Controversial issues in treating the dental patient with autism.

BACKGROUND

The author conducted a literature review to investigate concerns that parents of a child with an autism spectrum disorder may have when oral health care is provided to the child.

TYPES OF STUDIES REVIEWED

The author conducted a search of PubMed using the terms "mercury," "fluoride," "nitrous oxide," "antibiotics," "gluten," "casein," "acetaminophen" and "dentistry" each with the term "autism." He identified controlled studies and literature reviews in both medical and alternative medical literature that were related to areas of importance to oral health care workers. The use of mercury, fluoride, nitrous oxide, antibiotic agents and acetaminophen all are sources of controversy between dentistry and the parents of children who have autism.

RESULTS

The author found that patients who have autism frequently also have allergies, immune system problems, gastrointestinal disturbances and seizures. Dental health care workers must be aware of these comorbid conditions so they can provide optimal care to the children with autism spectrum disorders. The author found two distinct theories as to what causes autism: one that focuses on genetic causes, and one that focuses on the impact of the environment. He found that the interpretation of these theories might affect parents' concerns about various dental treatments.

CLINICAL IMPLICATIONS

Dentists treating patients who have autism may need to provide more than standard patient care, as the use of time-tested dental treatment and prevention modalities may be questioned or refused by parents.