Evaluation of Dental Caries Experience and Biofilm Accumulation in Mexican Pediatric Patients with Autism Spectrum Disorder (ADS): A Cross-Sectional Study
DOI:
https://doi.org/10.15517/qf5b8887Keywords:
Autism spectrum disorder; Disabled children; Biofilm; Dental caries.Abstract
Autism Spectrum Disorder (ASD) presents sensory and behavioral challenges that may complicate oral care. This study evaluated biofilm accumulation and caries prevalence in children with and without ASD, enrolled in an educational center in San Luis Potosí, México. A cross-sectional study was conducted at a specialized ASD educational center in San Luis Potosí, México. Twenty children with ASD and 40 neurotypical children, matched by age and sex, underwent oral examinations assessing biofilm using the simplified debris index (DI-S) and caries using the international caries detection and assessment system (ICDAS). Participants aged 5-12 years(90%male). Caries prevalence was significantly lower in the ASD group (60%) compared with controls (95%) (p=0.01). DI-S scores indicated fair-to-poor oral hygiene in both groups, with no significant differences. Early ICDAS lesions (codes 1-2) were more common in ASF primary teeth, whereas cavitated lesions (codes 3-6) were more frequent in neurotypical children. In this study population of children with ASD demonstrated lower caries prevalence yet similar biofilm accumulation compared with neurotypical peers.
Downloads
References
Stein L.I., Polido J.C., Mailloux Z., Coleman G.G., Cermak S.A. Oral care and sensory concerns in autism. Am J Occup Ther. 2011; 65: 539-542.
Brickhouse T.H., Farrington F.H., Best A.M., Ellsworth C.W. Barriers to dental care for children in Virginia with autism spectrum disorders. J Dent Child. 2009; 76: 188-193.
Delli K., Reichart P.A., Bornstein M.M., Livas C. Management of children with autism spectrum disorder in the dental setting: Concerns, behavioural approaches and recommendations. Med Oral, Patol Oral Cir Bucal. 2013; 18: e862-e868. DOI: https://doi.org/10.4317/medoral.19084
Askar H., Marques L.S., Paiva S.M., Martins C.C. Behavioural interventions for treating dental anxiety in children with autism spectrum disorder: A systematic review. Eur Arch Paediatr Dent. 2020; 21: 35-44.
Jaber M.A., Sayyab M., Abu Fanas S.H. Oral health status and dental needs of autistic children and young adults. J Investig Clin Dent. 2011; 2: 57-62. DOI: https://doi.org/10.1111/j.2041-1626.2010.00030.x
Bhandari R., Emerson A.B., Nadershah M. Dental Management of Autistic Patients. The Journal of Contemporary Dental Practice. 2018; 19: 599-605.
Herrera-Moncada M,. Campos-Lara P., Hernández-Cabanillas J.C., Bermeo-Escalona J.R., Pozos-Guillén A., Pozos-Guillén F., Garrocho-Rangel J.A. Autism and Paediatric Dentistry: A Scoping Review. Oral Health Prev Dent. 2019; 17: 203-210.
El Khatib A.A., El Tekeya M.M., El Tantawi M.A., Omar T. Oral health status and behaviours of children with autism spectrum disorder: A case-control study. Int J of Paediatr Dent. 2014; 24: 314-323. DOI: https://doi.org/10.1111/ipd.12067
Weil T.N., Bagramian R.A., Inglehart M.R. Autism and the child's oral health: Parental perceptions of dental care challenges. J Dent Hyg. 2011; 85: 201-208.
American Academy of Pediatric Dentistry. Caries-risk assessment and management for infants, children, and adolescents. The Reference Manual of Pediatric Dentistry. Chicago, III.: Pediatr Dent. 2024: 306-312.
