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Dietary Sugar Exposure and Oral Health Status in Children with Autism Spectrum Disorder: A Case-control Study

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Abstract

This case-control study compared dietary sugar exposure and oral health status between children with and without Autism Spectrum Disorder (ASD), aged 5–12 years (n = 136, each). Data regarding socio-demographics, child’s oral hygiene practices and behavior, diet-related behavior, oral habits and dental trauma were obtained. Child’s diet on the previous day was recorded using 24-h recall method and sugar exposure was calculated using Dental Diet Diary (D3) mobile application. Oral Hygiene Index-Simplified (OHI-S), deft and DMFT were recorded. Results showed no significant differences in sugar exposure, deft and DMFT between the groups. Although oral hygiene practices were significantly better in children with ASD, their OHI-S was significantly worse. Significantly more children with ASD reported mouth-breathing, bruxism and self-injurious habits.

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References

  • Advani, S., Kochhar, G., Chachra, S., & Dhawan, P. (2014). Eating everything except food (PICA): A rare case report and review. Journal of International Society of Preventive & Community Dentistry, 4(1), 1–4.

    Article  Google Scholar 

  • AlMaweri, S. A., Halboub, E. S., AlSoneidar, W. A., & AlSufyani, G. A. (2014). Oral lesions and dental status of autistic children in Yemen: A case–control study. Journal of International Society of Preventive and Community Dentistry, 4(Suppl 3), S199–S203.

    Article  Google Scholar 

  • Altun, C., Guven, G., Yorbik, O., & Acikel, C. (2010). Dental injuries in autistic patients. Pediatric Dentistry, 32(4), 343–346.

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed., pp. 88–90). American Psychiatric Association.

    Book  Google Scholar 

  • Bandini, L. G., Anderson, S. E., Curtin, C., Cermak, S., Evans, E. W., Scampini, R., Maslin, M., & Must, A. (2010). Food selectivity in children with autism spectrum disorders and typically developing children. The Journal of Pediatrics, 157(2), 259–264.

    Article  PubMed  PubMed Central  Google Scholar 

  • Baranek, G. T., David, F. J., Poe, M. D., Stone, W. L., & Watson, L. R. (2006). Sensory experiences questionnaire: Discriminating sensory features in young children with autism, developmental delays, and typical development. Journal of Child Psychology and Psychiatry, 47(6), 591–601.

    Article  PubMed  Google Scholar 

  • Barua, M., & Daley, T. C. (2012). Autism. Rehabilitation Council of India. Retrieved September 27, 2019, from http://www.rehabcouncil.nic.in/writereaddata/autism.pdf.

  • Carruth, B. R., Skinner, J., Houck, K., Moran, J., 3rd., Coletta, F., & Ott, D. (1998). The phenomenon of “picky eater”: A behavioral marker in eating patterns of toddlers. Journal of the American College of Nutrition, 17, 180–186.

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. National Center for Health Statistics. 2011–2012 U.S. National health and nutrition examination survey (NHANES) data for participants ages 18 years and younger with added sugar and caries data. Retrieved September 27, 2019, from https://www.cdc.gov/nchs/nhanes/ContinuousNhanes/Default.aspx?BeginYear=2011.

  • Chadha, M. G., Kakodkar, P., Chaugule, V., & Nimbalkar, V. (2012). Dental survey of institutionalized children with autistic disorder. International Journal of Clinical Pediatric Dentistry, 5(1), 29–32.

    Article  Google Scholar 

  • Chand, S., Chand, S., Dhanker, K., & Chaudhary, A. (2014). Impact of mothers’ oral hygiene knowledge and practice on oral hygiene status of their 12-year-old children: A cross-sectional study. Journal of Indian Association of Public Health Dentistry, 12, 323–329.

    Article  Google Scholar 

  • Chauhan, A., Sahu, J. K., Jaiswal, N., Kumar, K., Agarwal, A., Kaur, J., Singh, S., & Singh, M. (2019). Prevalence of autism spectrum disorder in Indian children: A systematic review and meta-analysis. Neurology India, 67, 100–104.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • da Silva, S. N., Gimenez, T., Souza, R. C., Mello-Moura, A., Raggio, D. P., Morimoto, S., Lara, J. S., Soares, G. C., & Tedesco, T. K. (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.

