Manejo comportamental de pacientes com transtorno do espectro autista na odontologia: revisão de literatura

Abstract

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with a rising prevalence. This increase, partly attributed to environmental factors, can also be explained by changes in diagnostic criteria introduced in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Individuals with ASD exhibit behavioral variability that impacts the approaches for dental treatment, presenting diverse limitations influencing their response to oral health care. Therefore, the application of behavioral management techniques is essential to accommodate, understand, and promote adherence to treatment. The objective of this study was to review the available techniques for the behavioral management of patients with ASD. The databases PubMed, Scientific Electronic Library Online (SciELO), LILACS and were utilized. The descriptors “Management,” “Autism,” and “Oral care” were employed for the selection process. Inclusion criteria were: studies published in English, Spanish, or Portuguese between 2010 and 2023 that focused on the behavioral management of individuals with ASD. Exclusion criteria included: articles without open access or online availability and articles not providing the full text. From the studies retrieved, 30 articles were selected, outlining techniques applicable to managing such patients, forming the basis of this review. Based on these findings, we conclude that both pharmacological and non-pharmacological techniques show positive outcomes in managing patients with ASD. Non-pharmacological techniques are generally more accepted by caregivers and patients as they employ behavior modulation strategies through activities, conversations, and demonstrations. However, there is no consensus on which methods are most effective for addressing each of the three levels of the autism spectrum. On the other hand, pharmacological techniques encounter lower acceptance in some cases due to their more invasive nature, such as medicated sedation, inhalation sedation with nitrous oxide, or general anesthesia in surgical settings. Nonetheless, for many cases, these techniques may represent the best option, particularly when non-pharmacological approaches fail to achieve the desired outcomes.