124 Volume 7 • Issue 2 April / June 2017 • Pediatric dentistry PROVIDING DENTAL CARE FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS Diana MURARU 1 , Tudor CIUHODARU 2 , Magdalena IORGA 3 1 Psychologist, PhD, Dept. Behavioral Sciences, „Grigore T. Popa” University of Medicine and Pharmacy, Iaşi, Romania 2 Associated Professor, PhD, MD, „Apollonia” University of Iaşi, Romania 3 Lecturer, PhD, Dept. Behavioral Sciences, „Grigore T. Popa” University of Medicine and Pharmacy, Iaşi, Romania Corresponding author: Tudor Ciuhodaru; e-mail: tudorciuhodaru@yahoo.co.uk Abstract Given the increasing prevalence of autism spectrum disorders, it is realistic to assume that dental professionals are likely to treat individuals with this diagnosis. Understanding the complexities of this disorder and its behavioral manifestations is indispensable for dentists. The present article presents several characteristics of autism spectrum disorder that impact dental interventions, along with medical and behavioral alternatives to better manage the dental problems of children with autism spectrum disorder. A multidisciplinary approach and family support are important for planning a dental intervention for these patients in order to avoid anxiety. Knowledge on autism, the dentist-patient relationship and the individual preparation for dental interventions is useful for constructing a controllable medical experience. Keywords: autism spectrum disorder, dental care, dental professionals. 1. INTRODUCTION Autism spectrum disorder (ASD) is a neuro developmental disorder that affects lifelong living. The signs can be seen in early infancy, but there are also children who develop normally during the frst 1-2 years of life and lose their verbal and social skills afterwards. Autism spectrum disorders include a wide range of disorders - like autism, Asperger’s syndrome, childhood disintegrative disorder and pervasive developmental disorder not otherwise specifed [1,2]. Diagnosis of autism spectrum disorder is based on two main criteria: (a) persistent defcits in social communication and interaction, (b) restricted, repetitive patterns of behavior, interests, or activities [3]. Both genetic and environmental factors appear as causes for ASD: • the pathophysiology identifed mitochondrial defects, cytosine disregulation, high maternally-derived intrauterine androgen concentrations [4], • boys are 4 times more likely to develop this disorder compared to girls (4.6: 1), • families with an older child suffering from ASD face an increased risk of developing this disorder. Verbal delay, the lack of social interaction skills or emotional disturbances frequently occur among family members or relatives, • comorbidities, • extremely preterm babies, • older ages of parents. The characteristics of ASD are different and diverse. Autistic children show delayed or inexistent verbal skills, diffculty in developing social relationships, infexible adherence to rituals, mental retardation, repetitive movements; they develop daily routine activities and are resistant to changes. 2. ORAL HEALTH-RELATED PROBLEMS IN AUTISTIC CHILDREN Oral health–related problems in autistic children are due to several causes: • harmful behavioral problems (bruxism or tongue thrusting, lip biting), • dental problems (anterior open bite and dental crowding),