    Article  PubMed  Google Scholar 

  • DeMattei, R., Cuvo, A., & Maurizio, S. (2007). Oral assessment of children with an autism spectrum disorder. Journal of Dental Hygiene, 81(3), 65.

    PubMed  Google Scholar 

  • Dental Diet Diary [Mobile Application Software]. (2017). (Version 2.0). Mumbai: SM Techno Consultants Pvt. Ltd. Retrieved March 28, 2019, from https://play.google.com/store/apps?hl=en.

  • Dibdin, G. H., & Shellis, R. P. (1988). Physical and biochemical studies of streptococcus mutans sediments suggest new factors linking the cariogenicity of plaque with its extracellular polysaccharide content. Journal of Dental Research, 67(6), 890–895.

    Article  PubMed  Google Scholar 

  • Djemal, S., Darbar, U. R., & Hemmings, K. W. (1998). Case report: Tooth wear associated with an unusual habit. The European Journal of Prosthodontics and Restorative Dentistry, 6(1), 29–32.

    PubMed  Google Scholar 

  • Dunn, M. A., Gomes, H., & Gravel, J. (2008). Mismatch negativity in children with autism and typical development. Journal of Autism and Developmental Disorders, 38, 52–71.

    Article  PubMed  Google Scholar 

  • 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, 314–323.

    Article  PubMed  Google Scholar 

  • Featherstone, J. D. (1977). Diffusion phenomena during artificial carious lesion formation. Journal of Dental Research, 56(D), D48–D52. Special.

    Article  PubMed  Google Scholar 

  • General Assembly of the World Medical Association. (2014). World medical association declaration of Helsinki: Ethical principles for medical research involving human subjects. The Journal of the American College of Dentists, 81(3), 14–18.

  • Gibbons, R. J. (1984). Adherent interactions which may affect microbial ecology in the mouth. Journal of Dental Research, 63, 378–385.

    Article  PubMed  Google Scholar 

  • Gillcrist, J. A., Brumley, D. E., & Blackford, J. U. (2001). Community socioeconomic status and children’s dental health. Journal of American Dental Association, 132(2), 216–222.

    Article  Google Scholar 

  • Gokhale, N., & Nuvvula, S. (2016). Influence of socioeconomic and working status of the parents on the incidence of their children’s dental caries. Journal of Natural Science, Biology and Medicine, 7(2), 127–129.

    Article  Google Scholar 

  • Greene, J. C., & Vermillion, J. R. (1964). The simplified oral hygiene index. Journal of American Dental Association, 68, 7–13.

    Article  Google Scholar 

  • Gurunathan, D., Moses, J., & Arunachalam, S. K. (2018). Knowledge, attitude, and practice of mothers regarding oral hygiene of primary school children in Chennai, Tamil Nadu, India. International Journal of Clinical Pediatric Dentistry, 11(4), 338–343.

    Article  PubMed  PubMed Central  Google Scholar 

  • Holt, R. D. (1991). Foods and drinks at four daily time intervals in a group of young children. British Dental Journal, 170(4), 137–143.

    Article  PubMed  Google Scholar 

  • Jaber M. A. (2011). Dental caries experience, oral health status and treatment needs of dental patients with autism. Journal of Applied Oral Science: Revista FOB, 19(3), 212–217.

    Article  PubMed  PubMed Central  Google Scholar 

  • Klein, U., & Nowak, A. J. (1998). Autistic disorder: A review for the pediatric dentist. Pediatric Dentistry, 20, 312–317.

    PubMed  Google Scholar 

  • Kolawole, K. A., Folayan, M. O., Agbaje, H. O., Oyedele, T. A., Oziegbe, E. O., Onyejaka, N. K., Chukwumah, N. M., & Oshomoji, O. V. (2016). Digit sucking habit and association with dental caries and oral hygiene status of children aged 6 months to 12 years resident in Semi-Urban Nigeria. PloS One, 11(2), e0148322.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kotha, S. B., AlFaraj, N., 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kuppuswamy, B. (1981). Manual of socio-economic status (Urban) (1st ed., p. 8). Manasayan.

    Google Scholar 

  • Lam, P. P., Du, R., Peng, S., McGrath, C. P., & Yiu, C. K. (2020). Oral health status of children and adolescents with autism spectrum disorder: A systematic review of case-control studies and meta-analysis. Autism: The International Journal of Research and Practice, 24(5), 1047–1066.

