Parental Perception of the Oral Health-Related Quality of Life of Children and Adolescents with Autism Spectrum Disorder (ASD)

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

BACKGROUND

Children with autism spectrum disorder (ASD) face unique challenges related to oral health, which can negatively impact their day-to-day lives, significantly compromising their overall quality of life. Primary caregivers of children with ASD have a critical role in delivering and seeking oral health care. Hence, it is vital to study their perspective towards their children's oral health and its impact on their quality of life.

AIM

To explore the parental perception of oral health-related quality of life in children with autism.

METHODS

A systematic electronic and manual search was conducted in Medline (via PubMed), Embase, Google Scholar, Scopus, and LILACS of articles published from January 2003 to May 2023 using appropriate MeSH terms, keywords, and other terms. A four-phase study selection process was followed according to PRISMA guidelines, and data extraction and synthesis were performed using an extraction form. The selected studies were critically appraised using the QATSDD and Crombie's assessment tool. The inter-reviewer agreement was assessed using the kappa with a linear weighting coefficient.

RESULTS

Out of the 885 results, 15 studies were included in the review after the two selection phases, and the study characteristics were summarized in tabular form. Study quality varied considerably, and out of a total possible QATSDD score of 42, scores for the individual studies ranged from 14 to 40. The risk of bias for the seven criteria was found to be low.

CONCLUSION

The parental perception of the OHRQoL in children with ASD is poor, and the most significant perceived impact is on the child's functional and social well-being aspects. Parental-Caregiver Perception Questionnaire was the most commonly used. The most frequent symptoms include bad breath, food lodgment, mouth breathing and night grinding. The familial impact and influence on the OHRQoL of siblings were also studied.

Oral habits, sociopsychological orthodontic needs, and sociodemographic factors perceived by caregivers impact oral health-related quality of life in children with and without autism?

BACKGROUND

Caregivers play a crucial role in assessing the oral health-related quality of life (OHRQoL) of young individuals with autism spectrum disorder (ASD).

AIM

This study assessed the impact of sociodemographic and oral conditions on OHRQoL and family dynamics in young individuals with and without autism, as perceived by guardians.

DESIGN

This comparative cross-sectional study included young individuals aged 6 to 14 years and their guardians. Data were collected at a specialized institution and dental schools. Guardians completed the Parental-Caregiver Perceptions Questionnaire (P-CPQ), Family Impact Scale (FIS), and sociodemographic and oral habits questionnaires. The sociopsychological need for orthodontic treatment was assessed using the Index of Orthodontic Treatment Need (IOTN).

RESULTS

The sample included 144 youths and caregivers. The ASD group had higher P-CPQ and FIS scores. Factors associated with poorer perceived OHRQoL included higher youth age, lower caregiver education, higher IOTN scores, teeth clenching (RR = 1.20; 95% CI: 1.01-1.41), and lip sucking. Lower parental education (RR = 1.75; 95% CI: 1.10-2.80) and higher IOTN scores from the caregiver's perspective impacted family dynamics.

CONCLUSION

Caregivers of young individuals with ASD perceived a lower OHRQoL, and families in this group were more affected by sociodemographic and oral conditions.

Perceptions of Parents/Caregivers About the Impact of Oral Conditions on the Quality of Life of Children and Adolescents with Autism Spectrum Disorder

PURPOSE

To investigate the perceptions of parents/caregivers about the impact of oral conditions on the oral health-related quality of life (OHRQoL) of children/adolescents with autism spectrum disorder (ASD) compared to the perceptions of parents/caregivers of children/adolescents without ASD.

METHODS

A comparative cross-sectional study was conducted involving 80 children/adolescents with ASD three to 16 years of age matched by sex and age with 80 children/adolescents without ASD and their parents/caregivers. Clinical examinations were performed for the diagnosis of dental caries experience (DMFT/dmft), clinical consequences of untreated dental caries (PUFA/pufa), visible plaque (VPI), bleeding on probing (BPI), malocclusion and traumatic dental injury (TDI). Parents/caregivers answered a questionnaire addressing sociodemographic characteristics and the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ), which measures OHRQoL from the perspective of parents/caregivers. Data analysis involved the Wilcoxon test, chi-squared test and Poisson regression.

RESULTS

Dental caries experience impacted OHRQoL in the group with ASD regarding the total P-CPQ score (p < 0.001) as well as the "oral symptoms" (p = 0.011) and "wellbeing" (p < 0.011) domains. No differences were found between the perceptions of parents/caregivers of children/adolescents with ASD and perceptions of parents/caregivers of children/adolescents without ASD (p = 0.721).

CONCLUSION

Dental caries experience can have a negative impact on the OHRQoL of children/adolescents with ASD.

Components of Oral Health Related to Motor Impairment in Children With Neuropsychiatric Disorders

Introduction Oral health significantly influences functions such as chewing, swallowing, and overall well-being. Children with neuropsychiatric disorders (NPD) often experience compromised oral functions, escalating their risk of malnutrition. Materials and methods Our study, conducted in Varna, Bulgaria, from April to October 2017, aimed to evaluate some components of the oral health of 49 children with NPD and its relation to their motor impairments. In the studied cohort, participants were categorized based on their Gross Motor Function Classification System (GMFCS) scores into two groups: minor limitations (ML), encompassing GMFCS levels 1-3, and gross limitations (GL), which included GMFCS levels 4-5. Comprehensive oral examinations were conducted by a trained dentist. Data analysis utilized the JAMOVI v.2.2.2.0 software with a 0.05 significance threshold. Results Preliminary findings indicate that children with more pronounced motor limitations have poorer oral health compared to their mildly impaired counterparts. A mere 14.3% (n=7) of the children with NPD had recorded dental visits. The data show that 18.2% (n=6) of ML children had at least an annual dental consultation, while only a single child (6.2%) from the GL group had a dental visit, leaving a staggering 93.8% (n=15) without any. Statistical analyses indicate a significant relationship between motor activity (MA) and toothbrushing frequency (r=0.529, p=0.0001), suggesting that children with better MA have improved chances of maintaining oral hygiene. A significant correlation was observed between dental visits and toothbrushing frequency (r=0.371, p=0.0007). Conclusion Given their challenges, children with NPD require increased attention to dental care, emphasizing regular checkups and preventive oral health measures. This study prompts a reevaluation of these care standards.