Children with autism spectrum disorder (ASD) face substantial barriers to dental care because of heightened anxiety, sensory sensitivity, and communication challenges. A French clinical study showed that introducing animal-assisted therapy (AAT), particularly in trained dogs, during early dental visits may reduce anxiety, improve cooperation, and support the transition to standard care, with effects that persist after the intervention.

Dog Assisted

Children with ASD often experience difficulties during dental visits because of sensory overload, communication barriers, and anxiety. These factors can compromise patient care and clinical outcomes.

To ease treatment, clinicians use behavioral strategies such as hypnosis, positive reinforcement to reward appropriate behavior, modeling to encourage imitation, and demystification to explain procedures and reduce fear.

AAT, particularly with dogs, offers an additional approach to support dental care in children with ASD by reducing anxiety during treatment.

Violaine Smail-Faugeron, DDS, PhD, one of the study authors, speaking with Medscape’s French edition, noted that researchers evaluated whether AAT, introduced during two dental sessions in children with ASD who had difficulty cooperating, could support transition to conventional dental care without the dog by reducing anxiety.

The study was conducted in collaboration with the Service de Médecine bucco-dentaire of Hôpital Bretonneau (AP-HP), the Unité de Recherche Clinique of Hôpitaux Necker-Enfants malades and Cochin–Port-Royal (AP-HP), Université Paris Cité, and Institut National de la Santé et de la Recherche Médicale (Inserm), Paris, France.

The researchers enrolled 49 children with ASD aged 6-16 years, all of whom had high anxiety scores. Participants were randomly assigned to either a control group (n = 23) that received standard psychobehavioral approaches without a therapy dog or an experimental group (n = 26) that received the same approaches with exposure to a therapy dog, Pookie, during the first two dental care sessions, from the waiting room through the completion of treatment.

All participants underwent three dental care sessions, with the third session conducted without the therapy dog.

Dental procedures included scaling and tooth extraction but excluded those requiring an operating room.

"The therapy dog served as an in vivo model and positive reinforcer, with clinicians first demonstrating procedures on the animal before performing them on the child. It also provided distraction and sensory mediation, particularly through petting," said Smail-Faugeron.

Anxiety Reduction

The mean anxiety scores were lower in the experimental group in the third session, indicating that AAT may help children adapt to dental care and facilitate their transition to conventional sessions without animals.

"Because of its calming presence, which helped reduce stress, the animal led to a reduction in anxiety in the children even when the animal was no longer present," said Smail Faugeron.

"The impact was so beneficial that some parents decided to adopt a pet because of its therapeutic benefits," she added.

The dogs involved in the study were specially trained in preparatory work conducted by an animal-assisted therapist to adapt to the dental environment. Hospital staff also reported reduced stress in the presence of therapy dogs.

Based on these findings, the Île-de-France Regional Health Agency funded the continuation of the program, allowing Pookie to remain in the oral medicine department at Hôpital Bretonneau, AP-HP. Smail-Faugeron said that future research may extend this approach to children without disabilities who experience increased anxiety during dental care.

This story was translated from Medscape’s French edition.