Behavioral guidance for improving dental care in autistic spectrum disorders
Open accessAbstract
Introduction: Autism spectrum disorders (ASDs) impair many aspects of everyday life and may prevent access to dental care, often limiting it to emergencies. Impaired oral health has long-lasting negative consequences on health status and on the acquisition of oral habits (e.g., oral respiration and grinding) or competencies (e.g., proper speech production). Children with ASD may be scared in the dental setting, which is rich in sensory stimuli and requires physical contact. Due to their behavioral manifestations, they represent a challenge for dentists and hygienists. We created a dedicated pathway with behavioral support for children with ASD to allow dental care and possibly limit the use of general anesthesia. Methods: We evaluated the effects of behavioral support in a quasi-experimental design by comparing two groups of children with ASD. The first group (n = 84) was visited every 2 months for 3 years and received additional support (visual aids, caregiver training, and longer visit duration). A control group, matched for age and sex, was visited at least twice a year or more, if needed, according to standard healthcare guidelines. Results: Compliance with the schedule was high throughout the 3 years. The degree of collaboration significantly improved after 1 year in the supported group, while the control group did not change. At the end of the study, collaboration remained significantly higher than at the beginning in the supported group. Half of dental treatments were possible without general anesthesia in supported children. No adverse effect was apparent on collaboration due to COVID-19 restrictions. Discussion: Behavioral techniques improved the compliance of ASD children to regular dentistry visits and treatment. Furthermore, oral hygiene at home was similarly improved, addressing oral health from a lifelong perspective.
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Children with neurodevelopmental disorders, especially autism spectrum disorder, commonly have sensory over-responsivity, communication differences, and difficulty tolerating changes in routine.
“These conditions are commonly associated with sensory over-responsivity, communication differences, and difficulty tolerating changes in routine.”
From Adapting the Chairside: Pediatric Dental Management for Children with Neurodevelopmental Disorders – A Scoping Review (2026) · cites this paper as [1]
The Introduction describes communication difficulties and altered sensitivity in children with ASD, and the Discussion identifies language and sensory problems as common traits. The paper does not establish difficulty tolerating changes in routine, and its statements about these traits concern ASD rather than neurodevelopmental disorders generally. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThese chairside factors may lead to avoidance, resistance to change, behavioral escalation, increased appointment duration, reduced procedural quality, and safety concerns for the child and dental team.
“These factors may lead to avoidance, resistance to change, or behavioral escalation. They may also increase appointment duration, reduce procedural quality, and raise safety concerns for both the child and the dental team.1–3”
From Adapting the Chairside: Pediatric Dental Management for Children with Neurodevelopmental Disorders – A Scoping Review (2026) · cites this paper as [1]
The Results (section 3.2; page not supplied) document children refusing parts of visits and dental instruments, and the Discussion (section 4; page not supplied) says behavioral difficulties may prevent timely and proper dental treatment. The paper does not establish that chairside factors cause resistance to change or behavioral escalation, lengthen appointments, or create safety concerns for the dental team. Its longer appointments were planned as part of the intervention, not reported as a consequence of those factors. (LLM, conf=0.86)
Experimental — accuracy not yet measuredSensory, communication, and routine-tolerance features in children with neurodevelopmental disorders can amplify dental anxiety and distress, reduce cooperation, and contribute to delayed or incomplete care.
“Such features can amplify dental anxiety and distress in the operatory, reduce cooperation, and contribute to delayed or incomplete care.1–3”
From Adapting the Chairside: Pediatric Dental Management for Children with Neurodevelopmental Disorders – A Scoping Review (2026) · cites this paper as [1]
The Abstract says children with ASD may be scared in the sensory-rich dental setting and that access to care may be limited to emergencies. The Introduction links communication and sensory difficulties to impaired access, and the Discussion says behavioral difficulties may preclude timely, proper treatment. These passages support the claim for children with ASD, but do not establish it for children with neurodevelopmental disorders generally or specifically link routine tolerance to these outcomes. (LLM, conf=0.84)
Experimental — accuracy not yet measuredBehavioral challenges in autism spectrum disorder and other neurodevelopmental disorders at chairside are often triggered by predictable aspects of dental care (bright lights, sounds, smells, physical proximity, intraoral touch) and by difficulties understanding unfamiliar instructions or coping with uncertainty.
