Comparative evaluation of oral hygiene practices and oral health status in autistic and normal individuals

Comparative Evaluation of Oral Health Status and Treatment Needs of Children With Autism Spectrum Disorder: A Cross-Sectional Study

INTRODUCTION

 Oral health care is essential yet challenging in children with autism spectrum disorder (ASD) due to their impaired emotional and behavioral stability, lack of communication skills, and inability to perform daily home hygiene routines properly. The present study was planned with the aim of assessing the Oral Health Status and Treatment Needs of children with ASD in comparison with children without any systemic disease.

METHODS

A total of 160 children, in the age group of 5-14 years, divided equally into two groups, i.e., Group A (children with ASD) and Group B (children without any systemic disease), were assessed for Dental caries, Oral Hygiene Status, and Treatment Needs. The behavior of children in each group, during oral examination, was also assessed and recorded. Student t test and Chi square test were used for quantitative and qualitative analysis, respectively.

RESULTS

The mean age of participating children was 7.96±2.43 years with a male predominance (male to female ratio - 1.58:1). Children with ASD displayed more negative behavior with 15% showing definitely negative behavior, 21.2% negative behavior on Frankl's Behavior Rating scale; the statistically lower prevalence of dental caries (Group A - mean decayed, missing and filled primary teeth (dmft): 1.7±3.2, mean decayed, missing and filled permanent teeth (DMFT): 0.19±0.71; Group B - mean DMFT: 5.44±4.88, mean DMFT: 1.01±1.51; p=0.0001), better oral hygiene (Group A - 18.8% showed good Simplified Oral Hygiene Index Score (OHI-S), 56.2% showed fair OHI-S; Group B - 6.2% showed good OHI-S and 46.3% showed fair OHI-S) and lower treatment needs compared to children without any systemic disease.

CONCLUSION

 Children with ASD showed better oral health and lower treatment needs. This suggests that introducing oral hygiene care and diet modifications in daily routine can significantly improve the Oral Health Status in children with ASD.

Autistic individuals have worse oral status than neurotypical controls: a systematic review and meta-analysis of observational studies

OBJECTIVE

To compare dental caries, oral hygiene, periodontal status, bruxism, malocclusion, tooth loss, and salivary alterations between autistic and typical developing individuals.

MATERIAL AND METHODS

Observational studies presenting clinical measures of oral outcomes between autism spectrum disorder (ASD) individuals and controls. EMBASE, LILACS, PubMed, PsycINFO, Scopus, Web of Science, Google Scholar, and ProQuest were searched up to June 26, 2023. Pairs of reviewers independently conducted study selection, data extraction, and assessments of methodological quality and certainty of evidence. Meta-analyses of standardized mean differences (SMD) and risk ratio (RR) were performed.

RESULTS

A total of 47 studies comprising 6885 autistic individuals were included in the review. Autistic individuals had significantly higher severity of dental-caries experience in primary teeth (SMD 0.29, 95%CI 0.02, 0.56), of dental plaque presence (SMD 0.59, 95%CI 0.24, 0.94), and of gingivitis (SMD 0.45, 95%CI 0.02, 0.88). Autistic individuals showed higher probability of occurrence of gingivitis (RR 1.34, 95%CI 1.08, 1.66,), bruxism (RR 4.23, 95%CI 2.32, 7.74), overjet (RR 2.16, 95%CI 1.28, 3.64), overbite (RR 1.62, 95%CI 1.02, 2.59), crossbite (RR 1.48, 95%CI 1.02, 2.13), and openbite (RR 2.37, 95%CI 1.46, 3.85), when compared to neurotypical individuals. Most estimates showed a small effect size with very low certainty of evidence.

CONCLUSION

Autistic individuals show worse oral health status than controls.

CLINICAL RELEVANCE

The findings reported herein can help to build health policies to better serve autistic individuals including prevention actions and access to specialized dental care.

