Oral-Health Considerations in Children with Autism Spectrum Disorder: A Narrative Review

REVIEW
Argjira Veseli, Milazim Gjocaj, Shefqet Mrasori, Enis Veseli, Edon Behluli, Kaltrina Veseli

 
For citation: Veseli A, Gjocaj M, Mrasori S, Veseli E, Behluli E, Veseli K. Oral-Health Considerations in Children with Autism Spectrum Disorder: A Narrative Review. International Journal of Biomedicine. 2025;15(3):441-445. doi:10.21103/Article15(3)_RA1

Originally published September 5, 2025

Abstract: 

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that markedly increases children’s vulnerability to oral diseases because sensory hypersensitivities, communication challenges, and behavioral inflexibility complicate both self-care and dental attendance. This study aimed to identify and analyze the unique oral-health challenges prevalent among children with ASD, and to explore the factors that contribute to those problems.
Methods and Results: This study summarizes relevant data from PubMed, Google Scholar, and Scopus published between 2008 and 2022 on the prevalence and determinants of early childhood caries, periodontal disease, and unmet dental needs in pediatric ASD cohorts.
Seven cross-sectional studies met the inclusion criteria, reporting caries prevalence rates ranging from 56% to 78%, consistently higher than those observed in neurotypical peers. Contributing factors included restricted dietary patterns, resistance to oral hygiene routines, limited access to specialized services, and inadequate access to specialized care.  Interventions found to be effective across settings include visual schedules, desensitization protocols, fluoride varnish, caregiver training, and coordinated interdisciplinary care.
Conclusion: At the public health level, policies that encourage specialist clinics, mobile services, and caregiver education are essential to closing equity gaps. Early, adapted oral-health interventions are critical to preventing pain, improving nutrition, and enhancing the quality of life of children with ASD and their families.

