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Background: Providing dental treatment for children with autism spectrum disorder (ASD) represents a challenge for dentists. In the dental care of such children, the treatment plans implemented are usually determined by several factors, including: the type of autism spectrum disorder, the degree of patient cooperation, dentist/patient communication, the required treatment, self-care skills and parental/dentist support. Purpose: The purpose of this case report was to report the dental care delivered in the cases of two pediatric patients with ASD. Case 1: A 10.7 year-old boy with a nonverbal form of ASD who was experiencing recurrent pain in his lower left posterior tooth and also presented a blackened tooth. Case 2: A 9.6 year-old boy with a nonverbal form of ASD suffering from numerous painful cavities. Case management 1: On the day of the first visit, the boy was the subject of several behavioral observations. During the day of the second visit, he underwent a brief intraoral examination at a dental unit in order to arrive at a temporary diagnosis before appropriate was decided upon treatment in consultation with his parents. The implemented treatment plans comprised dental extraction and preventive restoration under general anesthesia. Case management 2: On the first visit, the boy underwent behavioral observations followed by early intraoral examination involving physical restraint approach. During the second visit, several treatment plans such as: general anesthesia, tooth extraction, restoration, and pulp-capping treatment were formulated. Conclusion: It can be concluded that general anesthesia was considered an appropriate dental treatment plan since the two patients in question were extremely co-operative during the necessary procedures. In other words, pediatric dental care treatment plans in cases of ASD should be determined by clearly-defined criteria, specifically the benefits and risks of the treatment plans for the safety of both patient and dental care team.

Muscular hypotonia is one of the clinical signs in patients with Down syndrome. As a characteristic of patients with Down syndrome, hypotonia is clearly evident in face expression and oral dysfunction. Dentocraniofacial growth abnormalities in patients with Down syndrome may be influenced by genetic and environmental factors. Stomatognathic system musculature as an environmental factor (factor outside the bone) can affect dentocraniofacial growth by orofacial muscles activities when chewing, swallowing, breathing, and speaking. Oral dysfunctions commonly seen in patients with Down syndrome are open mouth, protruding tongue posture, difficulties when chewing, swallowing, and speaking, drooling, and mouth breathing. The purpose of this study was to observe how the mastication muscular tone affecting the facial size of Down syndrome patient. Twenty five of 14–18 years old children with Down syndrome were diagnosed by clinical characteristic and cytogenetic examination. Mastication muscular tone was described by masseter and temporalis muscle synergy and oral function, whereas the facial size consisted of facial size of lateral, anteroposterior and vertical growth. The result of regression test revealed that the degree of mastication muscular tone has a significant effect on facial size of the anteroposterior growth and facial size of vertical growth, but did not significantly influence the facial size of lateral growth.