Protective Stabilization for Dental Management in a Child with Developmental Language Disorder: A Case Report

Children with Special Health Care Needs (SHCN) often present behavioral and developmental challenges, including Autism Spectrum Disorder (ASD), a neurodevelopmental condition characterized by deficits in social communication and restricted, repetitive patterns of behavior. ASD may also involve persistent difficulties in understanding and using spoken language, which can complicate oral health care. General Anesthesia (GA) is commonly used for full-mouth rehabilitation in uncooperative children with SHCN; however, parental concerns regarding safety, cost, or cultural beliefs may limit its acceptability. Protective Stabilization (PS), including the use of a papoose board, is a non-pharmacological alternative recommended by the American Academy of Pediatric Dentistry (AAPD). A 7-year-old boy with ASD and associated speech and language delay presented with recurrent discomfort during eating, frequent food impaction, and difficulty expressing pain. The family, who resided in Saudi Arabia, was visiting Indonesia and sought care at the Pediatric Dentistry Clinic, Universitas Padjadjaran Dental Hospital, Bandung. Although GA is commonly used for dental rehabilitation in Saudi Arabia, the parents declined this approach due to cultural and familial concerns regarding their child “falling asleep” during GA and provided consent for PS. Clinical findings included generalized calculus and reversible pulpitis involving multiple primary molars. No carious lesions with pulpal involvement were detected. This case illustrates the challenges of providing dental treatment for children with ASD, in whom communication barriers may hinder cooperation. PS enabled safe and effective dental care, resolving food impaction and improving oral comfort. The literature regarding PS use in children with ASD remains limited, highlighting the need for further clinical reports. PS provided a safe and effective alternative to GA in this child with Developmental Language Disorder (DLD), emphasizing the importance of individualized, family-centered, non-pharmacological approaches