Dental desensitization by dentists and occupational therapists for autistic adults: A pilot study

LAY ABSTRACT

Managing patients with autism in the dental clinic often requires resorting to pharmacological behavioral control techniques, including general anesthesia. References in the literature to desensitization programs are scarce and focus on training children with autism to undergo oral examinations and preventive procedures. This study shows that a dental desensitization program implemented by dentists and occupational therapists could help in performing not only oral examinations but also simple dental therapeutic procedures for a considerable percentage of adults with autism, without using a pharmacological intervention (sedation or general anesthesia).

Manual and Powered Toothbrushing Effectiveness on Autistic Children's Oral Hygiene Status

Background

Autistic children want a lot of help cleaning their teeth and they have a higher risk of periodontal disorder and less caries than the general public. The study's purpose is to see how helpful manual and powered toothbrushing are for autistic kids aged 6-12 years.

Materials and Methods

A total of 40 autistic children aged 6-12 years were chosen at random from Mangalore city schools. The simplified oral hygiene index was used to determine the baseline oral health (OHI-S). Children were split into two classes during an oral review. Children in Group 1 received a manual toothbrush, and those in Group 2 received a powered toothbrush. Many of the children were given Colgate fluoride-free toothpaste. Under the guidance of care professionals, children were taught to brush for 3 min. They were taught to count from 1 to 20 when brushing each buccal and lingual section. The index was rechecked at the conclusion of the 1st month (30th day) and the next month (3rd month) (90th day). On the 60th day, the recently learned techniques were reinforced (end of the 2nd month).

Result

In Group 1, a statistically significant reduction in mean OHI-S scores was observed in baseline versus 30 days and baseline versus 90 days, while in Group 2, a statistically highly significant reduction in baseline versus 30 days, baseline versus 90 days, and 30 days versus 90 days was observed.

Conclusion

Furthermore, in autism children, powered teeth brushing shows potential. Long-term follow-up and greater sample size are, however, needed.

Oral health knowledge, attitude, and performance of the parents of 3-12-year-old autistic children

BACKGROUND

This study aimed to assess the oral health knowledge, attitude, and performance of the parents of autistic 3-12-year-old.

MATERIALS AND METHODS

This descriptive cross-sectional study evaluated 50 parents of autistic 3-12-year-old in Isfahan city. The oral health knowledge, attitude, and performance of the parents were evaluated using a self-administered questionnaire with closed questions, after confirming its validity and reliability. Data were analyzed using independent t-test, one-way ANOVA, Pearson's correlation coefficient, regression analysis, and Cronbach's alpha (α =0.05).

RESULTS

Of children, 32 (64%) were males and 18 (36%) were females. A total of 28 (56%) fathers and 22 (44%) mothers participated in this study. The mean age of the children and parents was 8.12 ± 2.4 years and 39.6 ± 6.8 years, respectively. The mean age at the time of diagnosis of autism was 4.08 ± 1.33 years. Of all children, 24 (46.2%) had a previous dental history. The mean scores of the knowledge and attitude of the parents were 5.2 ± 1.7 out of 11, and 16.1 ± 3.1 out of 30, respectively. Of demographic variables, order of child birth had a significant correlation with attitude of the parents, and those with one single child had significantly higher attitude score (P = 0.03).

CONCLUSION

The oral health knowledge, attitude, and performance of the parents of autistic children in Isfahan city were lower than expected, which calls for knowledge enhancement strategies in this respect.

Bridging the communication gap in autistic children, one picture at a time

One of the main domains of paediatric dentistry is providing oral health care, especially to the children with special needs, like those affected with autism spectrum disorder (ASD). Such children exhibit poor oral hygiene primarily due to their limited communication ability, lack of joint attention, oversensitivity to sensory stimuli and motor coordination deficits. In such cases, multiple studies suggest and emphasize on the importance of early use of interventional services. Children affected with ASD tend to be visual learners, and therefore, are better suited for visual interventional methods. Amongst which, picture exchange communication system (PECS), originally developed by Bondy-Frost, is gaining rapid momentum. It is suggested to help individuals to initiate requests and communicate their needs via picture cards; hence aid in acquiring functional communication and speech, improve socio-communicative impairments, and decrease the behavioural problems. This scoping review aims to raise awareness on PECS amongst the dental fraternity, by emphasizing its usage pertaining to dentistry. PECS though rated hard, has proved to be beneficial in improving oral hygiene practices among autistic children.