Dumas S.A., Weaver K.E., Park S.Y., Polk D.E., Weyant R.J., Bogen D.L. Accuracy of visible plaque identification by pediatric clinicians during well-child care. Clin Pediatr (Phila). 2013; 52: 645-651. DOI: https://doi.org/10.1177/0009922813483876
Al-Maweri S.A., Halboub E.S., Al-Soneidar W.A., Al-Sufyani G.A. Oral lesions and dental status of autistic children in Yemen: A case-control study. J Int Soc Prev Community Dent. 2014; 4 (Suppl 3): S199-203. DOI: https://doi.org/10.4103/2231-0762.149040
Oda G., Karayagmurlu A., Dagli I., Aren G., Soylu N. Oral health status in children with autism spectrum disorder: A cross-sectional study from Turkey. Psychiatry Behavior Sci. 2021; 11: 186-192. DOI: https://doi.org/10.5455/PBS.20210321075312
Greene J.C., Vermillion J.R. The simplified oral hygiene index. J Am Dent Assoc. 1964; 68: 7-13. DOI: https://doi.org/10.14219/jada.archive.1964.0034
Carneiro V.L., Fraiz F.C., Ferreira F.de M., Pintarelli T.P., Oliveira A.C., Boguszewski M.C. The influence of glycemic control on the oral health of children and adolescents with diabetes mellitus type 1. Arch Endocrinol Metab. 2015; 59: 535-40. DOI: https://doi.org/10.1590/2359-3997000000117
ICDAS Criteria Manual: International Caries Detection and Assessment System (ICDAS) International Caries Detection and Assessment System (ICDAS) Coordinating Committee. Workshop. Baltimore, Maryland, USA; March 2005.
Kim S.Y., Kim H.N. Assessment of early childhood caries using ICDAS and Snyder caries activity test among preschool children: A cross-sectional study. J Clin Pediatr Dent. 2023; 47: 163-170.
Ismail A.I., Sohn W., Tellez M., Amaya A., Sen A., Hasson H., Pitts N.B. The International Caries Detection and Assessment System (ICDAS): An integrated system for measuring dental caries. Community Dent Oral Epidemiol. 2007; 35: 170-178. DOI: https://doi.org/10.1111/j.1600-0528.2007.00347.x
Loo C.Y., Graham R.M., Hughes C.V. The caries experience and behavior of dental patients with autism spectrum disorder. J Am Dent Assoc. 2008; 139: 1518-1524. DOI: https://doi.org/10.14219/jada.archive.2008.0078
Kuter B., Güler N. Caries experience, oral disorders, oral hygiene practices and socio-demographic characteristics of autistic children. Eur J Paediatr Dent. 2019; 20 (3): 237-41.
Abdelaziz M., Zordán O.J. Detection, diagnosis, and monitoring of early caries: What the restorative dentist needs to know. Dent Clin North Am. 2023; 67 (3): 409-23.
Khoroushi M., Kachuie M. Prevention and treatment of white spot lesions in orthodontic patients. Contemp Clin Dent. 2017; 8 (1): 11-9. DOI: https://doi.org/10.4103/ccd.ccd_216_17
Mishra P., Fareed N., Battur H., Khanagar S., Bhat M.A., Abad O.O. Role of fluoride varnish in preventing early childhood caries: A systematic review. Dent Res J (Isfahan). 2017; 14 (3): 169-76. DOI: https://doi.org/10.4103/1735-3327.208766
Nunes-Da Silva S., Gimenez T., Souza R.C., Mello-Moura A.C.V., Raggio D.P., Morimoto S., Lara J.S., Soares G.C., Tedesco T.K. Oral health status of children and young adults with autism spectrum disorders: Systematic review and meta-analysis. Int J Paediatr Dent. 2017; 27: 388-398. DOI: https://doi.org/10.1111/ipd.12274
Namal N., Vehit H.E., Koksal S. Do autistic children have higher levels of caries? A cross-sectional study in Turkish children. J Indian Soc Pedod Prev Dent. 2007; 25: 97-102. DOI: https://doi.org/10.4103/0970-4388.33457
Fakroon S., Arheiam A., Omar S. Dental caries experience and periodontal treatment needs of children with autism spectrum disorder. Eur Arch Paediatr Dent. 2015; 16: 205-209. DOI: https://doi.org/10.1007/s40368-014-0156-6
Hussein F.J., Alaa M.M., Sazgar M.S. Dental caries experience and periodontal health status in a sample of autism children. Zanco J Med Sci. 2018; 22: 73-81. DOI: https://doi.org/10.15218/zjms.2018.010
Huebner C.E., Chi D.L., Masterson E., Milgrom P. Preventive dental health care experiences of preschool-age children with special health care needs. Spec Care Dentist. 2015; 35: 68-77. DOI: https://doi.org/10.1111/scd.12084
Richa, Yashoda R., Puranik M.P. Oral health status and parental perception of child oral health related quality-of-life of children with autism in Bangalore, India. J Indian Soc Pedod Prev Dent. 2014; 32: 135-9. DOI: https://doi.org/10.4103/0970-4388.130967
Sami W., Ahmad M.S., Shaik R.A., Miraj M., Ahmad S., Molla M.H. Oral health statuses of children and young adults with autism spectrum disorder: An umbrella review. J Clin Med. 22; 13: 59-74. DOI: https://doi.org/10.3390/jcm13010059
Mohinderpal-Chadha G., Kakodkar P., Chaugule V., Nimbalkar V. Dental survey of institutionalized children with autistic disorder. Int J Clin Pediatr Dent. 2012; 5: 29-32. DOI: https://doi.org/10.5005/jp-journals-10005-1130
Corridore D., Zumbo G., Corvino I., Guaragna M., Bossù M,. Polimeni A., Vozza I. Prevalence of oral disease and treatment types proposed to children affected by Autistic Spectrum Disorder in Pediatric Dentistry: A Systematic Review. Clin Ter. 2020; 171: e275-e282.
