Barriers to attaining and maintaining oral health in persons with autism : the parents’/caregivers’ perspective : a cross-sectional study

Abstract

Aims: The purpose of this study was to investigate the perceptions of parents/caregivers of individuals with autism spectrum disorders when encountering barriers to attain and maintain oral health of the individuals. These barriers can be experienced at home during self-care oral health maintenance or at the dental clinic. Methodology: After ethical approval was gained from the Dean of the Faculty of Dental Surgery, the Faculty of Research Ethics Committee and from the Autism Parents’ Association, an anonymous online questionnaire was modulated from a previous questionnaire of the same area of study and a pilot study was carried out to test its validity. After the necessary arrangements, the cross-sectional survey was distributed through convenience sampling to the participants of the association. Results: 62 participants completed the questionnaire. The barriers were divided into patient based, family-based and operator-based. The most reported barriers were lack of co-operation (50%, n=31), the individual being impatient in the waiting area (47%, n=29), fear of the dentist (36%, n=22) and the dentist’s inability to understand the individual’s condition (31%, n=19). Furthermore, Chi-Square tests for independence, Kruskal-Wallis test and Mann Whitney U-test revealed significant associations between these barriers and demographics of individuals with autism, such as hypersensitivity with impatience in the waiting area and the type of dentist seeing the individual with the inability to understand the condition. Conclusions: Patient behaviours associated with Autism Spectrum Disorder (ASD) and dental health provider knowledge and behaviours in response to persons with ASD influence the provision of dental care to persons with ASD. Further local research and an increase in awareness of health professionals and the public is required to overcome such barriers and to facilitate oral health maintenance in individuals with autism.