Health status of people with autism spectrum disorder

Purpose

The aim of this study is to determine what changes occur in the health status of people with autism spectrum disorder (ASD) compared to neurotypical controls.

Design/methodology/approach

The authors performed a comparative analysis of data collected from 72 subjects with ASD and 75 neurotypical controls aged 3–24 years using the Rochester Health Status Survey IV (RHSS-IV). A structured individual interview was conducted to compare the health status of subjects in Macedonia.

Findings

A majority of people with ASD take vitamins, supplements and use recommended drug therapies compared to the neurotypical population and experience a larger number of side effects (p = 0.000). Compared to people with neurotypical development, children with ASD have a higher prevalence of oral ulcers (31.9% vs 17.3%; p = 0.039), changes in neurological health status – epilepsy (19.4% vs 2.7%; p = 0.001) and ADD/ADHD (only persons with ASD-19.4%; p = 0.000); respiratory diseases – angina (30.5% vs 8%; p = 0.000), rhinitis and/or sinusitis (40.3% vs 17.3%; p = 0.02); changes in the gastrointestinal system – constipation (31.9% vs 10.6%; p = 0.02), intestinal inflammation (19.4% vs 8%; p = 0.043), permeable intestines (only persons with ASD – 13.9%; p = 0.000) and the presence of the fungus Candida albicans (19.4% vs 4%; p = 0.043); psychiatric disorders – sleep problems (only in people with ASD – 18%; p = 0.000) and tics (6.9% vs 2.6%; p = 0.25) and skin diseases – eczema/allergic skin rash (36.1% vs 18.7%; p = 0.02).

Originality/value

Many children with ASD have health problems. These findings support and complement the professional literature on their mutual causality.

Longitudinal stability of salivary microRNA biomarkers in children and adolescents with autism spectrum disorder

BACKGROUND

Autism spectrum disorder (ASD) is a complex neurological condition with increasing prevalence. Few tools accurately predict the developmental trajectory of children with ASD. Such tools would allow clinicians to provide accurate prognoses and track the efficacy of therapeutic interventions. Salivary RNAs that reflect the genetic-environmental interactions underlying ASD may provide objective measures of symptom severity and developmental outcomes. This study investigated whether salivary RNAs previously identified in childhood ASD remain perturbed in older children. We also explored whether RNA candidates changed with therapeutic intervention.

METHOD

A case-control design was used to characterize levels of 78 saliva RNA candidates among 96 children (48 ASD, 48 non-ASD, mean age: 11 years). Thirty-one children (22 ASD, 9 non-ASD developmental delay, mean age: 4 years) were followed longitudinally to explore changes of RNA candidates during early intervention. Saliva RNA and standardized behavioral assessments were collected for each participant. Associations between candidate RNAs and behavioral scores were determined in both groups via Spearman Correlation. Changes in candidate RNAs across two time-points were assessed in the younger cohort via Wilcoxon rank-sum test.

RESULTS

Seven RNAs were associated with VABS-II and BASC scores in the older group ([R] >0.25, FDR< 0.15). Within the younger cohort, 12 RNAs displayed significant changes over time (FDR< 0.05). Three microRNAs were associated with behavioral scores and changed over time (miR-182-5p, miR-146b-5p, miR-374a-5p).

CONCLUSION

Several salivary RNAs are strongly associated with autistic behaviors in older individuals with ASD and change as early as three months after therapy initiation in younger children. These molecules could be used to track treatment effectiveness and provide prognoses. Further validation is necessary.