Keywords: 
autism spectrum disorder • pediatric dentistry • early-childhood caries • sensory sensitivity • interdisciplinary care • public health
References: 
  1. Maenner MJ, Warren Z, Williams AR, Amoakohene E, Bakian AV, Bilder DA, Durkin MS, Fitzgerald RT, Furnier SM, Hughes MM, Ladd-Acosta CM, McArthur D, Pas ET, Salinas A, Vehorn A, Williams S, Esler A, Grzybowski A, Hall-Lande J, Nguyen RHN, Pierce K, Zahorodny W, Hudson A, Hallas L, Mancilla KC, Patrick M, Shenouda J, Sidwell K, DiRienzo M, Gutierrez J, Spivey MH, Lopez M, Pettygrove S, Schwenk YD, Washington A, Shaw KA. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020. MMWR Surveill Summ. 2023 Mar 24;72(2):1-14. doi: 10.15585/mmwr.ss7202a1. PMID: 36952288; PMCID: PMC10042614.
  2. Adeghe EP, Okolo CA, Ojeyinka OT. Navigating early childhood caries management in children with autism and developmental disorders: a U.S. perspective. Int J Biol Pharm Sci Arch. 2024;7(1):129–140. doi:10.53771/ijbpsa.2024.7.1.0029.
  3. Prynda M, Pawlik AA, Emich-Widera E, Kazek B, Mazur M, Niemczyk W, Wiench R. Oral Hygiene Status in Children on the Autism Spectrum Disorder. J Clin Med. 2025 Mar 10;14(6):1868. doi: 10.3390/jcm14061868. PMID: 40142676; PMCID: PMC11942761.
  4. Cermak SA, Stein Duker LI, Williams ME, Dawson ME, Lane CJ, Polido JC. Sensory Adapted Dental Environments to Enhance Oral Care for Children with Autism Spectrum Disorders: A Randomized Controlled Pilot Study. J Autism Dev Disord. 2015 Sep;45(9):2876-88. doi: 10.1007/s10803-015-2450-5. PMID: 25931290; PMCID: PMC4554774.
  5. Cermak SA, Stein Duker LI, Williams ME, Lane CJ, Dawson ME, Borreson AE, Polido JC. Feasibility of a sensory-adapted dental environment for children with autism. Am J Occup Ther. 2015 May-Jun;69(3):6903220020p1-10. doi: 10.5014/ajot.2015.013714. PMID: 25871593; PMCID: PMC4453036.
  6. Ferrazzano GF, Salerno C, Bravaccio C, Ingenito A, Sangianantoni G, Cantile T. Autism spectrum disorders and oral health status: review of the literature. Eur J Paediatr Dent. 2020 Mar;21(1):9-12. doi: 10.23804/ejpd.2020.21.01.02. PMID: 32183521.
  7. Du RY, Yiu CK, King NM, Wong VC, McGrath CP. Oral health among preschool children with autism spectrum disorders: A case-control study. Autism. 2015 Aug;19(6):746-51. doi: 10.1177/1362361314553439. Epub 2014 Nov 28. PMID: 25432504.
  8. González-Domenech P, Cárdenas-Rodríguez M, Mendoza M, Segura M, Fernández E, Pérez M. Interventions for giftedness and autism spectrum disorder: toward enhancing quality of life. Psicología e Intervención. 2022;31(2):101–110. doi:10.5093/pi2022a16.
  9. Stein Duker LI, Como DH, Jolette C, Vigen C, Gong CL, Williams ME, Polido JC, Floríndez-Cox LI, Cermak SA. Sensory Adaptations to Improve Physiological and Behavioral Distress During Dental Visits in Autistic Children: A Randomized Crossover Trial. JAMA Netw Open. 2023 Jun 1;6(6):e2316346. doi: 10.1001/jamanetworkopen.2023.16346. PMID: 37266941; PMCID: PMC10238943.
  10. Fallea A, Zuccarello R, Roccella M, Quatrosi G, Donadio S, Vetri L, Calì F. Sensory-Adapted Dental Environment for the Treatment of Patients with Autism Spectrum Disorder. Children (Basel). 2022 Mar 10;9(3):393. doi: 10.3390/children9030393. PMID: 35327765; PMCID: PMC8947452.
  11. Farmani S, Ajami S, Babanouri N. Prevalence of Malocclusion and Occlusal Traits in Children with Autism Spectrum Disorders. Clin Cosmet Investig Dent. 2020 Aug 24;12:343-349. doi: 10.2147/CCIDE.S262679. PMID: 32904713; PMCID: PMC7457711.
  12. Jaber MA. Dental caries experience, oral health status and treatment needs of dental patients with autism. J Appl Oral Sci. 2011 May-Jun;19(3):212-7. doi: 10.1590/s1678-77572011000300006. PMID: 21625735; PMCID: PMC4234331.
  13. Naidoo M, Singh S. The Oral health status of children with autism Spectrum disorder in KwaZulu-Nata, South Africa. BMC Oral Health. 2018 Oct 12;18(1):165. doi: 10.1186/s12903-018-0632-1. PMID: 30314501; PMCID: PMC6186069..
  14. Pi X, Liu C, Li Z, Guo H, Jiang H, Du M. A Meta-Analysis of Oral Health Status of Children with Autism. J Clin Pediatr Dent. 2020;44(1):1-7. doi: 10.17796/1053-4625-44.1.1. PMID: 31995423.
