Challenges and solutions in managing dental problems in children with autism

Table 4 Summary of studies on modified dental tools and techniques for managing dental disorders in children with autism spectrum disorder using the PICO framework

Ref.	Population	Intervention	Comparison	Outcome	Study design	Key findings	Study quality rating
Dangulavanich et al[31], 2017	Children with ASD (n = 95)	Evaluated cooperation during dental treatment based on sensory processing factors and behavioral characteristics	None	Age, education, behavior before treatment significantly influenced cooperation	Cross-sectional study	Older children (11–18 years) and those in special education showed better cooperation	Moderate quality
Narzisi et al[32], 2020	Children with ASD (n = 59)	ICT-based intervention (MyDentist) to familiarize children with dental settings	Conventional dental visits	Improved oral hygiene and cooperation during treatment	Feasibility study	ICT interventions can enhance dental care acceptance without pharmacological interventions	Moderate quality
Octavia et al[33], 2025	Children with ASD (n = 37)	Structured-visual behavioral model for compliance and cooperation	Standard dental approach	Improved cooperation and compliance during dental exams	Quasi-experimental study	75% achieved the highest cooperation scores on the Frankl Behavior Scale (FBS)	Moderate quality
Mah and Tsang[34], 2016	Children with ASD (n = 14)	Visual schedule system for dental visits	Tell-show-do method	Faster task completion and lower behavioral distress	RCT	Visual schedules improved dental visit success rates	High quality
Isong et al[35], 2014	Children with ASD (n = 80)	Electronic screen media to reduce dental anxiety	No media intervention	Decreased anxiety and improved behavior during dental visits	RCT	Video peer modeling and video goggles reduced fear and increased cooperation	High quality
Cenzon et al[36], 2022	Dental hygiene students	SVT for ASD patient management	No SVT training	Improved confidence and knowledge in treating ASD patients	Pilot study	Virtual training enhances ASD dental care preparedness	Moderate quality
Thomas et al[37], 2018	Parents of children with ASD (n = 17)	Parental experiences with dental care access and needs	None	Identified need for flexible dental environments and better communication	Qualitative study	Family-centered care and dentist-parent communication are crucial	Moderate quality
Wibisono et al[38], 2016	Children with ASD & caretakers	Use of dental visit pictures as communication tools	None	Positive perception of visual aids for dental preparation	Qualitative study	Pictures enhanced understanding of dental visits among ASD children	Moderate quality
Cagetti et al[39], 2015	Children with ASD (n = 83)	Visual supports-based dental care protocol	Standard dental care	Increased acceptance of dental procedures	Observational study	Non-verbal children benefitted from visual training	Moderate quality
Naidoo and Singh[40], 2020	Children with ASD	Dental communication board for improved communication	No communication board	Enhanced interaction between children and dentists	Mixed-methods study	Visual communication tools facilitated dental visits	Moderate quality
Nilchian et al[41], 2017	Children with ASD (n = 6-12 years)	Visual pedagogy for dental check-ups	Standard approach	Increased compliance with dental check-ups	RCT	Visual pedagogy improved cooperation in dental visits	High quality

ASD: Autism spectrum disorder; ICT: Information and communication technologies; RCT: Randomized controlled trial; SVT: Simulated-virtual training.