Autism-Associated Variant in the SLC6A3 Gene Alters the Oral Microbiome and Metabolism in a Murine Model

Background: Altered dopamine (DA) signaling has been associated with autism spectrum disorder (ASD), a neurodevelopmental condition estimated to impact 1 in 54 children in the United States. There is growing evidence for alterations in both gastrointestinal function and oral microbiome composition in ASD. Recent work suggests that rare variants of the SLC6A3 gene encoding the DA transporter (DAT) identified in individuals with ASD result in structural and functional changes to the DAT. One such recently identified de novo mutation is a threonine to methionine substitution at position 356 of the DAT (DAT T356M). The DAT T356M variant is associated with ASD-like phenotypes in mice homozygous for the mutation (DAT T356M+/+), including social deficits, hyperactivity, and impaired DA signaling. Here, we determine the impact of this altered DA signaling as it relates to altered oral microbiota, and metabolic and gastrointestinal dysfunction. Methods: In the DAT T356M+/+ mouse, we determine the oral microbiota composition, metabolic function, and gastrointestinal (GI) function. We examined oral microbiota by 16S RNA sequencing. We measured metabolic function by examining glucose tolerance and we probed gastrointestinal parameters by measuring fecal dimensions and weight. Results: In the DAT T356M+/+ mouse, we evaluate how altered DA signaling relates to metabolic dysfunction and altered oral microbiota. We demonstrate that male DAT T356M+/+ mice weigh less (Wild type (WT) = 26.48 ± 0.6405 g, DAT T356M+/+ = 24.14 ± 0.4083 g) and have decreased body fat (WT = 14.89 ± 0.6206%, DAT T356M+/+ = 12.72 ± 0.4160%). These mice display improved glucose handling (WT = 32.60 ± 0.3298 kcal/g, DAT T356M+/+ = 36.97 ± 0.4910 kcal/g), and an altered oral microbiota. We found a significant decrease in Fusobacterium abundance. The abundance of Fusobacterium was associated with improved glucose handling and decreased body fat. Conclusions: Our findings provide new insights into how DAT dysfunction may alter gastrointestinal function, composition of the oral microbiota, and metabolism. Our data suggest that impaired DA signaling in ASD is associated with a number of metabolic and gastrointestinal changes which are common in individuals with ASD.

The Oral Health Inequities between Special Needs Children and Normal Children in Asia: A Systematic Review and Meta-Analysis

This meta-analysis aimed to analyze the oral health inequalities among special needs children during 2004-2019 in Asia to reveal the importance and the needs of establishing integrated and equitable special needs dentistry care system in Indonesia. PubMed, Scopus, Cochrane Library, Web of Science, and Wiley Online Library were systematically searched for full-text observational studies published from 1 January 2004 to 15 January 2020, in English in Asia. Studies that included children under 18 years of age with special needs and compared them to healthy controls were selected. Study quality was assessed using the Joanna Briggs Institute 2017 Critical Appraisal Checklist. Risk of bias was assessed using the ROBINS-E tool. The decayed, missing, and filled permanent teeth (DMFT) index indicated that special needs children who suffer from intellectual disability or autism spectrum disorder had significantly more caries than normal children (p < 0.001). The special needs children who had more caries than normal children lived in countries that had a high average DMFT value among 12 years old children (p < 0.001), and these two variables showed a positive correlation in meta-regression analysis (p < 0.001). Having an integrated and equitable care system and elevating children's oral health are important to maintain special needs children's oral health.

Dental experiences of a group of autistic adults based in the United Kingdom

AIMS

Previous international research has shown that autistic people have difficulty accessing dental care due to sensory processing, anxiety and communication issues. However, it is not known whether autistic adults in the United Kingdom are experiencing similar dental care barriers. The current study investigated autistic adults' dental experiences in the United Kingdom.

METHODS AND RESULTS

A mixed methods survey was given to self-selecting autistic (n = 37) and non-autistic adults (n = 43) to compare whether autistic individuals had more negative experiences than non-autistic individuals. Closed questions asked about anxiety, patient-practitioner communication, satisfaction and the dental environment. Open questions asked about autism-specific dental challenges, what works well at the dentist, and improving autistic individuals' experiences. Responses were analyzed using thematic analysis. Overall, results demonstrated that autistic adults in the United Kingdom have more negative dental experiences than non-autistic adults. These predominantly related to interactions with dental practitioners, a challenging sensory environment, anxiety, pain, and disclosure. Participants recommended sensory environment adaptations, ways to increase preparedness, longer appointments, and individual accommodations.

