Trauma will be very common in patients with ASD as they do not have an accurate sense of danger and have a very high pain tolerance. Unusual patterns of wear or unexplained trauma may be due to PICA when the child chews on non-food items like wood or rocks. In addition, the individual may not think to show their parents/caregivers they have been hurt (Figure 13). As dental professionals, we must pay careful attention and be an advocate for those we feel are being abused. This can be extremely difficult with persons with ASD because despite the best efforts of loving parents/caregivers individuals with autism are prone to wandering, and high levels of activity throughout the day that make it much more probable for accidents to occur and for them to occur more than once. Please consider individuals with autism are also “easy” targets for abuse as they may not fight back, and may not have the ability to communicate their needs. It can be a very difficult situation for dental professionals and imperative both scenarios are weighed carefully. Click here for an interactive guide to dental trauma.

Figure 13. Trauma to teeth.