Oral and Dental Healthcare of Autistic and Non-Autistic Adults

Background: Oral health is an integral part of health and well-being which impacts on quality of life. Adults on the spectrum maybe at a higher risk of poor oral health compared to adults not on the spectrum due to the nature of the neurodevelopment condition, high rate of comorbidities or limited adaptive skills. Little is known about the oral and dental healthcare of autistic adults which limits the capacity for any intervention.

Objectives: To 1) examine oral hygiene practices 2) identify dental needs 3) examine dental visit experiences and 4) identify barriers to accessing professional dental care in autistic and non-autistic adults.

Methods: We developed an online survey to better understand oral and dental health of autistic adults in Australia, in comparison to a general adult population. Survey items asked about socio-demographics, oral hygiene practices, dental problems and dentist visit experience including barriers to dental care and services. The Autism Quotient (AQ) was included as a diagnostic proxy for autism spectrum disorder. Autistic adults either self-completed or sought assistance from a substitute decision maker to complete the survey. Twenty six autistic adults and 21 non-autistic adults completed the survey.

Results: Autistic adults were significantly older than non-autistic adults (36.7 vs 23.1 years, p = .001). Across both groups, most adults held degree qualifications and were single. The AQ among autistic adults was significantly higher compared with non-autistic adults (38.4 vs 17.3, p = .001). Daily oral hygiene practices did not differ significantly across the two groups for tooth brushing. Over 40% of autistic adults reported oral/dental problems compared to 9% non-autistic adults (p = .015). Dental decay and tooth sensitivity were the most commonly reported problems while sensory sensitivities made dental visits more difficult for autistic adults compared with non-autistic adults (p = .001). Oral instrumentation, bright lights and smells were reported as significant challenges for autistic adults as well as perceived feelings of being afraid to go to the dentist for routine dental cleaning. However, no significant differences emerged between the two groups for how often they visited the dentist.

Conclusions: Autistic adults’ oral hygiene practices are similar to non-autistic adults in the Australian community. Dental decay and tooth sensitivities appear to be an unmet dental need among autistic adults. Although the frequency of dental visits was similar to those of non-autistic adults. Sensory sensitivities posed as barriers to dental care whilst fear about teeth cleaning may further compromise the dental visit experience among autistic adults. Although this preliminary study requires exploration, the results suggest preparatory or supporting preventative dental interventions may be beneficial to autistic adults. The findings have implications for future research into clinical dental health care of autistic adults including psycho-educational strategies which may assist them in overcoming sensory sensitivities or dental fear.