CONCLUSION

This study offers best-practice strategies for working with autistic patients and highlights the importance of dentists working with autistic individuals to maximize the quality of care and outcomes for this underserved population.

Oral health knowledge and dental behavior among individuals with autism in Jordan: a case-control study

Background

Oral care is acknowledged as an integral component of general health and plays an essential role in establishing the desired level of quality of life for individuals with autism spectrum disorder (ASD).

Purpose

To investigate oral health knowledge and dental behaviors in individuals with ASD in comparison with individuals without ASD in Jordan.

Methods

A case–control study was carried out among 296 caregivers of individuals with ASD (n = 147) and control (n = 149) groups. A closed ended, validated self-designed questionnaire was distributed. The questionnaire included questions addressing participant’s oral health knowledge and behaviour. Data were analyzed using SPSS® software Version 22 with a 0.05 level of significance. A Chi-square test and contingency-table analysis were performed.

Results

Individuals with ASD in Jordan were significantly less knowledgeable about different oral health aspects than individuals without ASD (p < 0.05). Fewer individuals in the ASD group brushed their teeth once or twice daily (89%), compared to the control group (93%). Only 15% of the ASD participants could brush their teeth without help. The use of fluoridated toothpaste and the frequency of using mouth rinse demonstrated a significant difference between groups (p < 0.05).

Conclusion

ASD individuals in Jordan suffer from a significant lack of oral knowledge comparing to their controls, leading to a misunderstanding of the basic and highly important dental health aspects. Indicating that the knowledge was not enough to influence their dental behaviors. Children with ASD and their families should receive appropriate education in special need oral health care given by oral health professionals to reduce the risk of having dental problems and oral disease and enhance their quality of life.

Oral Health of Children with Autism: The Influence of Parental Attitudes and Willingness in Providing Care

Objectives

Parents play a crucial role in health-related practices of children with autism spectrum disorder (ASD). This study assessed the association between oral health status and oral health practices of children with ASD in relation to their parental attitudes and comfort in providing oral care.

Methods

This cross-sectional study included 75 children with ASD attending the special needs schools in Eastern Saudi Arabia from 2015-2018. Parents responded to a self-administered questionnaire assessing their attitudes toward oral health and comfort in providing oral care for children. The clinical examination assessed dental caries (decayed, extracted, and filled: (DMF and def)), gingival disease, and plaque accumulation. The Pearson correlation coefficient was used to assess the relationship between the study variables, while ANOVA followed by post hoc was used to assess the differences.

Results

Prevalence of dental caries in primary teeth was 76% and 68% in the permanent dentition with a mean of 0.85 ± 1.9 and 1.03 ± 2.9, respectively. Thirty-one participants had gingival problems, mean gingival index was 1.03 ± 0.88, and mean plaque index was 0.95 ± 0.43. Half of the parents supervised their children's brushing, which was significantly associated with plaque accumulation (p = 0.004), gingival disease (p < 0.0001), and def (p = 0.02). Parental attitudes and comfort in providing oral health care were not associated with oral health status of ASD children; however, positive parental attitudes were associated with lower sugar consumption (p = 0.043). An inverse correlation was observed between comfort in providing oral health care with gingival and plaque scores r = -0.18 and -0.23, respectively.

Conclusions

The data are indicative of poor oral health practices and status among ASD children. Parents' oral health care practices seem to be reactive rather than proactive. Positive parental attitudes were associated with lower sugar consumption. Greater comfort in providing care was negatively correlated with plaque accumulation and gingival problems.

