MANEJO DE USUÁRIOS AUTISTAS NO ATENDIMENTO ODONTOLÓGICO: UMA REVISÃO NARRATIVA DA LITERATURA
Data
2023
Autores
Orientador
Rados, Andreas Rucks Varvaki
Banca
Teixeira, Mauricio Fernando Nunes
Dhein, Gisele
Título do periódico
ISSN
Título do Volume
Editor
Resumo
O Transtorno do Espectro Autista (TEA) é definido como uma condição neuropsiquiátrica que engloba uma ampla variedade de distúrbios de socialização e desenvolvimento denominados Transtornos Invasivos do Desenvolvimento. Não tem cura, porém o correto manejo facilita a convivência dos autistas com essa condição. Estudos realizados nos últimos anos têm mostrado um aumento exponencial no número de pessoas com TEA, se mantendo a proporção de uma menina para cada dois meninos. A etiologia do autismo ainda não é plenamente conhecida, mas está fortemente relacionada com fatores genéticos e ambientais. As principais características clínicas do TEA são o prejuízo persistente na comunicação social recíproca e na interação social, além de padrões restritos e repetitivos de comportamento, interesses ou atividades. O TEA não manifesta nenhuma característica física ou anatômica anormal nos usuários acometidos. Dentre as principais características bucais, se pode citar grande presença de biofilme, alta prevalência da doença cárie, doenças do periodonto e mal oclusões. Secundariamente, podem estar presentes xerostomia e hipossalivação, e problemas de coagulação, devido ao uso de medicamentos. Segundo o Manual Diagnóstico e Estatístico de Transtornos Mentais DSM-5, o TEA pode ser subdividido em três graus, de acordo com o nível de autonomia que o indivíduo desenvolve. O diagnóstico só pode ser definido a partir dos dois anos de idade e se dá a partir da observação de características comportamentais. O Cirurgião-Dentista não está habilitado para diagnosticar o TEA, mas deve saber identificar os sinais, orientar a família e construir um plano de tratamento adequado. Para o diagnóstico de autismo, devem ser identificadas pelo menos três características dominantes, sendo duas sociais e ao menos uma de comunicação e/ou comportamental. Dentre as técnicas de manejo, estão o planejamento de atividades com a equipe multiprofissional e a família, na identificação de gatilhos e no condicionamento comportamental através da Análise do Comportamento Aplicada, organização adequada do ambiente do atendimento e a preservação de uma rotina. A metodologia escolhida foi a Revisão Narrativa de Literatura, com uma busca livre na literatura, em diversas plataformas, abrangendo estudos de 1943 até 2023, nos idiomas português e inglês. Além disso, os conhecimentos adquiridos sobre as técnicas de manejo de usuários com TEA foram aplicados na rotina clínica do especialista responsável por esses usuários, que atua no CEO do município (Lajeado-RS) e observados pelo estudante. Concluiu-se que ainda são poucos os estudos do TEA voltados para Odontologia, porém o crescente número de diagnósticos de TEA reforça a importância do profissional estar preparado para o atendimento desses usuários. Mesmo não sendo tão específicas em questões odontológicas, a Psicologia e a Psiquiatria fornecem informações importantes para o Cirurgião-Dentista. A observação da aplicação das técnicas junto ao profissional que atende usuários com TEA no município foi de grande importância, pois vislumbra grande potencial de eficácia nos atendimentos, mesmo que não se tenha observado em procedimentos mais invasivos. Por isso, a realização deste trabalho trouxe grande crescimento pessoal e profissional.
