An 11 year old female patient has come for a routine dental examination. She gives a history of epileptic episodes. General examination also reveals lack of eye contact, poor co-ordination, non-communicative, poor muscle tone, drooling, hyperactive knee jerk and strabismus. Which of the following techniques is contraindicated in the management of this child ?

Children with Autism Spectrum Disease have multiple medical and behavioral problems that may make dental treatment difficult. These children often have poor muscle tone, poor coordination, drooling, a hyperactive knee jerk, and strabismus; 30% eventually develop epilepsy. Children with ASD may have strict routines and prefer soft foods and sweetened foods. Because of poor tongue coordination, children with ASD tend to “pouch” food instead of swallowing. This habit, combined with the desire for sweetened foods, leads to increased susceptibility to caries. Because of their tendency to adhere to routines, children with ASD may require several dental visits to acclimate to the dental environment. The use of a Papoose Board or Pedi-Wrap and preappointment conscious sedation may be necessary and in some instances has a calming effect on the child.