Oral Health of Autistic Children and Awareness of Care Providers towards their Oral Hygiene

Autism is a lifelong neurodevelopmental disease characterised by qualitative abnormalities in reciprocal social interaction and patterns of communication. The incidence of autism has increased in recent years and therefore, the possibility of dentists encountering children with autism is higher. Knowledge about the prevalence of dental disease in these children and the awareness of their care providers towards oral health is crucial to provide quality dental healthcare. Aim: To evaluate the oral health status of children with Autism Spectrum Disorder (ASD) and to assess the awareness of the parents/care providers regarding their oral health. Materials and Methods: This study was a two-stage cross-sectional study carried out in July, August 2015 at AB Shetty Memorial Institute of Dental Sciences, affiliated to NITTE Deemed to be University. Twenty children diagnosed with ASD formed the study group while 20 healthy children formed the control group. A clinical examination assessed dental caries (DMFT/dft). Gingival disease and oral hygiene of all children were evaluated using the Loe and Sillness gingival index and simplified oral hygiene index, respectively. Parents/care providers of the autistic children were asked to complete a questionnaire regarding the oral hygiene practices and oral health problems of the children. Descriptive statistics were performed for continuous variables, frequencies and percentages for categorical variables and comparisons were made using the Mann-Whitney U test, independent t-test and Chi-square test. Statistical analyses were conducted using EZR software (R version 3.6.3© 2020) and significance level was set at p<0.05. Results: The dft values in the children with autism were significantly lower than the control group (p=0.035). Children with autism had higher DMFT values, however this difference was not found to be significant (p=0.757). No statistically significant differences were found in the gingival and oral hygiene indices amongst the children with autism and their healthy controls, (p=0.811, 0.365, respectively). An 85% (n=17) of children were found to use tooth brush and paste for oral hygiene procedures. An 85% (n=17) of children with autism had supervised tooth brushing while only 20% (n=4) of the children with autism had previously visited a dentist. Most care providers of children with ASD seemed to be unaware of the causative factors of dental disease. Pouching of food was not seen in most of the autistic children. Conclusion: Caries experience in the permanent dentition in the autistic children and healthy children were comparable while autistic children had a lower caries experience in the primary dentition. Both autistic children and healthy children exhibited mild gingival inflammation. Whereas, the oral hygiene status was comparable amongst the two groups of children. Most of the autistic children had assisted tooth brushing (parental), however there were significant lacunae of knowledge in the oral health awareness of the parents/care providers.