Comparative Evaluation of Oral Health Status in Healthy Children and Children with Autism Spectrum Disorder

Objective Autism spectrum disorder (ASD) is regarded a severe neuropsychiatric disorder. The objective of this study was to compare the status of the oral health between children with and without ASDs.

Methods A total of 95 children (44 with ASD and 51 without ASD) were included. dmft/DMFT (d/D: decay; m/M: missing; f/F: filling; t/T: teeth) scores and plaque data of all participants were recorded. Saliva Streptococcus mutans and lactobacilli load were determined using CRT bacteria.

Results Streptococcus mutans load was >105 CFU in 54.5% of the ASD group and 43.1% in the non-ASD group. Lactobacilli load was >105 CFU in 47.70% of the ASD group and 49.0% in the non-ASD group. There was no statistically significant difference in the S. mutans or lactobacilli loads between the ASD and non-ASD groups. A total of 83.1% of the ASD group had caries, with dmft = 3.25 and DMFT = 5.10. In the non-ASD group, 81.10% of patients had caries, with dmft = 3.10 and DMFT = 4.90; 38.6% of the ASD group and 29.4% of the non-ASD group had no clinical signs of periodontal disease.

Conclusion The examination of the amount of saliva S. mutans and lactobacilli at intervals with these patients will provide quantitative data to evaluate the effectiveness of oral health care.

Oral Health Status of Children with Autism in Central Italy

Children with autism spectrum disorder (ASD) have significantly higher prevalence and caries severity compared to the average population. Knowledge about the oral health indices of children with this mental disorder is key to designing efficient plans of intervention. This paper reports the results of a study on the oral health status of children with ASD in central Italy. This is the first study of this type in Italy. The sample consists of 229 autistic children aged between 5 and 14 years, attending the Unit of Special Needs Policlinico Umberto I in Rome. Each patient received an intraoral examination to investigate decayed, missing, and filled teeth as well as periodontal status. Information on demographic attributes, dietary habits, medical history, and child’s cooperativeness at the first visit was also recorded. Of the participants, 79.26% presented signs of gingivitis and about 90% of them had plaque. Caries prevalence was 66.38%. The average of the total number of decayed, missing, and filled teeth in the permanent and primary dentition was 2.91. Among the factors considered, only dietary habits and the periodontal indices showed statistically significant association with caries prevalence and caries severity. Despite the selection bias, that prevents us to interpret the results presented as epidemiological evidence, our study suggests that children with ASD in central Italy represent a population at risk.

Dental Caries Status in Autistic Children: A Meta-analysis

The objective of this meta-analysis was to assess the dental health status of children with ASD in terms of decayed, missing, and filled permanent teeth (DMFT) and decayed, missing, and filled deciduous teeth (dmft). PubMed, Embase, psycINFO, and Cochrane library were searched for studies published until September 2018. A random-effects model was applied to estimate the pooled results.Nine studies comprising 532 children with ASD and 622 controls were included. No significant differences between children with ASD and controls were observed for DMFT and dmft in the world. Subgroup analyses revealed that children with ASD had a significantly higher dmft index than that of controls in Asia.Children with ASD have a worse dental health status than healthy children in Asia, but caution is necessary given the limited studies available for analysis.

Salivary Factors Related to Caries in Children with Autism

Many predisposing factors to caries are present in autism, however, it is unlikely that autistic patients exhibit higher caries indexes than the rest of the population.

OBJECTIVE

To evaluate salivary factors related to caries in autistic patients.

STUDY DESIGN

34 autistics and 34 controls aged between 4-13 years old were included. Decayed, missing, and filled teeth (DMFT) index and oral hygiene simplified index (IHO-S) were assessed, as well as, pH, total proteins, phosphate, calcium and IgA in saliva. All data were analyzed by chi² and Student t tests for independent samples. P values<0.05 were considered statistically significant.

