Predictive Factors for Caries in Children With Autism Spectrum Disorders

Objectives: Little has been studied regarding dental needs of children with autism spectrum disorders (ASD) and factors that contribute to an increased risk for having unmet dental needs. The objective of this study was to investigate which aspects of a child’s background and oral health care contribute significantly to an increase in dental caries.
Methods: The study was a retrospective medical record review of patients with a confirmed ASD diagnosis seen in both the Developmental Medicine Center and the Dental Clinic at Boston Children’s Hospital within the same 12-month period. The DMFT and dmft were recorded along with information regarding oral hygiene habits, snacking patterns, insurance and child behavior. To determine the relationship between the total-DMFT and the predictive factors, bivariate analysis and a linear regression model were performed using SPSS.
Results: 133 charts were reviewed. The mean age of the sample was 10.2 years and 83.5% of subjects were male. Bivariate analysis was performed on all covariates. Those with a significance of p<0.2 were included in a linear regression. The final model included insurance status, whether the child or the parent brushes at home, and if sedation was used for treatment. The model showed a statistically significant difference in total-DMFT between patients who had private insurance and those who did not (p=0.024). Patients who required sedation for treatment were found to have significantly higher total-DMFT scores (p<.001). There was no significant difference in total-DMFT depending on who brushes the child’s teeth at home.
Conclusions: This study provides useful information to dentists regarding the risk factors influencing caries status in the ASD population. In particular, the need for sedation in the dental office may provide insight for providers on the child’s ability to tolerate and maintain sufficient oral hygiene at home.