Neurodiversity-based non-pharmacological behavioral management techniques for dental care in children with autism spectrum disorder (ASD)
DOI:
https://doi.org/10.29166/od.v28i1.10102Keywords:
Autism Spectrum Disorder, Pediatric Dentistry, Oral Health, Behavioral Therapy, Child, AdolescentAbstract
Dental care for children with autism spectrum disorder (ASD) constitutes a clinical challenge due to communication difficulties, the need for predictability, and alterations in sensory processing, factors that may increase anxiety and limit cooperation during the consultation. Objective: To analyze the available evidence on non-pharmacological behavioral management techniques based on neurodiversity to improve cooperation, reduce anxiety, and support dental care and oral hygiene in children with ASD. Materials and methods: An exhaustive narrative review was conducted through a structured search in PubMed/MEDLINE and Scopus, limited to publications between 2020 and 2025. After record screening and full-text review, 17 documents were included in the qualitative synthesis. The evidence was organized into five thematic areas: adapted sensory environment, visual pedagogy and structured aids, virtual reality and digital supports, desensitization and behavioral guidance, and preventive oral hygiene programs. Results: The studies show a favorable trend, although with methodological and clinical heterogeneity. Non-pharmacological interventions were mainly associated with reduced anxiety and behavioral distress, improved cooperation during dental examination or treatment, and strengthened oral hygiene habits. The most consistent results were observed in sensory adaptation strategies and in interventions that combined visual or digital preparation with structured behavioral support. Conclusions: These techniques constitute a clinically relevant alternative for the dental care of children with ASD. Longitudinal evidence is required to determine their effectiveness according to diverse current clinical profiles.
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References
1. Prynda M, Pawlik AA, Niemczyk W, Wiench R. Dental adaptation strategies for children with autism spectrum disorder—a systematic review of randomized trials. J Clin Med. 2024;13:7144. doi:10.3390/jcm13237144.
2. Pastore I, Bedin E, Marzari G, Bassi F, Gallo C, Mucignat-Caretta C. Behavioral guidance for improving dental care in autistic spectrum disorders. Front Psychiatry. 2023;14:1272638. doi:10.3389/fpsyt.2023.1272638.
3. Carli E, Pasini M, Pardossi F, Capotosti I, Narzisi A, Lardani L. Oral health preventive program in patients with autism spectrum disorder. Children (Basel). 2022;9:535. doi:10.3390/children9040535.
4. Stein Duker LI, Como DH, Jolette C, Vigen C, Gong CL, Williams ME, et al. Sensory adaptations to improve physiological and behavioral distress during dental visits in autistic children: a randomized crossover trial. JAMA Netw Open. 2023;6(6):e2316346. doi:10.1001/jamanetworkopen.2023.16346.
5. Balian A, Cirio S, Salerno C, Wolf TG, Campus G, Cagetti MG. Is visual pedagogy effective in improving cooperation towards oral hygiene and dental care in children with autism spectrum disorder? A systematic review and meta-analysis. Int J Environ Res Public Health. 2021;18(2):789. doi:10.3390/ijerph18020789.
6. Tang SJ, Wei HL, Li CY, Huang MN. Management strategies of dental anxiety and uncooperative behaviors in children with autism spectrum disorder. BMC Pediatr. 2023;23:612. doi:10.1186/s12887-023-04439-7.
7. Cirio S, Salerno C, Mbanefo S, Oberti L, Paniura L, Campus G, et al. Use of visual pedagogy to help children with ASDs facing the first dental examination: a randomized controlled trial. Children (Basel). 2022;9:729. doi:10.3390/children9050729.
8. Al Kheraif AA, Adam TR, Wasi A, Alhassoun RK, Haddadi RM, Alnamlah M. Impact of virtual reality intervention on anxiety and level of cooperation in children and adolescents with autism spectrum disorder during the dental examination. J Clin Med. 2024;13:6093. doi:10.3390/jcm13206093.
9. Narzisi A, Bondioli M, Pardossi F, Billeci L, Buzzi MC, Buzzi M, et al. “Mom let’s go to the dentist!” Preliminary feasibility of a tailored dental intervention for children with autism spectrum disorder in the Italian public health service. Brain Sci. 2020;10(7):444. doi:10.3390/brainsci10070444.
10. Cunningham A, McPolin O, Fallis R, Coyle C, Best P, McKenna G. A systematic review of the use of virtual reality or dental smartphone applications as interventions for management of paediatric dental anxiety. BMC Oral Health. 2021;21:244. doi:10.1186/s12903-021-01602-3.
11. Fallea A, Zuccarello R, Roccella M, Quatrosi G, Donadio S, Vetri L, Calì F. Sensory-adapted dental environment for the treatment of patients with autism spectrum disorder. Children (Basel). 2022;9:393. doi:10.3390/children9030393.
12. Martínez Pérez E, Adanero Velasco A, Gómez Clemente V, Miegimolle Herrero M, Planells Del Pozo P. Importance of desensitization for autistic children in dental practice. Children (Basel). 2023;10:796. doi:10.3390/children10050796.
13. Aljubour A, AbdElBaki M, El Meligy O, Al-Jabri B, Sabbagh H. Effect of culturally adapted dental visual aids on anxiety levels in children with autism spectrum disorder: a randomized clinical trial. Children (Basel). 2023;10(6):1040. doi:10.3390/children10061040.
14. Aljubour AA, AbdElBaki M, El Meligy O, Al Jabri B, Sabbagh H. Culturally adapted dental visual aids effect on behavior management during dental visits in children with autism spectrum disorder. J Contemp Dent Pract. 2024;25(1):20-28. doi:10.5005/jp-journals-10024-3620.
15. Octavia A, Sitthisettapong T, Kettaratad-Pruksapong M, Dewanto I. Structured-visual model for dental examination in autism spectrum disorder children: cooperation and compliance. Int Dent J. 2025;75:2182-2193. doi:10.1016/j.identj.2024.12.015.
16. Krishnan L, Iyer K, Kumar PDM. Effectiveness of two sensory-based health education methods on oral hygiene of adolescent with autism spectrum disorders: an interventional study. Spec Care Dentist. 2021:1-8. doi:10.1111/scd.12606.
17. Usilla B, Cheruku SR, Silla SS, Mohammad Z, Reddy A, Mehta J. A comparative study to evaluate the effectiveness of different modes of oral health education aids in children with autism spectrum disorder. Int J Clin Pediatr Dent. 2025;18(1):80-85.
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Copyright (c) 2026 Silvia Verónica Yepez de los Reyes, María Daniela Calle Prado
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