Covariates Associated with Dental Problems in Children with Autism Spectrum Disorders

Background: Children with autism spectrum disorders (ASDs) often have atypical oral sensations and behaviors that interfere with oral hygiene efficacy and compliance with professional services in the dental office.  These challenges place children with ASDs at high risk for dental problems. 

Objectives:  To examine the rate of and covariates for dental problems in children with ASDs. 

Methods: A retrospective review of children ages 3 to 15 years who were enrolled in our local ATN site between March 2009 and April 2011 was performed.  Parents completing the ATN Registry Parent Baseline Assessment and the Sensory Profile were questioned about past or current dental problems, activity in behavioral and educational interventions, presence of sensory differences and abnormal feeding behaviors especially pica.  Demographic and questionnaire data for children with versus those without a dental problem were compared using descriptive statistics, chi square analyses, and t-tests.  Statistical significance was set a priori at p<0.05.   

Results: One hundred seventy children (146 males, 24 females) were enrolled during the study period and subject to chart review.  Fifty six of 170 children (33%) were reported to have a dental problem.  Dental caries (34%), orthodontic concerns (21%), and tooth grinding (18%) were most commonly recorded.  Dental problems were more frequently reported when children needed occupational therapy but did not receive speech therapy (p<0.01).  Children scored as having definite differences in the tactile subscale of the Sensory Profile were more likely to have dental problems (p=0.05).   Other covariates including ASD diagnosis, use of medications, presence and severity of sensory, attention, and hyperactivity problems, participation in pica, and differences in the taste/smell, movement, and visual subscales of the Sensory Profile were comparable among the groups.   Only one child reported to have a dental problem was listed for subspecialty referral to a dentist.

Conclusions: Dental problems, as described by parents of children with ASDs, are similar to those expressed by parents of children without ASDs.  The high rate of dental problems reported in this study supports greater involvement of dentists in interdisciplinary team care for children with ASDs.  The impact of concurrent occupational and speech therapy on the prevention and management of dental problems warrants further study.