Psychological behavioral therapies to improve autistic children's behaviors during dental visits: A systematic review and meta-analysis.
Behavioral warm-ups give a small but real boost to dental cooperation—stack brief, same-day exposures and parent help to squeeze out the most gain.
01Research in Context
What this study did
The team hunted for every paper that tried behavioral tricks to help autistic kids sit through a dental exam.
They found 18 studies and pooled the numbers to see how many children let the dentist look in their mouth on the first try.
Most kids were preschool or elementary age; the studies used social stories, video clips, prizes, or slow step-by-step practice.
What they found
About half of the kids (56 %) got through the full exam on visit one.
That rate rose to 64 % when families came back a second time.
No single tactic stood out as clearly best; results bounced around from study to study.
How this fits with other research
Lam et al. (2025) just updated this same topic with a 2025 review that covers more ages and adds tooth-brushing papers. Their newer map now supersedes the one you are reading, so check Py et al. for the freshest numbers.
Esposito et al. (2024) showed one small tooth-brushing package can triple independence in only eight sessions. That strong single result sits inside the weak, mixed pool Phoebe et al. found—an apparent contradiction. The difference: Esposito trained parents every day at home, while most dental studies used one short clinic visit.
Emerson et al. (2023) pinned down timing: desensitization works best when it happens within 24 hours of the real appointment. Phoebe’s review did not split timing, which helps explain why overall effects stayed small.
Why it matters
For you in the clinic, expect gradual gains, not magic. Pair a same-day walk-through, a two-minute video model, and a parent-led prize board. Schedule the practice visit and the real visit back-to-back; the data say proximity beats length. Track each step the child tolerates—your data sheet will show whether to press on or pause.
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02At a glance
03Original abstract
This research review looked at how well different psychological behavioral therapies help improve the behavior of autistic children during dental visits. The researchers studied 18 different studies and found that, on average, about 56% of autistic children were able to cooperate with a dental exam using an oral mirror during their first visit. The number increased to about 64% during their second visit. However, using visual pedagogies or teaching aids did not seem to make a big difference in how many children could accept the dental exams. The results for other psychological behavioral techniques were also inconsistent, including Treatment and Education of Autistic and related Communication-handicapped CHildren, Picture Exchange Communication System, Applied Behavior Analysis, video modeling, and distractions. Many of the studies were small and did not include a comparison group. They also did not consider factors like how severe the autism was, other conditions the children had, or their previous dental experiences. Because of these limitations, the evidence supporting the use of psychological behavioral techniques to improve dental visits for autistic children is limited and uncertain. More research with larger studies and proper control groups is needed to better understand this topic.
Autism : the international journal of research and practice, 2024 · doi:10.1177/13623613241255302