Do Autistic Children Suffer More Oral Health Care Problem?

Research team member Dr Phoebe Lam undergoes regular oral checkup for a kid

Every year’s 2 April is the internationally recognised World Autism Awareness Day. Autism spectrum disorder (ASD) is not uncommon around the globe and in Hong Kong. It refers to a neurodevelopmental condition that affects how a person socializes and interacts with the surrounding world. According to the epidemiological study 2007 by The University of Hong Kong, 49 children in every 10,000 is diagnosed with the disorder in Hong Kong. Report from Education Bureau indicated that autistic students in mainstream schools exceeded 10,000 in the 2017/18 academic year.

From the perspective of oral health, there are few reasons why people believed autistic children are more prone to oral diseases. Firstly, the medication prescribed to children with Autism Spectrum Disorder (ASD) can cause dry mouth and is usually a form of sweetened liquid, leading to a higher risk of tooth decay. Secondly, ASD children might differ in sensory processing and react differently to normal sensations in daily life. Thus, not only parents and caretakers have difficulties in helping them to maintain oral cleanliness; dentists also face challenges to provide oral examination or treatment to them. Thirdly, their dietary habits such as slow eating and preference for soft and sweet food might also create unfavourable oral environment that causes tooth decay.

The abovesaid induced postgraduate students from Faculty of Dentistry of the University of Hong Kong to reflect if ASD children are really having poorer oral health. Under the supervision of Professors, the team conducted a systematic review to look into the oral health conditions of both autistic and normally developing children and adolescents.

The team thoroughly searched the literature and found 15 articles comparing the oral health status of children diagnosed with Autistic Spectrum Disorder with other normally developing children. They found no differences between the two groups in terms of caries, oral hygiene, gum diseases, tooth malalignment and trauma, salivary flow and buffering capacity. What is dissimilar is the salivary pH value for which ASD children have a slightly lower salivary pH value. Nevertheless, that is not of clinical significance that might influence their chances of having more tooth decay. They also found weak evidence suggesting more ASD children grind their teeth.

Overall, their findings did not support the assumption that ASD will lead to more oral diseases. Instead, other social and behavioural factors, for instance inadequate oral hygiene and sugary diet, may play a more important role.

The findings suggest that with proper oral hygiene maintenance and good dietary habits, everyone can enjoy good oral condition and a healthy smile.” Hence, including parent, caretaker, teacher, medical, and dental personnel; everyone should work hand in glove to help our children.

The team included supervisors Professor Cynthia Yiu, Clinical Professor in Paediatric Dentistry and Professor Colman McGrath, Clinical Professor in Dental Public Health; Dr Simin Peng, Clinical Assistant Professor in Paediatric Dentistry, as well as postgraduate students, Dr Rennan Du and Dr Phoebe Lam.

To learn more about the team project, please watch the video:


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