The Caries Experience and Behavior of Dental Patients With Autism Spectrum Disorder

J Am Dent Assoc. 2008 Nov;139(11):1518-24. doi: 10.14219/jada.archive.2008.0078.


Background: Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder. The authors conducted a study to evaluate the demographics, caries experience and behavior of patients with ASD and compare these characteristics with those of patients without ASD (unaffected patients).

Methods: The authors reviewed patients' charts and identified a group of 395 patients with ASD and a group of 386 unaffected patients. They obtained the following patient data for analysis: primary diagnosis, age, sex, residence (home versus institution or group home), presence of seizure disorder, additional diagnosis (mental retardation, cerebral palsy, self-injurious behavior or pica), medications, caries prevalence, caries severity and behavior.

Results: The ASD group had a male:female ratio of 4:1, and patients had a diagnosis of autism, pervasive developmental disorder-not otherwise specified or Asperger syndrome. Sex distribution was equal in the unaffected group, which was younger and had a higher decayed, missing and filled teeth (DMFT) score than did the ASD group. When the authors controlled for age and sex, they noted a statistically significant association between ASD and dental caries prevalence. A significantly higher percentage of patients with ASD than unaffected patients were uncooperative and required dental treatment to take place under general anesthesia. Caries prevalence and severity in patients with ASD were not associated with institutionalization, presence of seizure disorder or additional diagnosis.

Conclusions: People with ASD were more likely to be caries-free and had lower DMFT scores than did their unaffected peers. Significantly more patients with ASD than unaffected patients were uncooperative and required general anesthesia to undergo dental treatment.

MeSH terms

  • Adolescent
  • Anesthesia, Dental / statistics & numerical data
  • Asperger Syndrome / complications*
  • Asperger Syndrome / psychology
  • Autistic Disorder / complications*
  • Autistic Disorder / psychology
  • Case-Control Studies
  • Child
  • Child Behavior
  • Child, Preschool
  • Cross-Sectional Studies
  • DMF Index
  • Dental Care for Children / statistics & numerical data
  • Dental Care for Disabled* / statistics & numerical data
  • Dental Caries / complications*
  • Dental Caries / psychology
  • Dental Caries / therapy
  • Female
  • Humans
  • Male
  • Oral Health*
  • Reference Values
  • Statistics, Nonparametric
  • Young Adult