A cross-sectional study on oral health and dental care in intellectually able adults with autism spectrum disorder

BMC Oral Health

Göran Dahllöf¹  Susanne Bejerot²  My Blomqvist¹ 

[1] Division of Paediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, SE-14104, Sweden;Department of Psychiatry, Örebro University, Örebro, Sweden

关键词: Dental appointments;    Dental caries;    Adult;    Asperger syndrome;    Autism;   

Others  :  1219303
DOI  :  10.1186/s12903-015-0065-z

 received in 2015-06-21, accepted in 2015-07-08,  发布年份 2015

【 摘 要 】

Background

Autism spectrum disorder (ASD) is characterized by impairments in social interaction and communication, restricted patterns of behaviour, and unusual sensory sensitivities. The hypotheses to be tested were that adult patients with ASD have a higher caries prevalence, have more risk factors for caries development, and utilize dental health care to a lesser extent than people recruited from the normal population.

Methods

Forty-seven adults with ASD, (25 men, 22 women, mean age 33 years) and of normal intelligence and 69 age- and sex-matched typical controls completed a dental examination and questionnaires on oral health, dental hygiene, dietary habits and previous contacts with dental care.

Results

Except for increased number of buccal gingival recessions, the oral health was comparable in adults with ASD and the control group. The group with ASD had less snacking, but also less frequent brushing of teeth in the mornings. The stimulated saliva secretion was lower in the ASD group, regardless of medication. Frequencies of dental care contacts were equal in both groups. The most common reason for missing a dental appointment was forgetfulness in the ASD group.

Conclusions

Adults with ASD exhibited more gingival recessions and considerably lower saliva flow compared to healthy controls. Despite equal caries prevalence, the risk for reduced oral health due to decreased salivary flow should be taken into consideration when planning dental care for patients with ASD. Written reminders of dental appointments and written and verbal report on oral health status and oral hygiene instructions are recommended.

