Factors associated with cooperative levels of Autism Spectrum Disorder children during dental treatments

Abstract

Aims To evaluate the cooperation rates in Thai ASD patients and analyse factors associated with cooperation levels in ASD patients during dental treatment. Materials and methods A group of 95 subjects aged between 3-18 years diagnosed with ASD and who had been evaluated for sensory processing by an occupational therapist received dental treatment in the dental clinic at the Rajanukul Institute of Bangkok (Thailand), which is the governmental institute providing medical and dental services to the community, including special needs children. Data were collected from medical records and parental questionnaires as well as behaviour rating during dental treatment using the Frankl rating scale. Qualitative data were analysed using descriptive analysis. Chi-square test and multiple logistic regression analysis were used to analise the factors associated with clinical behaviour during dental treatment (p < 0.05). Results Total subjects were 95 (82 males, 13 females). Mean age was 8.7±3.9 yrs. Age, behaviour before dental treatment and dental procedures (p < 0.001), proprioception system (p=0.021), tactile system (p=0.043), education (p=0.004), verbal communication ability (p=0.007), ability to follow the instruction (p=0.014), tooth brushing habit (p=0.014), and toilet training (p=0.001) were significantly associated with a cooperative behaviour during dental treatment. Multiple logistic regression analysis showed that age, education, and behaviour before dental treatment were associated with the cooperative behaviour of ASD patients during dental treatment. The level of cooperation in ASD dental patients aged 11-18 yrs was 11 times higher than for patients aged 3-7 yrs old (adjusted OR=11.51, p=0.004). Subjects who had attended special education system showed a cooperation level almost 13 times greater than subjects who did not (adjusted OR=12.7, p=0.014). Subjects who showed a positive behaviour before the dental procedure started showed higher cooperation during dental treatment, 15 times greater than that of patients with negative behaviour (adjusted OR=15.26, p < 0.001). Conclusion School-age ASD children who have been trained in special education programmes and showed positive behaviour before dental treatment show a higher cooperation level during treatment.