  15. Sarangi S, Ranjan Raj R, Rawat A, Salam S, Tripathi S, Aggarwal D, Kashwani R. Oral health care concerns among autism patients: A review. Bioinformation. 2024 Sep 30;20(9):1017-1021. doi: 10.6026/9732063002001017. PMID: 39917221; PMCID: PMC11795469.
  16. Piraneh H, Gholami M, Sargeran K, Shamshiri AR. Oral health and dental caries experience among students aged 7-15 years old with autism spectrum disorders in Tehran, Iran. BMC Pediatr. 2022 Mar 5;22(1):116. doi: 10.1186/s12887-022-03178-5. PMID: 35248005; PMCID: PMC8897865.
  17. da Motta TP, da Mota DG, Bitencourt FV, Jardim PF, Abreu LG, Zina LG, de Abreu MHNG, Vargas-Ferreira F. Dental Caries of Individuals with Autism Spectrum Disorder (ASD): A Systematic Review and Meta-Analysis. J Autism Dev Disord. 2025 Feb 20. doi: 10.1007/s10803-025-06754-7. Epub ahead of print. PMID: 39976759.
  18. Martínez Pérez E, Adanero Velasco A, Gómez Clemente V, Miegimolle Herrero M, Planells Del Pozo P. Importance of Desensitization for Autistic Children in Dental Practice. Children (Basel). 2023 Apr 28;10(5):796. doi: 10.3390/children10050796. PMID: 37238344; PMCID: PMC10217695.
  19. AlMaweri SA, Halboub ES, AlSoneidar WA, AlSufyani GA. Oral lesions and dental status of autistic children in Yemen: A case–control study. J Int Soc Prev Community Dent. 2014;4:S199–S203. doi: 10.4103/2231-0762.149040.
  20. Fakroon S, Arheiam A, Omar S. Dental caries experience and periodontal treatment needs of children with autistic spectrum disorder. Eur Arch Paediatr Dent. 2015 Apr;16(2):205-9. doi: 10.1007/s40368-014-0156-6. Epub 2014 Nov 11. PMID: 25385711.
  21.  El Khabit AA, El Tekeya MM, El Tantawi MA, Omar T. Oral health status and behaviours of children with Autism Spectrum Disorder: a case–control study. Int J Paediatric Dent. 2014;24:314–23. doi: 10.1111/ipd.12067.
  22. Luppanapornlarp S, Leelataweewud P, Putongkam P, Ketanont S. Periodontal status and orthodontic treatment need of autistic children. World J Orthod. 2010 Fall;11(3):256-61. PMID: 20877735.
  23. Jain A, Gupta J, Aggarwal V, Goyal C. To evaluate the comparative status of oral health practices, oral hygiene and periodontal status amongst visually impaired and sighted students. Spec Care Dentist. 2013 Mar-Apr;33(2):78-84. doi: 10.1111/j.1754-4505.2012.00296.x. Epub 2012 Dec 12. PMID: 23451928.
  24. Bartolomé-Villar B, Mourelle-Martínez MR, Diéguez-Pérez M, de Nova-García MJ. Incidence of oral health in paediatric patients with disabilities: Sensory disorders and autism spectrum disorder. Systematic review II. J Clin Exp Dent. 2016 Jul 1;8(3):e344-51. doi: 10.4317/jced.52923. PMID: 27398188; PMCID: PMC4930647.
  25. Qiao Y, Shi H, Wang H, Wang M, Chen F. Oral Health Status of Chinese Children With Autism Spectrum Disorders. Front Psychiatry. 2020 May 5;11:398. doi: 10.3389/fpsyt.2020.00398. PMID: 32477184; PMCID: PMC7232536.
  26. Du RY, Lam PPY, Yiu CKY, McGrath CP. Evaluation of visual pedagogy in improving plaque control and gingival inflammation among preschool children with autism spectrum disorder: An interventional study. Int J Paediatr Dent. 2021 Jan;31(1):89-105. doi: 10.1111/ipd.12688. Epub 2020 Aug 31. PMID: 32621656.
  27. Veseli E. Metaverse: a promise avenue for enhancing dental care. Khyber Medical University Journal. 2024;16(1):1-2.
  28. Veseli E, Krasniqi TP. Early diagnosis of children with autism using artificial intelligence during dental care. Eur Arch Paediatr Dent. 2024 Jun;25(3):453. doi: 10.1007/s40368-024-00889-4. Epub 2024 Mar 27. PMID: 38536606.
  29. Veseli E. Revolutionizing dentistry: the integration of artificial intelligence and robotics. Khyber Medical University Journal. 2024 Dec 31;16(4).
  30. Kuter B, Guler N. Caries experience, oral disorders, oral hygiene practices and socio-demographic characteristics of autistic children. Eur J Paediatr Dent. 2019 Sep;20(3):237-241. doi: 10.23804/ejpd.2019.20.03.13. PMID: 31489825.

Download Article
Received May 21, 2025.
Accepted July 6, 2025.
©2025 International Medical Research and Development Corporation.