Abstract
The objective of this meta-analysis was to assess the dental health status of children with ASD in terms of decayed, missing, and filled permanent teeth (DMFT) and decayed, missing, and filled deciduous teeth (dmft). PubMed, Embase, psycINFO, and Cochrane library were searched for studies published until September 2018. A random-effects model was applied to estimate the pooled results.Nine studies comprising 532 children with ASD and 622 controls were included. No significant differences between children with ASD and controls were observed for DMFT and dmft in the world. Subgroup analyses revealed that children with ASD had a significantly higher dmft index than that of controls in Asia.Children with ASD have a worse dental health status than healthy children in Asia, but caution is necessary given the limited studies available for analysis.
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References
Adair, P. M., Pine, C. M., Burnside, G., Nicoll, A. D., Gillett, A., Anwar, S., et al. (2004). Familial and cultural perceptions and beliefs of oral hygiene and dietary practices among ethnically and socio-economicall diverse groups. Community Dental Health,21(1 Suppl), 102–111.
Al-Maweri, S. A., Halboub, E. S., Al-Soneidar, W. A., & Al-Sufyani, G. A. (2014). Oral lesions and dental status of autistic children in Yemen: A case-control study. Journal of International Society of Preventive & Community Dentistry,4(Suppl 3), S199–203. https://doi.org/10.4103/2231-0762.149040.
Altun, C., Guven, G., Akgun, O. M., Akkurt, M. D., Basak, F., & Akbulut, E. (2010). Oral health status of disabled individuals attending special schools. European Journal of Dentistry,4(4), 361–366.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5): American Psychiatric Pub.
Arora, G., Mackay, D. F., Conway, D. I., & Pell, J. P. (2016). Ethnic differences in oral health and use of dental services: Cross-sectional study using the 2009 Adult Dental Health Survey. BMC Oral Health,17(1), 1. https://doi.org/10.1186/s12903-016-0228-6.
Awasthi, P., Peshwani, B., Tiwari, S., Thakur, R., Shashikiran, N. D., & Singla, S. (2015). Evaluation and comparison of the efficacy of low fluoridated and calcium phosphate-based dentifrice formulations when used with powered and manual toothbrush in children with autism. Contemporary Clinical Dentistry,6(Suppl 1), S188–191. https://doi.org/10.4103/0976-237X.166811.
Baio, J., Wiggins, L., Christensen, D. L., Maenner, M. J., Daniels, J., Warren, Z., et al. (2018). Prevalence of autism spectrum disorder among children aged 8 years—Autism and developmental disabilities monitoring network, 11 sites, united states, 2014. MMWR Surveillance Summaries,67(6), 1–23. https://doi.org/10.15585/mmwr.ss6706a1.
Bassoukou, I. H., Nicolau, J., & dos Santos, M. T. (2009). Saliva flow rate, buffer capacity, and pH of autistic individuals. Clinical Oral Investigations,13(1), 23–27. https://doi.org/10.1007/s00784-008-0209-5.
Battle, D. E. (2013). Diagnostic and statistical manual of mental disorders (DSM). Codas,25(2), 191–192.
Bhandary, S., & Hari, N. (2017). Salivary biomarker levels and oral health status of children with autistic spectrum disorders: A comparative study. European Archives of Paediatric Dentistry,18(2), 91–96. https://doi.org/10.1007/s40368-017-0275-y.
Buescher, A. V., Cidav, Z., Knapp, M., & Mandell, D. S. (2014). Costs of autism spectrum disorders in the United Kingdom and the United States. JAMA Pediatrics,168(8), 721–728. https://doi.org/10.1001/jamapediatrics.2014.210.
Chistol, L. T., Bandini, L. G., Must, A., Phillips, S., Cermak, S. A., & Curtin, C. (2018). Sensory sensitivity and food selectivity in children with autism spectrum disorder. Journal of Autism and Developmental Disorders,48(2), 583–591. https://doi.org/10.1007/s10803-017-3340-9.
da Silva, S. N., Gimenez, T., Souza, R. C., Mello-Moura, A. C. V., Raggio, D. P., Morimoto, S., et al. (2017). Oral health status of children and young adults with autism spectrum disorders: Systematic review and meta-analysis. International Journal of Paediatric Dentistry,27(5), 388–398. https://doi.org/10.1111/ipd.12274.
Delli, K., Reichart, P. A., Bornstein, M. M., & Livas, C. (2013). Management of children with autism spectrum disorder in the dental setting: Concerns, behavioural approaches and recommendations. Medicina Oral, Patologia Oral y Cirugia Bucal,18(6), e862–868.
Diab, H. M., Motlaq, S. S., Alsharare, A., Alshammery, A., Alshammery, N., Khawja, S. G., et al. (2016). Comparison of gingival health and salivary parameters among autistic and non-autistic school children in riyadh. Journal of Clinical and Diagnostic Research,10(10), ZC110–ZC113. https://doi.org/10.7860/jcdr/2016/23373.8692.