RESULTS

Autistic patients showed less caries than controls (p≤0.001), DMFT was 1±1 and 3±2 respectively (p≤0.001). In relation to IHO-S, values increased (p=0.008) in autistic patients (2.25±0.78) compared to controls (1.79±0.59), however Salivary ph means were similar (7.20±0.48 and 7.27±0.34 respectively). Decreased calcium levels (p=0.013) were observed in autistics (0.621±0.35 mmol/L) compared to controls (0.89±0.51 mmol/L), but phosphate levels were similar (6.17±4.22 M, 5.51±4.86 M respectively). When total proteins of saliva were assessed, autistics showed a slight increment (2.65±1.81 mg/mL) compared to controls (2.24±1.27 mg/mL) and zymography showed a higher proteolytic activity in autistic children. Finally, IgA concentration reached 116.55±90.97 μg/mL in autistics and 161.61 ± 193.37μg/mL (p=0.527) in the control group.

CONCLUSIONS

Even though patients with autism exhibited a poorer oral hygiene, caries indexes were lower, calcium levels in saliva were found to be lesser and phosphate levels higher.

Associations between Diet, Dietary and Oral Hygiene Habits with Caries Occurrence and Severity in Children with Autism at Dammam City, Saudi Arabia

AIM:

The purpose of the study is to achieve the baseline information of the autistic child’s oral health status about the diet, dietary and hygiene habits. The association of these factors with dental caries were assessed.

MATERIAL AND METHODS:

The survey was composed of self-administered questionnaires to parents about their children’s’ demographic data followed by questions related to diet, dietary and hygiene habits. This is later followed by oral examination for estimating the decayed, missing and filled [dmft] scores as per WHO norms. The variables are analysed using t-tests and ANOVA. Pearson’s correlation coefficients were calculated for each of the independent variables to examine for autocorrelation.

RESULTS:

The mean age for the present study is 5.8 years with more predilections of caries in females. The autistic children prefer soft diet and pouch it in oral cavity resulting in increased caries though not significant. Other foods like nuts and pulses confectioneries and soft drinks resulted in increased caries, and our study shows significant relation. Consumption of sugars between meals and increased quantity of sugar per day also increased dental caries with highly significant results in our study. Hygiene habits also made a difference in the occurrence of caries though, in our study, it’s not significant.

CONCLUSIONS:

The study suggests that the oral health education programs should be conducted for the parents, caregivers and the teachers about the diet, dietary and the hygiene habits and the role they play in maintaining the oral hygiene.

Oral Health Assessment of a Group of Children with Autism Disorder

OBJECTIVE

The aim of this research was to determine the oral status of a group of children with autism.

STUDY DESIGN

An observational transversal study was carried out in 96 pediatric patients between the ages of 2 and 16 years old with a diagnosis of autism. The patients were assessed to determine the presence of caries with Index Caries (WHO criteria) and debris and calculus with the Simplified Oral Hygiene Index, as well as the type of diet they followed.

RESULTS

It was established that 41.7% of the patients had caries, with the result of an index of DMFT= 0.96 and dmft =2.41. In terms of the periodontal health 59.4% suffered from calculus. The OHI-S was 3.4.

CONCLUSIONS

Children with autism exhibited a higher caries prevalence in primary teeth than in permanents. They also presented poor hygiene and an extensive presence of calculus.

Salivary biomarker levels and oral health status of children with autistic spectrum disorders: a comparative study

AIM

To evaluate the oral health status, salivary flow rate, pH and buffering capacity in children with autistic spectrum disorders (ASD) in comparison to their healthy siblings.

METHODS

A total of 30 subjects with ASD and 30 normal healthy siblings between the ages of 6-12 years of both genders attending various special schools and hospitals of Mangalore, India were recruited. Estimation of salivary pH, flow rate and buffering capacity were performed and oral health status was assessed using the WHO oral assessment form for children (World Health Organization in Oral health surveys: basic methods, World Health Organization, Geneva, 2013). The oral hygiene of the subjects was assessed using the oral hygiene index-simplified. Dental erosive lesions, presence of mucosal lesions and dental trauma were recorded for both the study and the control groups.

RESULTS

It was observed that salivary pH and buffering capacity were lower in children with ASD than their healthy siblings, the dental caries incidence was higher in ASD children when compared to their healthy siblings and oral hygiene was fair with gingival bleeding in children with ASD.