“At chairside, behavioral challenges in ASD and other NDD profiles are often triggered by predictable aspects of dental care. These include bright lights, sounds from suction or handpieces, unfamiliar smells, physical proximity, and intraoral touch. Difficulties in understanding unfamiliar instructions or coping with uncertainty can further increase distress.1–3”
From Adapting the Chairside: Pediatric Dental Management for Children with Neurodevelopmental Disorders – A Scoping Review (2026) · cites this paper as [1]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredThis review provides a systematic overview of recent chairside approach clusters, highlights measurement gaps, and identifies priorities for future work.
“Nevertheless, this review provides a systematic overview of recent chairside approach clusters, highlights measurement gaps, and identifies priorities for future work.1–5,7”
From Adapting the Chairside: Pediatric Dental Management for Children with Neurodevelopmental Disorders – A Scoping Review (2026) · cites this paper as [1]
The Introduction notes that evidence on psychological techniques for dental care in autistic children is scarce, often with small samples and no control group; the Discussion describes several behavioral approaches. But the Methods and Results present a quasi-experimental intervention study, not a systematic overview of chairside approach clusters. Its clustering concerns patients’ visits and behavior, and the passages do not establish the claimed overview or a set of future-work priorities. (LLM, conf=0.78)
Experimental — accuracy not yet measured
For children with high avoidance or low tolerance, structured preparation through graded exposure or desensitization combined with modeling may improve tolerance of examinations and preventive care over repeated visits.
“Second, for children with high avoidance or low tolerance, structured preparation through graded exposure or desensitization combined with modeling may improve tolerance of examinations and preventive care over repeated visits.1,4,7”
From Adapting the Chairside: Pediatric Dental Management for Children with Neurodevelopmental Disorders – A Scoping Review (2026) · cites this paper as [1]
The Methods (§2.2) describe repeated, individualized visits that gradually introduced the dental setting, instruments, examinations, and oral hygiene. The Discussion (§4) reports improved collaboration with examinations and hygiene and mentions desensitization, imitation, and video modeling. It does not establish that desensitization combined with modeling produced those improvements specifically in children with high avoidance or low tolerance; some children remained unable to receive treatment without general anesthesia. Page numbers are unavailable in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPreparation-focused strategies such as systematic desensitization, modeling, and stepwise rehearsal are frequently described as practical methods to increase acceptance of dental examinations and procedures.
“Preparation-focused strategies, such as systematic desensitization, modeling, and stepwise rehearsal, are frequently described as practical methods to increase acceptance of dental examinations and procedures.1,2”
From Adapting the Chairside: Pediatric Dental Management for Children with Neurodevelopmental Disorders – A Scoping Review (2026) · cites this paper as [1]
Repeated positive exposure with consistent structure may decrease the need for advanced management and improve access to routine preventive and restorative care.
“Repeated positive exposure with consistent structure may decrease the need for advanced management and improve access to routine preventive and restorative care.1”
From Adapting the Chairside: Pediatric Dental Management for Children with Neurodevelopmental Disorders – A Scoping Review (2026) · cites this paper as [1]
Pastore et al assessed a person-directed behavioral support pathway that included visual prompts, caregiver education, longer sessions, and intensive follow-up.
“Pastore et al assessed a person-directed behavioral support pathway that included visual prompts, caregiver education, longer sessions, and intensive follow-up.”
From Adapting the Chairside: Pediatric Dental Management for Children with Neurodevelopmental Disorders – A Scoping Review (2026) · cites this paper as [1]
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Self-citation
- Authors
- Pastore, I., Bedin, E., Marzari, G., Bassi, F., Gallo, C., & Mucignat-Caretta, C.
- Affiliations
- University of Padua (IT)
- Corresponding author
- Gallo, Claudio
- ORCID
- Bassi, Francesca
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2023-11-14
- Volume
- 14
- Pages
- 1272638-1272638
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC10682214
- OpenAlex
- W4388672012
- Cited by
- 19
- References
- 57
- Citations by year
- 2026: 11 · 2025: 5 · 2024: 3
- FWCI
- 5.35
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Padua Research Archive (University of Padova) (submittedVersion, cc-by)
- Topics
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Health Sciences › Dentistry › Oral Surgery › Dental Anxiety and Anesthesia Techniques
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- autism spectrum disorder, pediatric dental care, behavioral support, visual aids, caregiver education, general anesthesia avoidance, oral hygiene, dental anxiety, COVID-19 restrictions
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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