    Article  Google Scholar 

  • Legge, B. (2002). Can’t Eat, Won’t Eat: Dietary difficulties and autistic spectrum disorders. Jessica Kingsley Publishers.

    Google Scholar 

  • Leiva-García, B., Planells, E., Planells Del Pozo, P., & Molina-López, J. (2019). Association between feeding problems and oral health status in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 49(12), 4997–5008.

    Article  PubMed  Google Scholar 

  • Maat, G. J. R., & Van der Velde, E. A. (1987). The caries-attrition competition. International Journal of Anthropology, 2, 281.

    Article  Google Scholar 

  • Marsh, P. D. (1994). Microbial ecology of dental plaque and its significance in health and disease. Advances in Dental Research, 8(2), 263–271.

    Article  PubMed  Google Scholar 

  • Marshall, J., Sheller, B., & Mancl, L. (2010). Caries-risk assessment and caries status of children with autism. Pediatric Dentistry, 32, 69–75.

    PubMed  Google Scholar 

  • Mehta, V. V., Rajesh, G., Rao, A., Shenoy, R., Pai, M., & Nayak, V. (2017). Effect of motives for food choice on oral health among primary school children in Mangalore: An analytical survey. Journal of Clinical and Diagnostic Research, 11(5), ZC59–ZC63.

    PubMed  PubMed Central  Google Scholar 

  • Morales-Chávez M. C. (2017). Oral health assessment of a group of children with autism disorder. The Journal of Clinical Pediatric Dentistry, 41(2), 147–149.

    Article  PubMed  Google Scholar 

  • Morinushi, T., Ueda, Y., & Tanaka, C. (2001). Autistic children experience and severity of dental caries between 1980 and 1985 in Kagoshima City, Japan. Journal of Clinical Pediatric Dentistry, 25, 323–328.

    Article  PubMed  Google Scholar 

  • Moynihan, P., & Petersen, P. E. (2004). Diet, nutrition and the prevention of dental diseases. Public Health Nutrition, 7(1A), 201–226.

    Article  PubMed  Google Scholar 

  • Mummolo, S., Nota, A., Caruso, S., Quinzi, V., Marchetti, E., & Marzo, G. (2018). Salivary markers and microbial flora in mouth breathing late adolescents. Biomed Research International, 2018, 8687608.

    Article  PubMed  PubMed Central  Google Scholar 

  • Murshid, E. Z. (2005). Oral health status, dental needs, habits and behavior attitude towards dental treatment of a group of autistic children in Riyadh, Saudi Arabia. Saudi Dental Journal, 17, 132–139.

  • 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, 97–102.

    Article  PubMed  Google Scholar 

  • Newbrun, E. (1967). Sucrose, the arch criminal of dental caries. Odontologisk Revy, 18(4), 373–386.

    PubMed  Google Scholar 

  • Onol, S., & Kırzıoğlu, Z. (2018). Evaluation of oral health status and influential factors in children with autism. Nigerian Journal of Clinical Practice, 21, 429–435.

    PubMed  Google Scholar 

  • Palacios, C., Rivas-Tumanyan, S., Morou-Bermúdez, E., Colon, A. M., Torres, R. Y., & Elías-Boneta, A. R. (2016). Association between type, amount, and pattern of carbohydrate consumption with dental caries in 12-year-olds in Puerto Rico. Caries Research, 50(6), 560–570.

    Article  PubMed  Google Scholar 

  • Pliner, P., & Hobden, K. (1992). Development of a scale to measure the trait of food neophobia in humans. Appetite, 19, 105–120.

    Article  PubMed  Google Scholar 

  • Prentice, R. L., Mossavar-Rahmani, Y., Huang, Y., Van Horn, L., Beresford, S. A., & Caan, B. (2011). Evaluation and comparison of food records, recalls, and frequencies for energy and protein assessment by using recovery biomarkers. American Journal of Epidemiology, 174(5), 591–603.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rekha, C. V., Arangannal, P., & Shahed, H. (2012). Oral health status of children with autistic disorder in Chennai. European Archives of Paediatric Dentistry, 13, 126–131.

    Article  Google Scholar 

  • Rodrigues, C. S., & Sheiham, A. (2000). The relationships between dietary guidelines, sugar intake and caries in primary teeth in low income Brazilian 3-year-olds: A longitudinal study. International Journal of Paediatric Dentistry, 10(1), 47–55.