CONCLUSIONS

This study clearly indicates a need for better home care measures, parent, caregiver and institutional education on the importance of oral well-being among children with ASD.

A clinicomicrobiological study to evaluate the efficacy of manual and powered toothbrushes among autistic patients

AIM

To compare the efficacy of powered toothbrushes in improving gingival health and reducing salivary red complex counts as compared to manual toothbrushes, among autistic individuals.

MATERIALS AND METHODS

Forty autistics was selected. Test group received powered toothbrushes, and control group received manual toothbrushes. Plaque index and gingival index were recorded. Unstimulated saliva was collected for analysis of red complex organisms using polymerase chain reaction.

RESULTS

A statistically significant reduction in the plaque scores was seen over a period of 12 weeks in both the groups (P < 0.001 for tests and P = 0.002 for controls). This reduction was statistically more significant in the test group (P = 0.024). A statistically significant reduction in the gingival scores was seen over a period of 12 weeks in both the groups (P < 0.001 for tests and P = 0.001 for controls). This reduction was statistically more significant in the test group (P = 0.042). No statistically significant reduction in the detection rate of red complex organisms were seen at 4 weeks in both the groups.

CONCLUSION

Powered toothbrushes result in a significant overall improvement in gingival health when constant reinforcement of oral hygiene instructions is given.

Oral lesions and dental status of autistic children in Yemen: A case-control study

Purpose:

This study aimed to assess the prevalence of oral lesions among children with autism in Sana’a City, Yemen, and to evaluate their dental status.

Patients and Methods:

This case–control study included 42 children with autism, aged between 5 and 16 years, and 84 age- and gender-matched healthy children as controls. Oral lesions were assessed based on standardized criteria according to the World Health Organization (WHO) recommendations. Dental caries, gingival health, and oral hygiene status were assessed using dmft/DMFT index, Gingival Index (GI), and Plaque Index (PI), respectively. Chi-square test and Mann–Whitney's test were used to compare the groups.

Results:

Compared to controls, children with autism revealed higher proportion of fistulae (9.5% vs. 2.4%), ulcerative lesions (7.1% vs. 1.2%), gingival hyperplasia (4.8% vs. 0.0%), and cheilitis (4.8% vs. 2.4%); however, the differences were not statistically significant. The mean dmft score was significantly higher in children with autism than in controls (5.23 vs. 4.06; P < 0.001). Moreover, children with autism revealed poorer oral hygiene than controls, and the majority had gingivitis.

Conclusions:

Children with autism in Yemen have high prevalence of oral soft tissue lesions, caries, and gingivitis. Therefore, proper oral health education programs should be initiated and directed toward this special section of the society.

Dental caries experience and periodontal treatment needs of children with autistic spectrum disorder

AIM

To assess dental caries experience and periodontal treatment needs among Libyan children diagnosed with autistic spectrum disorder (ASD).

MATERIALS AND METHODS

A cross-sectional, comparative case-control study was used, in which dental caries experience of 50 children with ASD was compared with that of 50 controls. The children with ASD were recruited from Benghazi Centre of Children with ASD, Libya. Controls were recruited from school children and matched for age, gender and socioeconomic status. DMFT, dmft for dental caries experience and CPITN for periodontal treatment needs were calculated according to WHO criteria by a calibrated examiner. Scores for DMFT as well as CPITN indices were compared using bivariate analysis.

RESULTS

The data analysed for this study comprised observations from a group of children (cases = 50) diagnosed with ASD matched with healthy children (controls = 50). Consequently, each group consisted of 40 males and 10 females aged between 3 and 14 years (mean 7.29 ± 3.11). The ASD children showed significantly lower means for DMFT and dmft teeth as well as higher periodontal treatment needs (p > 0.05).

CONCLUSION

Children with ASD were found to be more likely caries-free and have lower DMFT scores and higher unmet periodontal treatment needs than did the unaffected control children.