Autism is defined as a neuropsychiatric condition envolving a wide range of developmental and socialization disorders collectively referred to as Pervasive Developmental Disorders. It has no cure, but proper management facilitates the daily routine. Diagnosis can only be made by the second year of age and is based on the observation of behavioral characteristics. Dentists are not qualified to diagnose autism, but they should be able to identify signs, provide guidance to families, and develop an appropriate treatment plan. Recent studies have shown an exponential increase in the prevalence of individuals with autism, maintaining a ratio of one girl for every two boys. The etiology of autism is not fully understood, but it is strongly related to genetic and environmental factors. The primary clinical features of autism include persistent impairment in reciprocal social communication and social interaction, as well as restricted and repetitive patterns of behavior, interests, or activities. Autists do not exhibit any abnormal physical or anatomical characteristics. Among the main oral characteristics are a high rate of biofilm, a high prevalence of dental caries, periodontal diseases, and malocclusions. Xerostomia, hyposalivation as well as coagulation problems may be present due to medication use. According to DSM-5, Autism can be subdivided into three levels, based on the level of autonomy the individual develops. For a conclusive diagnosis, at least three dominant characteristics must be identified, including two social features and at least one communication and/or behavioral feature. Management techniques involve planning activities with a multidisciplinary team and the family, identifying triggers, and utilizing Applied Behavior Analysis for behavioral conditioning, proper organization of the treatment environment, and maintaining a routine. The chosen methodology was Narrative Literature Review, involving a comprehensive search across various platforms for studies from 1943 to 2023, in both Portuguese and English languages. Furthermore, the knowledge acquired about management techniques for users with ASD was applied in the clinical routine of the specialist responsible for these users, who works at the municipality's CEO (Lajeado-RS) and observed by the student. It was concluded that there are still very few autism studies focusing on dentistry. However, the increasing number of autism diagnoses underscores the importance of dental professionals being prepared to provide care to these individuals. Even though not highly specialized, insights from psychology and psychiatry are valuable for dentists. Observing the application of these techniques in clinical settings with professionals who treat individuals with ASD in the municipality was of great importance, as it suggests significant potential for the effectiveness of these interventions, even if not observed in more invasive procedures. Therefore, the completion of this work has brought about significant personal and professional growth.
Autism is defined as a neuropsychiatric condition envolving a wide range of developmental and socialization disorders collectively referred to as Pervasive Developmental Disorders. It has no cure, but proper management facilitates the daily routine. Diagnosis can only be made by the second year of age and is based on the observation of behavioral characteristics. Dentists are not qualified to diagnose autism, but they should be able to identify signs, provide guidance to families, and develop an appropriate treatment plan. Recent studies have shown an exponential increase in the prevalence of individuals with autism, maintaining a ratio of one girl for every two boys. The etiology of autism is not fully understood, but it is strongly related to genetic and environmental factors. The primary clinical features of autism include persistent impairment in reciprocal social communication and social interaction, as well as restricted and repetitive patterns of behavior, interests, or activities. Autists do not exhibit any abnormal physical or anatomical characteristics. Among the main oral characteristics are a high rate of biofilm, a high prevalence of dental caries, periodontal diseases, and malocclusions. Xerostomia, hyposalivation as well as coagulation problems may be present due to medication use. According to DSM-5, Autism can be subdivided into three levels, based on the level of autonomy the individual develops. For a conclusive diagnosis, at least three dominant characteristics must be identified, including two social features and at least one communication and/or behavioral feature. Management techniques involve planning activities with a multidisciplinary team and the family, identifying triggers, and utilizing Applied Behavior Analysis for behavioral conditioning, proper organization of the treatment environment, and maintaining a routine. The chosen methodology was Narrative Literature Review, involving a comprehensive search across various platforms for studies from 1943 to 2023, in both Portuguese and English languages. Furthermore, the knowledge acquired about management techniques for users with ASD was applied in the clinical routine of the specialist responsible for these users, who works at the municipality's CEO (Lajeado-RS) and observed by the student. It was concluded that there are still very few autism studies focusing on dentistry. However, the increasing number of autism diagnoses underscores the importance of dental professionals being prepared to provide care to these individuals. Even though not highly specialized, insights from psychology and psychiatry are valuable for dentists. Observing the application of these techniques in clinical settings with professionals who treat individuals with ASD in the municipality was of great importance, as it suggests significant potential for the effectiveness of these interventions, even if not observed in more invasive procedures. Therefore, the completion of this work has brought about significant personal and professional growth.
Descrição
Palavras-chave
TRANSTORNO DO ESPECTRO AUTISTA; ODONTOLOGIA; MANEJO; AUTISM SPECTRUM DISORDER; DENTISTRY; MANAGEMENT
Citação
CASTOLDI, Silas Piccinini. MANEJO DE USUÁRIOS AUTISTAS NO ATENDIMENTO ODONTOLÓGICO: UMA REVISÃO NARRATIVA DA LITERATURA. 2023. Monografia (Graduação em Odontologia) – Universidade do Vale do Taquari - Univates, Lajeado, 14 nov. 2023. Disponível em: http://hdl.handle.net/10737/4001.