among parents of autism spectrum disorder children. Journal of Advanced Clinical and Research Insights. 2015;2(2): 82-86. https://doi.org/10.15713/ins.jcri.50
Nilchian F, Shakibaei F, & JarahZ. Evaluation of visual pedagogy in dental check-ups and preventive practices among 6–12-year-old children with autism. J. Autism Dev. Disord. 2017;47(3): 858-864. https://doi.org/10.1007/s10803-016-2998-8
Nazer T. Effectiveness of Picture Exchange Communication System (PECS) on Dental Plaque and Gingival Health of Children with Autism. Master’s thesis. Jordan University of Science and Technology; 2011. https://asnanportal.com/images/Tarik_Nazers_Thesis.pdf
Al Batayneh OB, Nazer TS, Khader YS, Owais AI. Effectiveness of a tooth-brushing programme using the picture exchange communication system (PECS) on gingival health of children with autism spectrum disorders. Eur Arch Paediatr Dent. 2020;21(2):277-283. https://doi.org/10.1007/s40368-019-00485-x
Hernández P, & Ikkanda Z. Applied behavior analysis. JADA. 2011;142(3): 81-87. https://doi.org/10.14219/jada.archive.2011.0167
Barry S. Improving access and reducing barriers to dental care for children with autism spectrum disorder. Tesis doctoral. University of Leeds; 2012.
Bondioli M, Buzzi M, Buzzi M, Giuca M, Pardossi F, Pelagatti S, Semucci V, Senette C, Uscidda F, Vagelli, B. MyDentist: Making Children with Autism Familiar with Dental Care. En International Symposium on Ambient Intelligence(pp. 365-372). Springer, Cham; 2018. https://doi.org/10.1007/978-3-030-01746-0_43
Suresh L, George C. Virtual Reality Distraction on Dental Anxiety and Behavior in Children with Autism Spectrum Disorder. Journal of International Dental and Medical Research. 2019;12(3): 1004-1010.http://www.jidmr.com/journal/wp-content/uploads/2019/10/28-D3_16086_Lekshmi-R-Suresh-final-review.pdf
Todos los documentos publicados en esta revista se distribuyen bajo una
Licencia Creative Commons Atribución -No Comercial- Compartir Igual 4.0 Internacional.
Por lo que el envío, procesamiento y publicación de artículos en la revista es totalmente gratuito.