Mayes SD, Zickgraf H Atypical eating behaviours in children and adolescents with autism, ADHD, other disorders, and typical development. Res Autism Spectrum Disorders. 2019; 64:76-83 https://doi.org/10.1016/j.rasd.2019.04.002
Specialty Doctor in Oral and Maxillofacial Surgery, Oral and Maxillofacial Surgery Department, Princess Alexandra Wing, Kingston Hospital, Surrey, KT2 7QB, UK
Many children struggle or refuse to take oral medications. The refusal of medication occurs for many reasons including learned and pre-existing anxiety, sensitivity to tastes and textures and sensory–motor/coordination difficulties (for tablet swallowing). Oral analgesics play a vital role in managing the odontogenic pain of children. This is especially true when they have limited access to appropriate dental care services, are pre-cooperative or lack the ability to be compliant for conventional dental treatment.
CPD/Clinical Relevance:
Practical advice around the facilitation of analgesic administration for odontogenic pain is lacking for parents of children who may not accept conventional preparations.
Article
Children with special needs (e.g. autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD)), may find taking analgesics challenging. Studies indicate that up to 62% of children with ASD display atypical eating behaviours and food selectivity.1 Preference for bland or beige food and limited food textures, may mean some cannot tolerate the fruity taste and gritty texture of age-appropriate analgesic solutions. Oro-sensory aversions can also develop in response to some medical conditions (e.g. gastro-oesophageal reflux, dysphasia) and trauma (e.g. choking, force feeding).
Many of these children will require referral for specialist input and access to sedation and/or general anaesthesia for their definitive dental treatment, for which there may be a significant wait. Furthermore, lack of chairside compliance may not allow for temporization/stabilization measures to be employed to ease symptoms in the interim.
Unmanaged long-standing and recurrent episodes of dental pain can cause dental anxiety and avoidance behaviours, with subsequent deterioration of the untreated dental problem.2 Therefore, the need for effective home administered odontogenic pain relief is paramount in this group of patients.
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