    Article  PubMed  Google Scholar 

  • Rydell, A. M., Dahl, M., & Sundelin, C. (1995). Characteristics of school children who are choosy eaters. Journal of Genetic Psychology, 156, 217–229.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Sehgal, P. (2019). Evaluation of the relationship between maternal oral hygiene related self-efficacy and brushing adherence and oral health status in children between aged 2 to 6 years. D Y Patil University.

    Google Scholar 

  • Sharma, R. (2017). Revised Kuppuswamy’s socioeconomic status scale: Explained and updated. Indian Pediatrics, 54(10), 867–870.

    Article  PubMed  Google Scholar 

  • Stein, L. I., Polido, J. C., Lopez Najera, S. O., & Cermak, S. A. (2012). Oral care experiences and challenges in children with autism spectrum disorders. Pediatric Dentistry, 24, 387–391.

    Google Scholar 

  • Stein, L. I., Polido, J. C., Mailloux, Z., Coleman, G. G., & Cermak, S. A. (2011). Oral care and sensory sensitivities in children with autism spectrum disorders. Special Care Dentistry, 31, 102–110.

    Article  Google Scholar 

  • Subramaniam, P., & Gupta, M. (2011). Oral health status of autistic children in India. Journal of Clinical Pediatric Dentistry, 36, 43–47.

    Article  PubMed  Google Scholar 

  • Thompson, F. E., Kirkpatrick, S. I., Subar, A. F., Reedy, J., Schap, T. E., Wilson, M. M., Susan, M., & Krebs-Smith, S. M. (2015). The national cancer institute’s dietary assessment primer: A resource for diet research. Journal of the Academy of Nutrition and Dietetics, 115(12), 1986–1995.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tinanoff, N., & Palmer, C. A. (2000). Dietary determinants of dental caries and dietary recommendations for preschool children. The Journal of Public Health Dentistry, 60(3), 197–206.

    Article  PubMed  Google Scholar 

  • Tomchek, S. D. (2010). Sensory processing in individuals with an autism spectrum disorder. In H. Miller Kuhaneck & R. Watling (Eds.), Autism: A comprehensive occupational therapy approach (3rd ed., pp. 135–162). AOTA Press.

    Google Scholar 

  • Tomchek, S. D., & Dunn, W. (2007). Sensory processing in children with and without autism: A comparative study using the short sensory profile. American Journal of Occupational Therapy, 61, 190–200.

    Article  Google Scholar 

  • Touger-Decker, R., & van Loveren, C. (2003). Sugars and dental caries. The American Journal of Clinical Nutrition, 78(4), 881S-892S.

    Article  PubMed  Google Scholar 

  • Verrips, G. H., Kalsbeek, H., & Eijkman, M. A. (1993). Ethnicity and maternal education as risk indicators for dental caries and the role of dental behavior. Community Dentistry and Oral Epidemiology, 21, 209–214.

    Article  PubMed  Google Scholar 

  • Wiater, A., Choma, A., & Szczodrak, J. (1999). Insoluble glucans synthesized by cariogenic streptococci: A structural study. Journal of Basic Microbiology, 39(4), 265–273.

    Article  PubMed  Google Scholar 

  • World Health Organization. (2013). Oral health surveys—basic method. World Health Organization.

    Google Scholar 

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Acknowledgments

The data collection for the study was performed between December 2018 and September 2019 and the writing of manuscript spanned from January 2020 to September 2020. This study was conducted towards the dissertation of Dr. Lakshmi Moorthy; which was submitted in December 2019.

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LM and UBD contributed to the study conception and design. LM and RK conducted the study and collected data with guidance from MPG. UBD contributed to statistical analysis and data interpretation. All authors contributed to writing of the manuscript. All authors approved the final manuscript.

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Correspondence to Uma B. Dixit.

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Uma B. Dixit—Formerly from Department of Pedodontics and Preventive Dentistry, DY Patil University-School of Dentistry, Navi Mumbai, India.

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Moorthy, L., Dixit, U.B., Kole, R.C. et al. Dietary Sugar Exposure and Oral Health Status in Children with Autism Spectrum Disorder: A Case-control Study. J Autism Dev Disord 52, 2523–2534 (2022). https://doi.org/10.1007/s10803-021-05151-0

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