The Oral Health Status and Treatment Needs of Pediatric Patients Living with Autism Spectrum Disorder: A Retrospective Study

Abstract

Background: The objective of this retrospective study was to assess the oral health status and treatment needs of children with ASD and to explore the differences in risk factors and oral health care status and the risk factors for treatment under GA. Methods: Dental charts of children between 6 and 14 years of age who were examined at a dental facility associated with the College of Dentistry, University of Saskatchewan between 2016 to 2019 were assessed. Children who were identified as having ASD, as well as an age- and gender-matched control group consisting of otherwise healthy children were included in the study. Results: The sample included 346 dental records, with 173 children having a diagnosis of ASD. Children diagnosed with ASD had significantly higher experience with caries (91.3% vs. 65.9%, p = 0.003) and severity (mean DMFT/dmft = 8.18 ± 1.62 vs. 4.93 ± 0.58 p = 0.007). Children with ASD were also older when visiting the dentist for the first time (age of 5.97 ± 1.18 vs. 2.79 ± 1.09, p = 0.02)). Children with ASD were less likely to brush once a day (66.5% vs. 88.4%, p = 0.02), were more likely to have bruxism (35.8% vs. 10.4%, p = 0.003) and were less likely to have class I occlusion (64.7% vs. 80.9%, p = 0.03). Findings from the logistic regression analysis revealed that children with ASD were also 2.13 times more likely to receive a referral for general anesthesia when all other variables were held constant (p = 0.03). Conclusions: This research demonstrates that children diagnosed with ASD may face more barriers with access to oral health care, leading to poorer outcomes and greater treatment dental needs.

Investigation of Dental and Oral Health in Children and Adolescents with Special Support Needs from a Child and Adolescent Psychiatric Perspective

“…Regarding the importance of dental and oral health issues, there are no significant differences observed among the three target groups in the overarching analysis, prompting us to dissolve the clear distinction between these subgroups and subsume them under the term “Children and Adolescents with Special Support Needs”, abbreviated as CA-SN hereafter. The subsumption of various vulnerable patient groups with disabilities or other impairments, such as physical or mental disabilities, psychological behavioral disorders or developmental disorders, like autism spectrum disorder, under the titles “special needs”, “special support needs” or “special healthcare needs” is quite common in dentistry, and the terms are also used synonymously with each other to some extent [ 11 , 12 , 13 , 14 , 15 , 16 , 22 , 23 , 24 , 25 ].…”

“…Causes for the poorer oral health status in CA-SN, from an international dental perspective, include irregular dental hygiene, often stereotypical unhealthy eating habits, decreased cooperation, a lack of dentists trained in special care dentistry, the absence of barrier-free clinics and the lack of specialized treatment concepts [ 22 , 23 , 24 , 26 , 27 ]. These dental perspectives align with the data gathered from the CAPPS and the national dental perspectives, mentioned in the introduction.…”

“…The survey illustrates that there is indeed an overlap between CAPPS and dentists in the explanatory approaches to poorer dental and oral health in CA-SN, referring to, for example, behavioral causes, illness-related causes and communication barriers [ 22 , 24 , 26 , 27 ]. Furthermore, the collected data cautiously suggest that CAPPS, in addition to the poorer dental and oral health status of CA-SN, tend to identify familial or psychosocial factors, such as the overwhelming of caregivers or the low priority given to dental health, while the dental profession is more likely to point out structural deficits, such as the lack of continuing education and training, the lack of research or the lack of financial incentives [ 22 , 23 , 24 , 26 , 27 ].…”

Parental perspectives on oral health‐related quality of life in children and adolescents with autism spectrum disorder: A systematic review

“…Therefore, adolescents and children with autism are considered high-risk groups for dental trauma and dental caries, leading to premature extractions and compromised oral health. 8 The impact of these oral health problems on the quality of life of children with autism can be significant. It can lead to difficulties with eating and drinking, which can impact the child's overall nutrition and health.…”

“…They are also more likely to have difficulties with dental care, such as tooth brushing and visiting the dentist. Therefore, adolescents and children with autism are considered high‐risk groups for dental trauma and dental caries, leading to premature extractions and compromised oral health 8 …”