Dias, G. G., Prado, E. F., Vadasz, E., & Siqueira, J. T. (2010). Evaluation of the efficacy of a dental plaque control program in autistic patients. Journal of Autism and Developmental Disorders,40(6), 704–708. https://doi.org/10.1007/s10803-009-0918-x.
Du, R. Y., Yiu, C. K. Y., & King, N. M. (2019). Oral health behaviours of preschool children with autism spectrum disorders and their barriers to dental care. Journal of Autism and Developmental Disorders,49(2), 453–459. https://doi.org/10.1007/s10803-018-3708-5.
El Khatib, A. A., El Tekeya, M. M., El Tantawi, M. A., & Omar, T. (2014). Oral health status and behaviours of children with autism spectrum disorder: A case-control study. International Journal of Paediatric Dentistry,24(4), 314–323. https://doi.org/10.1111/ipd.12067.
Fakroon, S., Arheiam, A., & Omar, S. (2015). Dental caries experience and periodontal treatment needs of children with autistic spectrum disorder. European Archives of Paediatric Dentistry,16(2), 205–209. https://doi.org/10.1007/s40368-014-0156-6.
Gace, E., Kelmendi, M., & Fusha, E. (2014). Oral health status of children with disability living in Albania. Materia Socio-Medica,26(6), 392–394. https://doi.org/10.5455/msm.2014.26.392-394.
Inoue, R., Sakaue, Y., Sawai, C., Sawai, T., Ozeki, M., Romero-Perez, G. A., et al. (2016). A preliminary investigation on the relationship between gut microbiota and gene expressions in peripheral mononuclear cells of infants with autism spectrum disorders. Bioscience, Biotechnology, and Biochemistry,80(12), 2450–2458. https://doi.org/10.1080/09168451.2016.1222267.
Jaber, M. A. (2011). Dental caries experience, oral health status and treatment needs of dental patients with autism. Journal of Applied Oral Science,19(3), 212–217.
Jaber, M. A., Sayyab, M., & Abu Fanas, S. H. (2011). Oral health status and dental needs of autistic children and young adults. Journal of Investigative and Clinical Dentistry,2(1), 57–62. https://doi.org/10.1111/j.2041-1626.2010.00030.x.
Kalyoncu, I. O., & Tanboga, I. (2017). Oral health status of children with autistic spectrum disorder compared with non-authentic peers. Iranian Journal of Public Health,46(11), 1591–1593.
Kotha, S. B., AlFaraj, N. S. M., Ramdan, T. H., Alsalam, M. A., Al Ameer, M. J., & Almuzin, Z. M. (2018). Associations between diet, dietary and oral hygiene habits with caries occurrence and severity in children with autism at Dammam City, Saudi Arabia. Open Access Macedonian Journal of Medical Sciences,6(6), 1104–1110. https://doi.org/10.3889/oamjms.2018.245.
Kumanyika, S. K. (2008). Environmental influences on childhood obesity: Ethnic and cultural influences in context. Physiology & Behavior,94(1), 61–70. https://doi.org/10.1016/j.physbeh.2007.11.019.
Lo1†, C. K.-L. (2014). Newcastle-Ottawa Scale.pdf. BMC Medical Research Methodology.
Loo, C. Y., Graham, R. M., & Hughes, C. V. (2008). The caries experience and behavior of dental patients with autism spectrum disorder. Journal of the American Dental Association,139(11), 1518–1524.
Mansoor, D., Al Halabi, M., Khamis, A. H., & Kowash, M. (2018). Oral health challenges facing Dubai children with Autism Spectrum Disorder at home and in accessing oral health care. European Journal of Paediatric Dentistry,19(2), 127–133. https://doi.org/10.23804/ejpd.2018.19.02.06.
Marshall, J., Sheller, B., & Mancl, L. (2010). Caries-risk assessment and caries status of children with autism. Pediatric Dentistry,32(1), 69–75.
McKinney, C. M., Nelson, T., Scott, J. M., Heaton, L. J., Vaughn, M. G., & Lewis, C. W. (2014). Predictors of unmet dental need in children with autism spectrum disorder: Results from a national sample. Academic Pediatric,14(6), 624–631. https://doi.org/10.1016/j.acap.2014.06.023.
Morales-Chavez, M. C. (2017). Oral health assessment of a group of children with autism disorder. Journal of Clinical Pediatric Dentistry,41(2), 147–149. https://doi.org/10.17796/1053-4628-41.2.147.
Murshid, E. Z. (2015). Dental knowledge of educators and healthcare providers working with children with autism spectrum disorders. Saudi Medical Journal,36(12), 1477–1485. https://doi.org/10.15537/smj.2015.12.12622.
