April marks Autism Awareness Month, a time to promote understanding, acceptance, inclusion and connectedness for
individuals with autism spectrum disorder (ASD).
ASD is a neurodevelopmental disorder encompassing not only social and communication challenges but also atypical
patterns of activities and behaviours.
Each and every individual within this spectrum is unique, with none showing identical patterns. While some
individuals with autism can live independently, others face severe disabilities and rely on lifelong care and
support.
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According to the World Health Organization (WHO), about one in 100 children has autism, a notable increase from the
2012 global prevalence report, which estimated that only six in 1,000 children were autism.
This upward trend in prevalence may reflect heightened awareness and recognition, resulting in earlier identification
and diagnosis. Despite the attention on the behavioural and social challenges faced by individuals with ASD, their
oral health is equally important but often overlooked and neglected.
A 2020 study conducted by the Xiamen Children’s Hospital reported that children with ASD have poorer oral hygiene and
worse periodontal conditions compared to their neurotypical counterparts.
Common oral problems observed in children with ASD include dental caries, oral pain, mouth breathing, biting hard
objects, drooling, lip biting, and bruxism.
Individuals with ASD may experience unique challenges in maintaining good oral health. Sensory processing issues
especially in a sensitive area of the mouth can make brushing teeth and flossing uncomfortable.
The sensation of toothbrush bristles or dental floss against their gums may be overwhelming or uncomfortable.
Moreover, the texture and flavour of toothpaste or mouthwash might trigger aversive responses in those with ASD,
further complicating their oral care routine, and potentially leading to reluctance or refusal to engage in this
essential oral care.
In addition, certain habits observed in individuals with ASD, such as teeth grinding, tapping or hitting their mouth
and teeth, chewing non-food objects, or selective eating behaviour with high-sugar foods, can increase the risk of
dental problems.
They may struggle to verbally express dental pain or discomfort, making it challenging for caregivers and dental
professionals to address their oral health needs promptly. As a result, untreated dental issues may persist, leading
to prolonged discomfort and potentially serious complications.
Therefore, to address the unique oral health challenges faced by individuals with ASD, it is crucial to implement a
range of strategies tailored to their specific needs.
Their overwhelmed sensory processing can be gradually desensitised through gentle and consistent exposure to oral care stimuli over time.
Avoid overwhelming stimuli
Moreover, establishing a consistent oral hygiene routine is crucial, facilitated by specialised oral care kits
equipped with softer toothbrushes, and a diverse range of flavoured toothpaste options to cater to their unique
preferences.
Additionally, sensory-friendly dental environments that minimise overwhelming stimuli like light, crowds, smell or
noise can greatly benefit individuals with sensory sensitiveness.
According to The National Autistic Society in the UK, incorporating relaxation techniques such as deep breathing or
guided imagery can help them regulate their sensory responses and reduce anxiety or stress during dental visits.
Equally important, prioritising the fulfilment of their sensory needs before the dental visit, such as chewing or
providing physical activities like jumping, can further help them become more relaxed, improving their overall
experience and cooperation during dental appointments.
