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Autistic individuals have worse oral status than neurotypical controls: a systematic review and meta-analysis of observational studies

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Abstract

Objective

To compare dental caries, oral hygiene, periodontal status, bruxism, malocclusion, tooth loss, and salivary alterations between autistic and typical developing individuals.

Material and methods

Observational studies presenting clinical measures of oral outcomes between autism spectrum disorder (ASD) individuals and controls. EMBASE, LILACS, PubMed, PsycINFO, Scopus, Web of Science, Google Scholar, and ProQuest were searched up to June 26, 2023. Pairs of reviewers independently conducted study selection, data extraction, and assessments of methodological quality and certainty of evidence. Meta-analyses of standardized mean differences (SMD) and risk ratio (RR) were performed.

Results

A total of 47 studies comprising 6885 autistic individuals were included in the review. Autistic individuals had significantly higher severity of dental-caries experience in primary teeth (SMD 0.29, 95%CI 0.02, 0.56), of dental plaque presence (SMD 0.59, 95%CI 0.24, 0.94), and of gingivitis (SMD 0.45, 95%CI 0.02, 0.88). Autistic individuals showed higher probability of occurrence of gingivitis (RR 1.34, 95%CI 1.08, 1.66,), bruxism (RR 4.23, 95%CI 2.32, 7.74), overjet (RR 2.16, 95%CI 1.28, 3.64), overbite (RR 1.62, 95%CI 1.02, 2.59), crossbite (RR 1.48, 95%CI 1.02, 2.13), and openbite (RR 2.37, 95%CI 1.46, 3.85), when compared to neurotypical individuals. Most estimates showed a small effect size with very low certainty of evidence.

Conclusion

Autistic individuals show worse oral health status than controls.

Clinical relevance

The findings reported herein can help to build health policies to better serve autistic individuals including prevention actions and access to specialized dental care.

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Acknowledgements

We thank the Brazilian fostering agency Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) for the financial support.

Autistic individuals have worse oral status than neurotypical controls: A systematic review and meta-analysis of observational studies

Funding

This study was funded by the Brazilian fostering agency Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).

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Authors and Affiliations

  1. Oral Science, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil

    Jaíne C. Uliana, Catiusse C. Del’ Agnese, Raquel P. Antoniazzi & Karla Z. Kantorski

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  1. Jaíne C. Uliana
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  2. Catiusse C. Del’ Agnese
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Contributions

Jaine C Uliana: Substantial contributions to the design of the work; the acquisition, analysis, and interpretation of data.

Catiusse C Del’Agnese: Substantial contributions to the acquisition, analysis, and interpretation of data.

Raquel P Antoniazzi: Substantial contributions to the design of the work; the acquisition, analysis, and interpretation of data.

Karla Z Kantorski: Substantial contributions to the conception and design of the study; the acquisition, analysis, and interpretation of data for the work; final approval of the version to be published.

All authors reviewed the manuscript.

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Correspondence to Karla Z. Kantorski.

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Uliana, J.C., Del’ Agnese, C.C., Antoniazzi, R.P. et al. Autistic individuals have worse oral status than neurotypical controls: a systematic review and meta-analysis of observational studies. Clin Oral Invest 28, 137 (2024). https://doi.org/10.1007/s00784-024-05500-0

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