The Silent Struggle: Oral Health Challenges in Autism

For many individuals with autism spectrum disorder (ASD),maintaining proper oral hygiene presents a significant,often insurmountable,challenge. This difficulty contributes to alarmingly high rates of dental caries and periodontal disease within this population, frequently necessitating dental interventions under sedation or general anesthesia. Recent research underscores the urgent need for targeted preventative measures.

A comprehensive review published in the Journal of Clinical Medicine highlights the severity of the issue. The study revealed that between 60.6% and 67.3% of children and adults with autism experiance dental caries, while periodontal disease affects 59.8% to 69.4% of the same group. Thes figures are considerably higher than those observed in the neurotypical population. Furthermore, the study noted a greater prevalence of dental trauma, often self-inflicted, and a higher frequency of dental procedures performed under general anesthesia.

The researchers noted the presence of caries with an incidence from 60.6% to 67.3%, and periodontal disease, from 59.8% to 69.4%. The study also reported high rates of dental cure in general anesthesia and higher prevalence of dental traumas also from self-element… highlighting the need for preventive actions aimed at promoting good oral hygiene practices.

A Proactive Approach: The SIDP Foundation’s Initiative

Recognizing this critical need, the Italian Society of periodontology and Implantology (SIDP) Foundation, a non-profit association, launched the ‘Oral Health Promotion for people with autism’ project. This initiative aims to equip individuals with autism, their families, and caregivers with the knowledge and tools necessary for effective oral hygiene practices. The project boasts a task force of over 300 dedicated volunteers, including dentists and hygienists.

Since its inception in September 2024, the project has reached over 2,000 individuals across more than 40 association centers. The ultimate goal is to extend its reach to a significant portion of the autistic population in Italy, estimated at approximately 600,000 individuals. This is particularly crucial given the rising prevalence of autism,currently estimated at 1 in 75 newborns,according to the CDC.

Understanding the Barriers: Sensory Sensitivities and Practical Difficulties

Pierpaolo Cortellini, president of the SIDP foundation, emphasizes the multifaceted challenges faced by individuals with ASD when it comes to oral hygiene.sensory sensitivities, such as the feel of a toothbrush or the taste of toothpaste, can create significant aversion. Others may struggle with understanding the duration of brushing or the necessary techniques.

Adults and children with autistic spectrum disorders may encounter insurmountable difficulties in performing correct oral hygiene practices. The reasons why this happens can be varied: some may find unpleasant the physical sensation of the toothbrush in the mouth or feel a sensory discomfort in the act of washing, others may have aversion for toothpaste, or have difficulty in understanding how long to brush the teeth.
Pierpaolo Cortellini, president of the SIDP Foundation

These challenges often led to compromised oral health from a young age, increasing the risk of systemic health issues like diabetes and cardiovascular diseases.Thus, preventative dental care is paramount for this vulnerable population.

Empowering Caregivers: Education and Practical Support

the SIDP Foundation’s project addresses these difficulties through a multi-pronged approach. The initial phase involves meetings between SIDP volunteers, educators, and families. These sessions focus on disseminating informative materials, such as flyers and video tutorials, and recommending essential oral hygiene tools, including electric or manual toothbrushes, appropriate toothpastes, and interdental cleaning aids.

Subsequent visits to the centers allow volunteers to observe and guide individuals with autism during their oral hygiene routines, ensuring that the educational interventions are effectively implemented. This hands-on approach enables volunteers to monitor progress and address any challenges encountered.

remote monitoring and Future Directions

To further enhance support, the SIDP Foundation has developed a free, downloadable app that enables dentists to remotely monitor patient progress. Caregivers can use the app to track key hygiene practices and assign scores, providing valuable insights into the patient’s adherence to the recommended routines.

Looking ahead, the project aims to train dentists and hygienists in effectively accommodating patients with autism, fostering trust, and creating a agreeable environment. This initiative seeks to ensure that individuals with complex needs receive the comprehensive oral healthcare they deserve, ultimately improving their overall quality of life. The long-term vision is to reach the entire autistic population, estimated at 600,000 individuals, and establish a new standard of oral health care.

This will guarantee a standard of oral health to more and more people with complex needs,with the ‘dream’ to cover the entire autistic population that it is estimated,to date,equal to 600 thousand people.
pierpaolo Cortellini, president of the SIDP Foundation