Oral Care Education for Children with Autism Spectrum Disorder (ASD)

Objective: To identify if oral health education (OHE) is taught to children with Autism Spectrum Disorder (ASD) in special schools in Singapore, the level of oral health knowledge of their teachers, teachers’ perceived barriers to the implementation of OHE and if teachers’ knowledge of oral health can be potentially modified through suitable interventions. Method:  Teachers working with children with ASD were recruited from special schools in Singapore. A pre-talk questionnaire evaluating oral health knowledge and perceived barriers to care was administered prior to a 20-minute presentation on OHE. Participants then completed a post-talk questionnaire. Results from the questionnaires were analysed and compared. Result: 178 teachers participated in this study. Teachers’ baseline knowledge was negatively associated with perceived overall (p<0.001) and personal barriers (p<0.001) in giving OHE. 74.8% of teachers felt that they had insufficient knowledge about fluoride, but were found to be knowledgeable regarding toothbrushing methods and how to select an ideal toothbrush. The extent of incorporation of OHE into their teaching was associated with 1) teachers’ perceived importance of oral hygiene (p=0.009); 2) history of OHE training by a dental professional (p=0.022); 3) availability of teaching materials (p=0.001); and 4) teachers’ perceived personal level of oral hygiene (p=0.012). Post-intervention, there was a significant increase in teachers’ oral health knowledge scores (p<0.001). Conclusion: OHE is incorporated to a limited extent into the curriculum of special schools in Singapore for children with ASD.  Barriers to the incorporation of OHE in special schools include teachers’ limited knowledge of oral health issues, lack of formal training by dental professionals and insufficient teaching materials. Talks by dental professionals are effective in delivering new information on oral health to participating teachers, but should be supplemented by provision of teaching materials.