Study Examines use of Oral Health Services and Access to Care Among Children with Autism Spectrum Disorder

January 22, 2010

Children with autism spectrum disorder (ASD) in Virginia face many barriers to oral health care," state the authors of an article published in the September-December 2009 issue of Journal of Dentistry for Children. Increased understanding of the barriers to oral health services for children with special health care needs has shown that their access to services is more limited -- and their needs greater -- than for those without special health care needs. Children with ASD present a unique challenge. ASD is accompanied by significant impairments in social interaction and communication that may make providing oral health care in a traditional manner difficult.

Determining the obstacles families face in obtaining oral health care for their children can help to minimize the difficulties they encounter. The article presents findings from a study to assess the use of oral health services among children with ASD and identify barriers that affect their access to care.

A questionnaire was mailed to all families in Virginia who were registered with the Autism Program of Virginia (TAPVA) and who cared for at least one child with ASD (n=200). The overall response rate was 29 percent (n=55). The analyses (1) described characteristics of individual factors and oral health care access measures; (2) examined relationships between the child's diagnosis, socioeconomic factors, insurance type, history of behavior in the dental office, and oral health care access measures; and (3) assessed factors independently significant in terms of a child's ability to access care.

In the final analysis, the child's history of behavior in the dental office (described as cooperative, somewhat cooperative, or extremely uncooperative) and household income (described as less than $20,000; $20,000 to $49,000, and $50,00 or more) were the only individual factors that remained significant for two oral health care access measures. The authors found that:

  • Children with ASD who displayed "extremely uncooperative" behavior and whose families' incomes were between $20,000 and $49,000 were least likely to have a regular dentist.
  • Children with ASD who displayed "extremely uncooperative" behavior and whose families' incomes were between $20,000 and $49,000 were least likely to receive care when needed.
  • There were no significant results found for the remaining dental care access issues, which included the following: (1) When was your child's last dental visit, (2) is your child currently scheduled for a checkup within the next 12 months, and (3) has your child ever been refused treatment.

The authors suggest that "these problems could be ameliorated through improved training opportunities for dentists, and by increasing parents' awareness of the need for early oral health intervention."

Brickhouse TH, Farrington FH, Best AM, et al. 2009. Barriers to dental care for children with autism spectrum disorders. Journal of Dentistry for Children 76(3):188-193. 

More information is available from the following MCH Library resources:

- Autism Spectrum Disorders: Knowledge Path

- Oral Health for Infants, Children, Adolescents, and Pregnant Women: Knowledge Path