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Oral Health and Dental Care Among Children with and without an Autism Spectrum Disorder in Australia: A Comparative Study

Friday, May 12, 2017: 12:00 PM-1:40 PM
Golden Gate Ballroom (Marriott Marquis Hotel)
J. Granich1, A. Lin2, A. Dass2, L. G. Do3, L. Luzzi4, M. Y. Rayner2 and A. J. Whitehouse1, (1)Telethon Kids Institute, University of Western Australia, Perth, Australia, (2)Telethon Kids Institute, The University of Western Australia, West Perth, Australia, (3)Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, Australia, (4)Australian Research Centre for Population Oral Health (ARCPOH), The University of Adelaide, Adelaide, Australia
Background:  Impairments associated with autism spectrum disorders (ASD) may limit children with ASD ability to engage in self-care and healthcare. Oral health is empirically linked with general health whilst dental health-care is fundamentally required across the life-course. Health behaviours are usually formed during the childhood years. However, little is known about oral health behaviours of children with ASD in the world and there are no published dental health reports for Australian children with ASD.

Objectives:

This study aimed to better understand oral and dental health of children with ASD in Australia. The objectives were:

  1. To examine dental health status and oral hygiene practices in children with ASD, in comparison with the general paediatric population.

  2. To identify oral health factors that may impact on dental health status of children with ASD.

  3. To examine dental visits experience of children with ASD.

  4. To identify barriers to dental care at home and at the dentist.

Methods:

An online survey asked parents about their child with ASD oral health status, oral hygiene practices and barriers to dental care. The survey data of 5-14 year olds with ASD (n = 57) was compared with the 2012-2014 Australian National Child Oral Health Survey (NCOHS) (n = 24, 664) on a range of socio-demographics and dental health factors. The NCOHS questionnaire data was parent-reported and child oral clinical examinations were performed by dental practitioners.

Results:

Children with ASD had a higher rate of deciduous dental decay and permanent filled teeth compared with NCOHS children (p < .001) (Figure 1). Children with ASD were more likely to visit the dentist for a dental problem or when in pain compared with NCOHS children (p < .001). Children with ASD were more likely to be older than NCOHS children at their first dental visit (p < .001) (Table 1). Nearly 20% of children with ASD had a negative experience during their last dental visit. Sixteen percent of children with ASD had conscious sedation or general anaesthesia for routine preventive treatments. Children with ASD had moderate-to-severe levels of oral (78.1%), taste (82.9%), light (72.3%) and sound (84.1%) sensitivities. Most parents (67.7%) of children with ASD had difficulties with children’s oral care. Over 40% of parents had little/quite a bit of difficulty locating a dentist willing to provide dental care for their child with ASD.

Conclusions:

This study provides information about oral and dental health problems among children with ASD, in Australia. It also adds value to the emerging worldwide evidence about oral health needs and barriers to dental care for children with ASD. Findings showed that children with ASD have more dental decay compared with the general paediatric population. This study highlights difficulties with oral care for children with ASD. Sensory sensitivities pose challenges to effective dental hygiene and dental care visits. This study has research and clinical implications focused on preventive strategies that can assist both, parents and children with ASD to overcome dental care problems in an effort to prevent or reduce dental disease.