Multidisciplinary dental management of autism spectrum disorder in Primary Health Care: clinical-sociocultural approach.
Manejo odontológico multidisciplinario del trastorno del espectro autista en Atención Primaria en Salud: enfoque clínico-sociocultural
| dc.contributor | en-US | |
| dc.contributor | es-ES | |
| dc.creator | Quintana Mallea, Benjamín | |
| dc.creator | Cofré Rivera, Valeria | |
| dc.date | 2021-01-18 | |
| dc.date.accessioned | 2021-04-16T03:03:15Z | |
| dc.date.available | 2021-04-16T03:03:15Z | |
| dc.identifier | https://revistas.uv.cl/index.php/asid/article/view/2653 | |
| dc.identifier.uri | https://revistaschilenas.uchile.cl/handle/2250/165596 | |
| dc.description | Background: Autism spectrum disorder (ASD) is a neurological disorder characterized by problems in socialization, communication, and repetitive and stereotyped behaviors, with an increasing incidence. In regard to oral health, these patients present multiple access barriers, greater susceptibility to oral pathologies, and usually require specialized clinical management. Difficulties in accessing preventive services in primary care (PHC) usually bind their treatment to secondary care, where social determinants of health (DSS), including immigration status and socioeconomic status, play a fundamental role. Clinical Presentation: 9-year-old male migrant patient, diagnosed ASD, potentially cooperative, goes to Posta Rural de San Miguel de Azapa consulting for dental care after failed care in other services. On clinical examination, multiple caries lesions, gingivitis, and residual roots are present. Comprehensive dental treatment was planned with previous desensitization appointments and adaptation to cross-sectional care, along with personalized education with visual pedagogy techniques, and coordinated interconsultations with psychology-nutritionist-medicine. Clinical relevance: Recent literature describes that ASD alone does not increase predisposition to oral pathologies, but there are associated factors that increase its risk1. Poor oral hygiene, a higher prevalence of periodontal disease, 2 prevalences of caries with dissimilar results, self-injuries, and aversive responses to dental care have been described. In addition, bidirectionality between ASD severity and oral dysbiosis is also postulated4. Regarding clinical management, short appointments are recommended, strategically scheduled, applying individualized behavioral techniques supported by visual pedagogy and multidisciplinary treatment5-6. On the other hand, it is important to recognize migration as a DSS, therefore, the associated access barriers must be reduced and the concept of the migrant's right to health and interculturality must be understood7. Other demographic-systemic barriers are the high costs associated with care and the lack of health insurance, also suggesting that ethnicity, socioeconomic status, and immigration status affect oral health8-9. It is imperative to create a therapeutic alliance between family members and the health team, applying preventive measures to avoid future dental decay, so PHC is essential to provide patient-centered care under the principles of the biopsychosocial model10. Conclusion: Dentists must be trained for the multidisciplinary dental treatment that ASD patients require, thus, being able to eliminate associated access barriers, analyzing the DSS involved under a biopsychosocial approach, and emphasizing the importance of PHC, applying preventive protocols and hence improving the quality of life from the patients. | en-US |
| dc.description | Antecedentes: El trastorno del espectro autista (TEA) es un desorden neurológico caracterizado por problemas en la sociabilización, comunicación y comportamientos repetitivos y estereotipados. Presenta múltiples barreras de acceso, mayor susceptibilidad a patologías orales y usualmente un manejo clínico especializado. Las dificultades para acceder a servicios preventivos en atención primaria (APS) restringen su tratamiento a atención secundaria, donde los determinantes sociales en salud (DSS), incluyendo el estado migratorio y situación socioeconómica, cobran un rol fundamental. Presentación Clínica: Paciente migrante sexo masculino, 9 años, TEA, potencialmente cooperador, consulta por atención odontológica tras atenciones fallidas en otros servicios. Al examen se presentan lesiones de caries, gingivitis, restos radiculares. Tratamiento integral con citas previas de desensibilización y adaptación, educación personalizada con técnicas de pedagogía visual e interconsultas coordinadas con psicología-nutrición-medicina. Relevancia Clínica: El TEA por si solo no aumenta la predisposición a patologías orales, pero hay factores asociados que aumentan su riesgo1. Se ha descrito una peor higiene oral, mayor prevalencia de enfermedad periodontal2, prevalencias de caries con resultados disímiles, autoinjurias y respuestas aversivas a la atención odontológica3. Se postula una bidireccionalidad entre la severidad del TEA y una disbiosis oral4. Se recomiendan citas cortas, programadas estratégicamente, con técnicas conductuales individualizadas con apoyo de pedagogía visual y tratamiento multidisciplinario5-6. Se reconoce la migración como un DSS por lo que se debe disminuir las barreras de acceso asociadas y entender el concepto del derecho a salud del migrante e interculturalidad7. Es imperativo una alianza terapéutica con familiares-equipo de salud con medidas preventivas evitando daño odontológico futuro, donde la APS es fundamental para otorgar una atención centrada en el paciente. Conclusión: Se debe capacitar para el tratamiento odontológico multidisciplinario de pacientes TEA eliminando barreras de acceso asociadas, analizando los DSS con enfoque biopsicosocial y enfatizando la importancia de la APS. | es-ES |
| dc.format | application/pdf | |
| dc.language | spa | |
| dc.publisher | Universidad de Valparaíso | es-ES |
| dc.relation | https://revistas.uv.cl/index.php/asid/article/view/2653/2585 | |
| dc.rights | Copyright (c) 2020 Applied Sciences in Dentistry | es-ES |
| dc.rights | http://creativecommons.org/licenses/by/4.0 | es-ES |
| dc.source | Applied Sciences in Dentistry; Vol. 1 (2020): Supl. 1 | en-US |
| dc.source | Applied Sciences in Dentistry; Vol. 1 (2020): Supl. 1 | es-ES |
| dc.source | 0719-5761 | |
| dc.source | 0719-5761 | |
| dc.subject | Autism Spectrum Disorder; Primary Health Care; Social Determinants of Health | en-US |
| dc.subject | Trastorno del Espectro Autista; Atención Primaria en Salud; Determinantes Sociales en Salud | es-ES |
| dc.title | Multidisciplinary dental management of autism spectrum disorder in Primary Health Care: clinical-sociocultural approach. | en-US |
| dc.title | Manejo odontológico multidisciplinario del trastorno del espectro autista en Atención Primaria en Salud: enfoque clínico-sociocultural | es-ES |
| dc.type | info:eu-repo/semantics/article | |
| dc.type | info:eu-repo/semantics/publishedVersion | |
| dc.type | en-US | |
| dc.type | es-ES |
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Applied Sciences in Dentistry
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