Presentations 2020: Special Care

334 - Case Study: Providing patient-centred care for a patient with challenging behaviour

KE Mortiboy D Garcia Lucas
Presented by: Kate Mortiboy
Holywell Hospital

Introduction: Autism is a developmental disorder and covers a wide range of abilities and difficulties, however there are three areas of difficulty common in all patients; social skills, communication skills and ritualistic behaviours. This triad can make routine dental treatment difficult for them. Patient-centred care and a multidisciplinary approach are key with regards to treatment planning for such patients. Case Description: This case study discusses a 15 year old autistic male who is non-verbal and lives in a special school for children with complex additional needs. He presented for a routine examination with his support workers who reported no concerns. A limited exam revealed minor caries on his upper anteriors. There was no indication that the patient was in any pain. The patient’s limited co-operation was not sufficient to treat the patient under LA or sedation and as such, a best interests meeting with the patient’s family and school support staff was held to discuss whether to treat the patient under GA for minor decay or to monitor. After discussion of the risks and benefit it was agreed to treat rather than monitor as the patient has had outbursts of aggressive behaviour so we did not want to delay treatment as we did not know how the patient would react if he was in pain. This case report discusses all the treatment planning that had to be carried out in order to get the patient to have a successful general anaesthetic. Conclusion: Although communication and behavioural problems in children with autism can pose challenges for dentists, treatment with proper planning and a lot of patience can lead to successful outcomes for everybody involved.
Consent Statement: Written informed consent for publication of their clinical details and/or clinical images was obtained from the patient/parent/guardian. A copy of the consent form is available for review by the the meeting organisers..

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