【 授权许可】

   
2015 Blomqvist et al.

【 参考文献 】

• [1]Russel G, Rodger LR, Ukommune OC, Ford T. Prevalence of Parent-Reported ASD and ADHD in the UK: Findings from the Millennium Cohort Study. J Autism Dev Disord. 2014.
• [2]American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorder, DSM5. Washington D.C.; 2013.
• [3]American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorder, DSM-IV-TR. Washington D.C.; 2000.
• [4]Gomot M, Wicker B. A challenging, unpredictable world for people with Autism Spectrum Disorder. Int J Psychophysiol. 2012; 83:240-247.
• [5]Klintwall L, Holm A, Eriksson M, Carlsson LH, Olsson MB, Hedvall A, Gillberg C, Fernell E. Sensory abnormalities in autism – a brief report. Res Dev Disabil. 2011; 32:795-800.
• [6]Markram H, Rinaldi T, Markram K. The intense world syndrome-an alternative hypothesis for autism. Front Neurosci. 2007; 1:77-96.
• [7]Stein LI, Polido JC, Maillaux Z, Coleman GG, Cermak SA. Oral care and sensory sensitivities in children with autism spectrum disorder. Spec Care Dentist. 2011; 31:102-110.
• [8]Kopycka-Kedzierawski DT, Auinger P. Dental needs and status of autistic children: results from the National Survey of Children's Health. Pediatr Dent. 2008; 30:54-58.
• [9]Bassaoukou IH, Nicolau J, Dos Santos MT. Saliva flow rate, buffer capacity, and pH of autistic individuals. Clin Oral Investig. 2009; 13:23-27.
• [10]Rai K, Hedge AM, Jose N. Salivary antioxidants and oral health in children with autism. Arch Oral Biol. 2012; 57:1116-1120.
• [11]Loo CY, Graham RM, Hughes CV. The caries experience and behaviour of dental patients with autism spectrum disorder. JADA. 2008; 139:1518-1524.
• [12]Orellana LM, Silvestre FJ, Martinez-Sanchis S, Martinez-Mihi V, Bautista D. Oral manifestations in a group of adults with autism spectrum disorder. Med Oral Patol Oral Bucal. 2012; 17:415-419.
• [13]Hsia Y, Wong AY, Murphy DG, Simonoff E, Buitelaar JK, Wong IC. Psychopharmacological prescriptions for people with autism spectrum disorder (ASD): a multinational study. Psychopharmacology. 2014; 231:999-1009.
• [14]Lai B, Milano M, Roberts MW, Hooper SR. Unmet dental needs and barriers to dental care among children with autism spectrum disorders. J Autism Dev Disord. 2012; 42:1294-1303.
• [15]Brickhouse TH, Farrington FH, Best AM, Ellisworth CW. Barriers to dental care for children in Virginia with autism spectrum disorders. J Dent Child. 2009; 76:188-193.
• [16]Baron-Cohen S, Wheelright S, Skinner R, Martin J, Clubley E. The autism-spectrum quotient (AQ): evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. J Autism Dev Disord. 2001; 31:5-17.
• [17]Ruzich E, Allison C, Smith P, Watson P, Auyeung B, Ring H, Baron-Cohen S. Measuring autistic traits in the general population: a systematic review of the Autism-Spectrum Quotient (AQ) in a nonclinical population sample of 6,900 typical adult males and females. Mol Autism. 2015; 6:2. BioMed Central Full Text
• [18]Bishop SL, Seltzer MM. Self-reported autism symptoms in adults with Autism Spectrum Disorders. J Autism Dev Disord. 2012; 42:2354-2363.
• [19]Ring H, Woodbury-Smith M, Watson P, Wheelwright S, Baron-Cohen S. Clinical heterogeneity among people with high functioning autism spectrum conditions: evidence favouring a continuous severity gradient. Behav Brain Funct. 2008; 20:11. BioMed Central Full Text
• [20]Hollender L, Koch G. Influence of topical application of fluoride on rate of progress of carious lesions in children. A long-term roentgenographic follow-up. Odontol Revy. 1969; 20:37-41.
• [21]Shwartz M, Gröndahl HG, Pliskin JS, Boffa J. A longitudinal analysis from bite-wing radiographs of the rate of progression of approximal carious lesions through human dental enamel. Arch Oral Biol. 1984; 29:529-536.
• [22]Axelsson P, Linde J. Effect of fluoride on gingivitis and dental caries in a preventive program based on plaque control. Community Dent Oral Epidemiol. 1975; 3:156-160.
• [23]Skaret E, Raadal M, Berg E, Kvale G. Missed and cancelled appointments among 12–18 year-olds in the Norwegian Public Dental Service. Eur J Oral Sci. 1998; 106:1006-1012.
• [24]Julihn A, Barr Agholme M, Grindefjord M, Modeer T. Risk factors and risk indicators associated with high caries experience in Swedish 19-year-olds. Acta Odontol Scand. 2006; 64:267-273.
• [25]Blomqvist M, Holmberg K, Fernell E, Ek U, Dahllöf G. Dental caries and oral health behavior in children with attention deficit hyperactivity disorder. Eur J Oral Sci. 2007; 115:186-191.
• [26]Blomqvist M, Ahadi S, Fernell E, Ek U, Dahllöf G. Dental caries in adolescents with attention deficit hyperactivity disorder: a population-based follow-up study. Eur J Oral Sci. 2011; 119:381-385.
• [27]Mobley CC. Nutrition and dental caries. Dent Clin North Am. 2003; 47:319-336.
• [28]Bejerot S, Nylander L. Low prevalence of smoking in patients with autism spectrum disorders. Psychiatry Res. 2003; 119:177-182.
• [29]Hirvikoski T, Blomqvist M. High self-perceived stress and poor coping in intellectually able adults with autism spectrum disorder. Autism. 2014.
• [30]Blomqvist M, Dahllöf G, Bejerot S. Experience of dental care and dental anxiety in adults with autism spectrum disorder. Autism Res Treat. 2014.
• [31]Nederfors T. Xerostomia and Hyposalivation. Adv Dent Res. 2000; 14:48-56.
• [32]Thomson WM, Locker D, Poulton R. Incidence of dental anxiety in young adults in relation to dental treatment experience. Community Dent Oral Epidemiol. 2000; 28:289-294.
• [33]Meyer BJ, Gardiner JM, Bowler DM. Directed forgetting in High-Functioning Adults with Autism Spectrum Disorders. J Autism Dev Disord. 2014.
• [34]Kisely S, Quek LH, Pais J, Lalloo R, Johnson NW, Lawrence D. Advanced dental disease in people with severe mental illness: systematic review and meta-analysis. Br J Psychiatry. 2011; 199:187-193.
• [35]Hesselmark E, Eriksson JM, Westerlund J, Bejerot S. Autism Spectrum Disorders and Self-reports: Testing Validity and Reliability Using the NEO-PI-R. J Autism Dev Disord. 2015; 45:1156-1166.