Toothbrushing in children with autism spectrum disorders: qualitative analysis of parental difficulties and solutions in France

Effect of Sensory Adapted Dental Environment (SADE) on physiological and behavioral parameters related to stress and anxiety in children with Autism Spectrum Disorder (ASD) undergoing dental treatment: A systematic review and meta-analysis

BACKGROUND

Children with autism exhibit a higher general and dental anxiety, due to altered sensory sensibilities.

AIM

This current systematic review aims to evaluate the effectiveness of Sensory adapted dental environment (SADE) over regular dental environment (RDE) on behavioral, physiological stress and overt anxiety in children with autism spectrum disorders (ASDs).

MATERIALS AND METHODS

Prospero registered (CRD42024508336). PubMed, Cochrane, Scopus databases are searched from years January 1, 1980-January 1, 2024 using pre-defined search strategy.

RESULTS

A total of 269 titles, were obtained from the included databases after application of filters, exclusion of duplicates and reviews and irrelevant articles led to the final inclusion of 12 articles for full text screening from which, three studies sustained the targeted PICO search.

CONCLUSION

Skin conductance level (parameter indicating physiological stress) is lower in SADE environment in children with ASD, other behavior stress related parameters there is no significant difference between SADE and RDE environments.

Development of oral health resources and a mobile app for caregivers and autistic children through consensus building

LAY ABSTRACT

Caregivers of autistic children often lack knowledge regarding oral homecare and when and where to see the dentist. To address this need, we developed a series of information on oral health. An autistic child assisted in developing two social stories to showcase a dental visit. A mobile app was developed to deliver the above mentioned. Other features include creation of customised social stories and visual schedule and an inbox to allow dentists to send messages to parents. The developed information and social stories were reviewed by experts and parents. The app also underwent anonymous and independent testing by parents. Overall the information and app were well received by the experts and parents.

Dimensions of young children's toothbrushing resistance: A qualitative content analysis of discussions on the online parenting forum Mumsnet

BACKGROUND

Young children's resistant behaviour is a barrier to parental-supervised brushing. Discussions on online parenting forums offer an insight into parental experiences, behaviour and attitudes. Analysing these discussions also demonstrates how dental advice is represented and potentially resisted.

AIM

To analyse how young children's toothbrushing resistance is discussed on an online parenting forum.

DESIGN

Qualitative content analysis of threads on toothbrushing resistance retrieved from the UK parenting forum Mumsnet.

RESULTS

A search was carried out on Mumsnet in April 2022. Overall, 204 relevant threads were identified and analysed. A coding frame was developed. Posters interacted by discussing their experiences of resistance, asking for advice, making suggestions and being both supportive and critical. Thirty-seven strategies for addressing resistance were identified. Discussions reflected attitudes and concerns relating to young children and toothbrushing resistance, including the idea brushing should be 'non-negotiable'. A key issue was the acceptability of physical force or restraint to achieve adequate brushing. Posters invoked dental authority to support their views.

CONCLUSION

Understanding how toothbrushing resistance is discussed on a parenting forum helps establish what information and advice is shared, and highlights attitudes and concerns that shape how this problem is approached.

Oral Health Barriers for African American Caregivers of Autistic Children

The most persistent oral health disparities in the United States impact children from racial and ethnic minoritized groups and children diagnosed as autistic. This paper aims to describe barriers to oral care as depicted by Black/African American (B/AA) parents of autistic children to further explore how and why oral health disparities persist in this population. A purposeful sample of eleven caregivers of autistic children, ages 4 to 14 years, who identified as B/AA were interviewed twice for approximately 60-90 min each. Thematic analysis utilizing a narrative approach was employed. Three themes emerged from the data concerning the barriers that affect oral health experiences: (a) difficulty in maintaining good oral health practices, (b) challenges with access to care and resources, and (c) poor patient-provider relationships. Due to the limited research that examines the intersection of autism, B/AA culture, and oral health practices, this study provides a rich picture of the barriers families face when obtaining oral care. Many families raised issues that other parents of autistic children also identified. B/AA caregivers have demonstrated that despite their own negative dental experiences, they understand the value of good oral care practices and are willing to pursue oral care for their children.

Factors influencing oral health behaviours, access and delivery of dental care for autistic children and adolescents: A mixed-methods systematic review

Background

Autistic children and young people (CYP) experience oral health (OH) inequalities. They are at high risk of dental disease and show significant levels of unmet need in relation to OH and access to dental care.

Aim

This study aimed to gather evidence on the factors that influence OH behaviours, access to and delivery of dental care for autistic CYP.

Design

This was a mixed‐methods narrative systematic review.

Data Sources

Embase, Web of Science, Dentistry & Oral Sciences Source, MEDLINE, Psychinfo, Scopus, CINAHL, SocINDEX and grey literature were the data sources for this study.

Review Methods

A systematic search was conducted for qualitative, quantitative and mixed‐methods research studies from countries with a High Development Index that related to OH behaviours, access to and delivery of dental care for autistic CYP. Results were analysed using narrative synthesis.

Results

From 59 eligible studies, 9 themes were generated: (1) affordability and accessibility; (2) autism‐related factors and cognitive or motor skill differences; (3) the dental environment; (4) managing CYP's behaviour; (5) responding and adapting to the needs of the autistic CYP and their parent/carer; (6) attitude of dental health professionals (DHPs) towards autistic CYP and their parents/carers; (7) knowledge of how to care for and support CYP's OH; (8) empowerment of parents/carers and collaboration with DHPs; and (9) communication and building rapport.

Conclusion

The adoption of healthy OH behaviours and access to dental care by autistic CYP is impacted by a range of factors including those intrinsically related to a diagnosis of autism, for example, communication and those often associated with autism, for example, sensory sensitivities. Access to better OH and dental care can be facilitated by responding to the individual needs of autistic CYP through accommodation, education and adaptation. This necessitates greater awareness and knowledge of autism amongst DHPs and the provision of appropriate services. More methodologically robust intervention studies are needed to identify effective ways to support autistic CYP in achieving good OH and access to dental care.

Patient and Public Contribution

The review protocol was developed with members of the project patient and public involvement group who provided the autistic voice, contributing to the interpretation of the review findings and writing of the manuscript.