Abstract
This study investigated the adaptation of autistic children and young adults to dental treatment and evaluated the changes in their cooperation with dental treatment. The subjects were 17 autistic patients ranging from 16 to 27 years old, who commuted to a welfare institution in Niigata City.
The subjects were first tested by the Language Decoding Test-Revised (LDT-R) to evaluate Ohta's Stage which is an index of the cognitive developmental stage of autistic patients. The subjects then underwent dental treatment with an ultrasonic scaler to remove dental calculus following the standard procedures at our dental hospital. After 6 months, each subject underwent the next scaling procedure by the same dentist under the same conditions. Their attitude and behavior during the first and second procedures were monitored and recorded on videotapes. The adaptability of the subjects to dental treatment was estimated using the videotapes and differences in their adaptability were compared between the first and the second treatments.
To determine the relationship among factors related to the adaptation of the autistic population to dental treatment, multivariate analysis was performed.
The results were as follows:
1. Each subject was tested with LDT-R three times in different situations. The first test was performed in the welfare facilities. The second test and the last test were performed in our clinic. In the last test, the subjects were tested in our clinic but by a different examiner who was guided by the LDT-R outline. Ohta's stages in these subjects on the first test agreed with findings at the second test in 88.2% of the subjects, and agreed with those at the last test in 70.6% of the sujects.
2. Non of the subjects had ever been treated in a clinic before. Though ten subjects (58.8%) allowed treatment with the ultrasonic scaler until the end the session, five subjects (29.4%) left the dental chair during the course of treatment. The other two subjects (11.8%) could not be treated at all.
3. Five subjects (29.4%) adapted to treatment well enough in the first session, and 8 subjects (47.1%) showed improved adaptation for the treatment six months later. The remaining four subjects (23.5%) were not able to improve their behavior. None of the subjects showed a worse adaptation to dental treatment during the second visit.
4. Multivariate analysis proved that the following three factors were significantly related to the adaptability of the autistic population to dental treatment; age, Ohta's Stage (cognitive developmental stage) and the drugs being given to the subjects. Experience with dental treatments and IQ had however little relation to adaptation.