Namal, N., Vehit, H. E., & Koksal, S. (2007). Do autistic children have higher levels of caries? A cross-sectional study in Turkish children. Journal of Indian Society of Pedodontics and Preventive Dentistry,25(2), 97–102.
Onol, S., & Kirzioglu, Z. (2018). Evaluation of oral health status and influential factors in children with autism. Nigerian Journal of Clinical Practice,21(4), 429–435. https://doi.org/10.4103/njcp.njcp_41_17.
Peterson, J., Welch, V., Losos, M., & Tugwell, P. (2011). The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa: Ottawa Hospital Research Institute.
Qiao, Y., Wu, M., Feng, Y., Zhou, Z., Chen, L., & Chen, F. (2018). Alterations of oral microbiota distinguish children with autism spectrum disorders from healthy controls. Scientific Reports,8(1), 1597. https://doi.org/10.1038/s41598-018-19982-y.
Saad, K., Abdel-Rahman, A. A., Elserogy, Y. M., Al-Atram, A. A., Cannell, J. J., Bjorklund, G., et al. (2016). Vitamin D status in autism spectrum disorders and the efficacy of vitamin D supplementation in autistic children. Nutritional Neuroscience,19(8), 346–351. https://doi.org/10.1179/1476830515Y.0000000019.
Sarnat, H., Samuel, E., Ashkenazi-Alfasi, N., & Peretz, B. (2016). Oral health characteristics of preschool children with autistic syndrome disorder. Journal of Clinical Pediatric Dentistry,40(1), 21–25. https://doi.org/10.17796/1053-4628-40.1.21.
Schardt, C., Adams, M. B., Owens, T., Keitz, S., & Fontelo, P. (2007). Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Medical Informatics and Decision Making,7, 16. https://doi.org/10.1186/1472-6947-7-16.
Shangase, S. L., Mohangi, G. U., Hassam-Essa, S., & Wood, N. H. (2013). The association between periodontitis and systemic health: An overview. SADJ,68(1), 10–12.
Shapira, J., Mann, J., Tamari, I., Mester, R., Knobler, H., Yoeli, Y., et al. (1989). Oral health status and dental needs of an autistic population of children and young adults. Special Care in Dentistry,9(2), 38–41.
Slayton, R. L. (2010). Autism spectrum disorder (ASD) may lead to lower prevalence and severity of dental caries than in children without ASD. Journal of Evidence Based Dental Practice,10(2), 105–106. https://doi.org/10.1016/j.jebdp.2010.02.008.
Stein, L. I., Polido, J. C., & Cermak, S. A. (2013). Oral care and sensory over-responsivity in children with autism spectrum disorders. Pediatric Dentistry,35(3), 230–235.
Subramaniam, P., & Gupta, M. (2011). Oral health status of autistic children in India. Journal of Clinical Pediatric Dentistry,36(1), 43–47.
Suhaib, F., Saeed, A., Gul, H., & Kaleem, M. (2019). Oral assessment of children with autism spectrum disorder in Rawalpindi, Pakistan. Autism,23(1), 81–86. https://doi.org/10.1177/1362361317730299.
Sun, X., Allison, C., Matthews, F. E., Sharp, S. J., Auyeung, B., Baron-Cohen, S., et al. (2013). Prevalence of autism in mainland China, Hong Kong and Taiwan: A systematic review and meta-analysis. Molecular Autism,4(1), 7. https://doi.org/10.1186/2040-2392-4-7.
Vajawat, M., & Deepika, P. C. (2012). Comparative evaluation of oral hygiene practices and oral health status in autistic and normal individuals. Journal of International Society of Preventive & Community Dentistry,2(2), 58–63. https://doi.org/10.4103/2231-0762.109369.
Weintraub, K. (2011). The prevalence puzzle: Autism counts. Nature,479(7371), 22–24. https://doi.org/10.1038/479022a.
Wong, V. C., & Hui, S. L. (2008). Epidemiological study of autism spectrum disorder in China. Journal of Child Neurology,23(1), 67–72. https://doi.org/10.1177/0883073807308702.
Yashoda, R., & Puranik, M. P. (2014). Oral health status and parental perception of child oral health related quality-of-life of children with autism in Bangalore, India. Journal of Indian Society of Pedodontics and Preventive Dentistry,32(2), 135–139. https://doi.org/10.4103/0970-4388.130967.
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This work was funded Sanming project of medicine in Shenzhen (No. SZSM201612079), Shenzhen Science and Technology Innovation Committee (JCYJ20160429185235132).
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Zhang, Y., Lin, L., Liu, J. et al. Dental Caries Status in Autistic Children: A Meta-analysis. J Autism Dev Disord 50, 1249–1257 (2020). https://doi.org/10.1007/s10803-019-04256-x
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DOI: https://doi.org/10.1007/s10803-019-04256-x