KUCHING: Today is World Autism Awareness Day, a reminder of the importance of celebrating neurodiversity and creating welcoming environments in dental care for autistic individuals.
In connection with this, dental lecturers at the Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Dr. Nurul Aliaa Ahmad Fauzi and Dr. Jessica Francis, have discussed the topic of ‘Can Autism Spectrum Disorder (ASD) Children Wear Braces?’
Dr. Nurul and Dr. Jessica explained that since ASD manifests in various ways, likely with no single cause, it also means there is no one-size-fits-all treatment, including orthodontic care.
“As more people understand ASD, it is likely more will seek braces treatment if they desire it. However, the ideal approach to braces won’t be the same for everyone on the spectrum,” they said in a statement.
They also noted that autistic individuals may need braces for the same reasons as others – to correct misaligned teeth or jaws.
“Patients on the autism spectrum face unique challenges during orthodontic treatment. Sensory sensitivities can make the dental environment overwhelming, with bright lights, the whirring of drills, unfamiliar antiseptic smells, and the taste of dental materials potentially contributing to sensory overload.
“This overload can make it difficult for patients to relax and cooperate during procedures.
“Additionally, the constant presence of braces can introduce new sensory challenges, such as the feel of metal against the lips and tongue, the pressure of adjustments, and potential irritation from the braces,” it explained.
Dr. Nurul and Dr. Jessica said that social communication challenges could arise, as some individuals with ASD may struggle to understand complex dental instructions or express discomfort or anxiety verbally.
“Motor skills vary greatly among autistic individuals. While some might have good coordination and dexterity, others might struggle with the fine motor skills needed for orthodontic care.
“These skills are crucial for tasks like using orthodontic elastics, inserting and removing retainers, and maintaining proper oral hygiene. This variation can make it harder for some autistic patients to learn and perform these tasks effectively,” it added.
Despite these challenges, autism itself does not disqualify someone from receiving braces treatment.
“Creating a comfortable and predictable environment can make a significant difference. Dental professionals can achieve this by using calm communication styles, clear and concise language, and allowing ample time for processing information.
“Offering headphones with chosen music can minimise loud noises, while providing sunglasses can help reduce discomfort from bright lights.
“Scheduling appointments during non-peak hours can minimise stress by reducing crowds and waiting times.
“Regular check-ups are essential to monitor progress and address any concerns throughout the treatment journey,” it advised.
Compared to the past, Dr. Nurul and Dr. Jessica noted that many dental professionals now use digital oral scanners, which are handheld cameras that take quick pictures of the teeth, creating a 3D model on the computer, making the process faster and more comfortable for patients with autism.
“Treatment aims can be modified, and options tailored to individual needs. Removable braces or clear aligners might be better alternatives for some patients with sensory sensitivities compared to traditional fixed braces.
“These options can minimise discomfort by eliminating hardware placement, simplifying oral hygiene, and reducing irritation to the gums and mouth,” it said.
To ensure optimal care, integrating orthodontic assessments into routine check-ups for early identification of dental issues is possible.
“Collaboration among the orthodontist, special care dentist, patient, and caregiver is crucial. This team approach allows for a personalized treatment plan that addresses physical limitations, communication needs, and the overall well-being of the autistic patient,” it highlighted.
Unfortunately, Dr. Nurul and Dr. Jessica explained that braces are not just a short-term commitment; retainers are typically required after braces treatment for long-term wear, often for life, to maintain the new smile.
“This introduces a new responsibility for the autistic individual to manage their oral hygiene routines and faithfully wear their retainers as instructed.
“Consistent retainer use is crucial to prevent teeth from shifting back to their original positions after the hard work of braces.
“Therefore, it is understandable why some parents with autistic children might wait until their children are older to consider braces,” it said.
This waiting period allows time for the children to develop the necessary maturity and motor skills to properly care for their teeth throughout treatment and beyond, especially regarding consistent retainer use.
