Level of support/commitment and behavior during mealtime and dental care negatively impact the dental caries prevalence in autistic individuals: cross-sectional study.

Objective: To verify whether factors associated with Autism Spectrum Disorder (ASD) would have impact on the dental-caries prevalence.

Materials and methods: All ASD-individuals receiving care in a specialized center with minimum of 4y old were recruited. Demographic, socioeconomic and behavioral characteristics, level of support/commitment (Childhood Autism Rating Scale), mealtime behavior (Brief Autism Mealtime Behavior Inventory) and medication use were answered by ASD-individual's parents. Behavior during dental care was evaluated from Frankl scale. Dental-caries prevalence was the primary outcome. Three examiners calibrated/trained collected the data. Chi-square test was used to compare the variables impact on the dental-caries prevalence.

Results: 61 ASD-individuals were potentially eligible, and the all parents/guardians consent to participate. Dental-caries prevalence was 42.9%, which was statistically associated with lower toothbrushing frequency, higher level of support/commitment, and worse behavior at meals and during in dental care. Dental-caries prevalence was approximately higher twice in ASD-individuals: (i) uncooperative with dental care when compared those cooperative (62% versus 32%, respectively); (ii) with severe level of support when compared to those with mild/moderate level (58% versus 28%, respectively); and (iii) with worse mealtime behavior when compared to those with better behavior (59% versus 28%, respectively). A medium statistical correlation was observed between support level and mealtime behavior (r_S=0.39). The BAMBI component statistically associated with dental-caries prevalence was the food refusal (capture problem when a child rejects a presented food, crying, spitting out food).

Conclusion: higher required level of support, worse mealtime behavior and uncooperative profile in dental care negatively affect the dental-caries prevalence.

Clinical relevance: our findings provide evidence of the need of specialized, preventive and individualized dental care among ASD-individuals.