Dental Treatment of the Autistic Patient: Utilization and Predictors of General Anesthesia

Objectives: Limited information currently exists on the patterns of dental treatment for patients with autistic spectrum disorder (ASD). The purpose of this study is to determine the frequency of dental treatment under general anesthesia (GA), possible predictors of such use, and the frequency of repeat GA sessions.
Methods: The non-archived electronic records and paper charts at the dental department of Franciscan Hospital for Children in Boston, Massachusetts was searched for active patients with a diagnosis of autism spectrum disorder (ASD) between 01/01/2009 and 03/31/2014. Exclusion criteria included incomplete records and patient age above 21 years of age at initial examination. A first analysis on a sample of 200 patients is reported here.
Results: Twenty-seven patients did not meet the inclusion criteria. Among the eligible ASD patients, the male: female ratio was 5:1. Along their ASD diagnosis, 61% of patients had a diagnosis of at least one additional condition. More than half of the ASD patients (58.4%) received dental treatment under GA. The most common reason for referral was the need for diagnostic, preventive and restorative services (53.5%), followed by restorative and exodontia services (excluding third molars) in 26.7% of the ASD patients. A second re-admission to the operating room occurred in 17.9% of the patients and a third re-admission occurred in 6.9% of the ASD patients. The most common reason for referral for the second and third visits was the need for restorative and prophylaxis services. The average number of years elapsed between GA was 3.3 years between the first and second visit, and 2.8 years between the second and third visit.
Conclusions: Our analysis to date indicates that patients with ASD are commonly referred for dental treatment under GA for invasive dental procedures; referrals for repeat GA sessions occur approximately every three years.