Study highlights oral health of children with autism

Dental Tribune International

Tue. 28. January 2020

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DURBAN, South Africa: As the number of reported cases of children with autism spectrum disorder (ASD) continues to climb across the globe, the special attention that they may require in order to help them avoid oral health problems has become more apparent. A study out of South Africa has shed light on this issue and pointed towards ways that could help decrease oral health inequalities in this population.

Though prevalence rates vary from nation to nation, the World Health Organisation has estimated that approximately one in 160 children suffer from an ASD. Since it is a neurodevelopmental disorder, children with ASD do not typically possess orofacial malformations. Instead, they often develop oral problems as a result of self-injurious behaviours, a preference for sweet and soft foods, a lack of manual dexterity, and certain medications taken for the condition.

As reported by Dental Tribune International last year, children with ASD often miss out on dental appointments owing to difficulty in persuading them to participate. This avoidance may lead to an increased risk of dental caries, oral infections and further dental problems.

To understand more about the oral health of children with ASD, researchers from the University of KwaZulu-Natal’s School of Health Sciences conducted intra-oral examinations of 149 children with this condition attending special needs schools in the South African province. Of these children, 85.2% were found to have untreated caries in their permanent teeth, a figure significantly higher than the 56.5% recorded for all children in a 2015 national oral health survey.

Of the children observed, 52.9% only brushed their teeth once per day, and self-inflicted soft-tissue trauma in the head and neck region was found in 68.5% of participants. To combat these problems, the study’s authors recommended that preventive and educational oral health programmes be developed to reduce the rate of caries and address those challenges specific to children with ASD.

In a follow-up article published in The Conversation, Dr Magandhree Naidoo, co-author of the study and now lecturer in the University of the Western Cape’s Department of Oral Hygiene, outlined some of the measures that could be installed in South Africa to address these oral health inequalities. An example of a successful initiative was the Sparkle Brush Programme, which trained special needs teachers, teaching assistants and nurses to provide oral prophylaxis instruction and demonstrated proper toothbrushing technique to the children. It was launched in four special needs schools in Kwa-Zulu Natal and in the Western Cape. This programme recently won an international social responsibility award for special needs at the 2019 International Federation of Dental Hygienists’ International Symposium on Dental Hygiene in Brisbane in Australia.

The study, titled “The oral health status of children with autism spectrum disorder in KwaZulu-Natal, South Africa”, was published online on 12 October 2018 in BMC Oral Health. The article in The Conversation can be found here.

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