Oral Health Complications Higher in Adolescents with Autism Spectrum Disorders and Other Developmental Disabilities (ODDs) with Obesity Compared to Healthy Adolescents

December 13, 2021

Dr. Vinodh Bhoopathi., an Assistant Professor of Public Health and Community Dentistry at the University of California at Los Angeles (UCLA) School of Dentistry, a dentist certified by the American Board of Dental Public Health, is leading a study focusing on oral health complications and utilization of dental care services among several high-risk groups: adolescents with Autism Spectrum Disorders (ASDs), Other Developmental Disabilities (ODDs), and Obesity. Dr. Kathryn Atchison, DMD, MPH., and Dr. Francisco Ramos-Gomez., DDS, MPH., research team members, represent the Division of Public Health and Community Dentistry, and Division of Growth and Development at UCLA School of Dentistry. The study, funded by the Maternal and Child Health Bureau, is the first-ever national study to assess oral health-related outcomes in ASD/ODD adolescents with obesity.

Nationally, the prevalence of ASDs and ODDs have increased in the past two decades among adolescents, and so has obesity levels and dental caries experience. Recent evidence shows an association between dental caries (decayed teeth or cavities) and obesity, with both diseases, sharing common risk factors. ASD/ODD adolescents with obesity who are already at high risk of health complications, may experience poor oral health status and/or utilize dental care minimally due to social, functional, behavioral, and physical limitations. Thus, Dr. Bhoopathi, hypothesized that adolescents without ASD/ODDs or obesity compared to adolescents with ASD/ODDs and obesity have a lower rate of experiencing chronic difficulty with one or more oral health complications.

For this study, the authors used an analytical sample of adolescents of ages 10 to 17 years (n=68,942) using data from 2016 through the 2019 National Survey of Children’s Health (NSCH). We categorized the analytical sample into 4 groups for comparisons: adolescents with ASD/ODDs and obesity (Group A), adolescents without ASD/ODDs but with obesity (Group B), adolescents with ASD/ODDs but no obesity (Group C), and adolescents without ASD/ODDs or obesity (Group D). Almost 7% of the sample were ASD/ODD adolescents with obesity representing approximately 2.31 million high-risk U.S. adolescents. Parents completing the survey, answered questions on their child’s demographics, health status, health care utilization, and other relevant health-related information. They also report their child’s experiences of chronic or frequent difficulty in the past 12 months with decayed teeth, toothaches, bleeding gums, and eating or swallowing due to a health condition (the outcomes of this report). A negative binomial regression yielded intriguing results. As hypothesized, we found that Group D compared to Group A adolescents had a rate 0.58 times significantly lower in experiencing chronic difficulty with one or more oral health complications. A similar association was observed while comparing Group B with Group A adolescents, but not while compared Group C. with Group A adolescents. We also found that adolescents with medical home compared to those without had a rate 1.26 times significantly greater in experiencing chronic difficulty with one or more oral health complications. This finding stresses the importance of integrated and coordinated care between medical and dental professionals to mitigate oral health complications among adolescents.

Our study found that there is a substantial number of adolescents with both ASD/ODDs and obesity in the U.S that have significantly high oral health problems compared to normal and healthy adolescents. Very little is known about this group and our study highlights the oral health-related knowledge gaps about this group. It is recommended that more research be done to further understand the characteristics of this group, their utilization of dental and medical services, health issues they face, and other socio-ecological factors that may influence their overall health.