UK-based specialist dental professionals' experiences of working with autistic patients.

AIMS: Previous research has demonstrated that autistic individuals often experience difficulties accessing dental care, both as a result of autism specific difficulties and practitioners' attitudes towards autism. However, very little research exists that explores dental professionals' experiences of providing care to their autistic patients. The aim of this study was to investigate the strategies UK-based dental professionals' use when working with autistic patients METHODS AND RESULTS: In this study, dental professionals (n = 16) from a variety of specialty roles (special care, paediatrics, orthodontics) were interviewed. We asked participants to talk through, in depth, specific cases they had encountered in their practice, what sorts of accommodations they had provided, and what concerns had arisen during appointments. Thematic analysis was used to analyses the data and revealed four main themes: the unique dental needs associated with being autistic, effective adaptations to practice, the crucial role of the caregiver, and the importance of specialist knowledge CONCLUSION: Recommendations for how dentists can improve the dental experiences of autistic patients can be drawn from the specialist dentists' responses in this study. These include involving autistic patients in decisions about their treatment and being flexible and willing to work with autistic patients and their caregivers.

Considerations in the management of trans patients.

It is essential to raise awareness of the health and social needs of trans individuals. This article presents the barriers that trans people may encounter when accessing healthcare services and offers practical recommendations on how holistic care may be achieved.

Dental experiences of a group of autistic adults based in the United Kingdom.

AIMS: Previous international research has shown that autistic people have difficulty accessing dental care due to sensory processing, anxiety and communication issues. However, it is not known whether autistic adults in the United Kingdom are experiencing similar dental care barriers. The current study investigated autistic adults' dental experiences in the United Kingdom. METHODS AND RESULTS: A mixed methods survey was given to self-selecting autistic (n = 37) and non-autistic adults (n = 43) to compare whether autistic individuals had more negative experiences than non-autistic individuals. Closed questions asked about anxiety, patient-practitioner communication, satisfaction and the dental environment. Open questions asked about autism-specific dental challenges, what works well at the dentist, and improving autistic individuals' experiences. Responses were analyzed using thematic analysis. Overall, results demonstrated that autistic adults in the United Kingdom have more negative dental experiences than non-autistic adults. These predominantly related to interactions with dental practitioners, a challenging sensory environment, anxiety, pain, and disclosure. Participants recommended sensory environment adaptations, ways to increase preparedness, longer appointments, and individual accommodations. CONCLUSION: This study offers best-practice strategies for working with autistic patients and highlights the importance of dentists working with autistic individuals to maximize the quality of care and outcomes for this underserved population.

UK dental professionals' knowledge, experience and confidence when treating patients on the autism spectrum.

Background Over 1% of the UK population have a diagnosis of autism, and yet there is minimal information regarding the experiences of dental professionals working with people on the autistic spectrum. The current study is the first to investigate UK dental professionals' knowledge of autism, their perceived confidence when treating autistic patients, and the factors that affect this.Methods An online, self-report survey was completed by 482 UK dental professionals and included questions on participants' training, prior experiences and knowledge of autism, and confidence when treating autistic patients.Results Over half the respondents reported having no formal autism training but average knowledge levels across the whole sample were good. Conversely, levels of confidence were only moderate. Respondents often cited conflict between understanding the additional needs for successful treatment of autistic patients and a lack of resources to implement support strategies. Despite this, the vast majority were positive about making the necessary modifications to support autistic patients.Conclusion This study highlights ways in which UK dental professionals adapt their practices to meet the needs of their autistic patients, yet report only moderate confidence levels when doing so. Implications for future training initiatives are discussed.

Bisphosphonate-related osteonecrosis of the jaws and its relevance to children--a review.

Bisphosphonate-related osteonecrosis of the jaws (BRONJ) has been detailed extensively in adults, but to date, there have been no similar cases in children. Members of the dental team may treat children prescribed bisphosphonate therapy often for management of osteogenesis imperfecta (OI). There is uncertainty as to how best treat this patient group. This review explores the background of bisphosphonates, indications for their prescription in children, adverse effects with special emphasis on BRONJ, and protocols available to guide dental management.

Severe periodontal destruction in alpha-mannosidosis: a case series.

Alpha-mannosidosis is a rare genetic lysosomal storage disorder that is inherited in an autosomal recessive pattern. Severe periodontal breakdown in alpha-mannosidosis patients has not previously been reported in the literature. The purposes of this paper are to: present the cases of 2 siblings diagnosed with alpha-mannosidosis, each of whom had varying severity of periodontal destruction; and provide an overview of alpha-mannosidosis, the possible reasons for the periodontal destruction, and the periodontal management in the 2 affected siblings. Both had preventive and nonsurgical periodontal therapy followed by a 5-year period of supportive therapy. Their pattern of bone loss was consistent with those with periodontitis as a manifestation of systemic diseases, with the extent of periodontal destruction being related to the severity of the alpha-mannosidosis. Alpha-mannosidosis patients present with social disfigurements and, to prevent tooth loss that can add to this, early periodontal diagnosis is important to optimize management and intervention.

Case of idiopathic loss of deciduous teeth and associated alveolus.

We describe exfoliation of the lower left deciduous canine and deciduous first molar (CD) and associated alveolus of unknown cause in a 5-year-old healthy boy. Extraction of the teeth and removal of local bone led to healing without complication.

Multiple crown-root fractures in primary molars and a suspected subcondylar fracture following trauma: a report of a case.

Dental trauma is common and often more than one injury is found. Injuries to the primary dentition are usually luxations and mandibular fractures rarely occur. With trauma sustained to the chin, the posterior primary teeth are at increased risk of trauma and mandibular fractures can occur. The case discussed is of a 4-year-old female who presented 2 weeks following dental trauma with multiple primary molar fractures and a possible subcondylar fracture. The need for a detailed examination is emphasized and the management of the case under general anaesthesia is described.