Orthodontic and Oral Health Assessment in Children With Autism: A Comparative Study With Typically Developing...

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that may influence oral health and orthodontic characteristics due to associated behavioural, sensory, and motor challenges. This study aimed to compare orthodontic treatment need, Angle classification, and oral hygiene status between children with ASD and typically developing children.

This cross-sectional comparative study included 50 children aged 6-18 years with ASD and 43 age- and sex-matched typically developing children. Malocclusion and orthodontic treatment need were assessed using Angle classification and the Index of Complexity, Outcome, and Need (ICON), respectively. Oral hygiene was evaluated with the Simplified Oral Hygiene Index (OHI-S). Intra-rater reliability was assessed with the intraclass correlation coefficient (ICC = 0.96). Group differences were assessed using the Mann-Whitney U, chi-square, or Fisher's exact tests, as appropriate. Spearman's correlation and age- and sex-adjusted multivariable regression analyses were also performed.

ICON scores were significantly higher in children with ASD than in typically developing children (p = 0.024). Oral hygiene was significantly poorer in the ASD group (p < 0.001), whereas Angle classification did not differ significantly between the groups (p = 0.118). After adjustment for age and sex, ASD diagnosis remained significantly associated with higher ICON scores (adjusted B = 9.74, 95% CI: 2.95-16.53, p = 0.005) and greater odds of being classified in a poorer oral hygiene category (adjusted OR = 4.65, 95% CI: 2.05-10.56, p < 0.001). CARS scores were not significantly correlated with ICON scores (rho = -0.152, p = 0.291).

Within the limitations of this study sample, children with ASD showed higher ICON scores and poorer oral hygiene status compared with typically developing children. These findings indicate an association between ASD status, orthodontic treatment need as assessed by ICON, and oral hygiene status in the study population. Further studies are needed to better understand the factors influencing orthodontic and oral health outcomes in children with ASD.