Lu Y.Y., Wei I.H., Huang C.C. Dental health – A challenging problem for a patient with autism Spectrum disorder. Gen Hosp Psychiatry 2013; 35: 214.e1-214.e3. DOI: https://doi.org/10.1016/j.genhosppsych.2012.06.012
Bartolomé-Villar B., Mourelle-Martínez M.R., Diéguez-Pérez M., de Nova-García M.J. Incidence of oral health in pediatric patients with disabilities: Sensory disorders and autism spectrum disorder. Systematic review II. J Clin Exp Dent. 2016; 8: e344-351. DOI: https://doi.org/10.4317/jced.52923
Mattei R., Cuvo A., Maurizio S. Oral assessment of children with an autism spectrum disorder. J Dent Hyg. 2007; 81: 65.
Bassoukou I.H., Nicolau J., dos Santos M. Saliva flow rate, buffer capacity, and pH of autistic individuals. Clin Oral Investig. 2009; 13: 23-27. DOI: https://doi.org/10.1007/s00784-008-0209-5
Fahlvik-Planefeldt Ch., Herrström P. Dental care of autistic children within the non-specialised public dental service. Swed Dent J. 2001; 25: 113-118.
Rai K., Hegde A.M., Jose N. Salivary antioxidants and oral health in children with autism. Arch Oral Biol 2012; 57: 1116-1120.
Jaber M.A. Dental caries experience, oral health status and treatment needs of dental patients with autism. Journal of Applied Oral Science. 2011; 19: 212-217. DOI: https://doi.org/10.1590/S1678-77572011000300006
Morales-Chávez M.C. Oral health assessment of a group of children with autism disorder. J Clin Pediatr Dent. 2017; 41: 147-149. DOI: https://doi.org/10.17796/1053-4628-41.2.147
Subramaniam P., Gupta M. Oral health status of autistic children in India. J Clin Pediatr Dent. 2011; 36: 43-47. DOI: https://doi.org/10.17796/jcpd.36.1.l6287842uj536x13
Blomqvist M., Bejerot S., Dahllöf G. A cross-sectional study on oral health and dental care in intellectually able adults with autism spectrum disorder. BMC Oral Health; 2015; 15: 81. DOI: https://doi.org/10.1186/s12903-015-0065-z
Rai K., Hegde A.M., Jose N. Salivary antioxidants and oral health in children with autism. Arch Oral Biol 2012; 57: 1116-1120. DOI: https://doi.org/10.1016/j.archoralbio.2012.03.006
Hammersmith K.J., Harlan T.A., Fenning R.M., Chan J., Stephenson K.G., Macklin E.A., Casamassimo P.S., Townsend J.A., Butter E.M., Steinberg-Epstein R.B. Correlates of oral health fatalism in caregivers of children with autism spectrum disorder. Spec Care Dentist. 2021; 41: 145-153. DOI: https://doi.org/10.1111/scd.12564
Published
Issue
Section
License
Copyright (c) 2026 usana Esparza-Loredo, Saray Aranda-Romo, Huri Morales-Saavedra, Daniela Guzmán-Uribe, Antonio Cepeda-Bravo, Gabriela Torre-Delgadillo, Fátima Aguilar-Diaz, Guadalupe García-De la Torre, Arturo Garrocho-Rangel.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
ODOVTOS - Int. J. Dent. Sc. endorses CC BY-NC-SA
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator. If you remix, adapt, or build upon the material, you must license the modified material under identical terms. CC BY-NC-SA includes the following elements:
BY: credit must be given to the creator.
NC: Only noncommercial uses of the work are permitted.
SA: Adaptations must be shared under the same terms.
