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Let’s help them to smile

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Autistic individuals may need help with their daily dental routines, to avoid oral health complications (Nahrizul Adib Kadri - Unsplash)

By: Dr. Najihah Lokman

April marks Autism Awareness Month, a time to promote understanding, acceptance, inclusion and connectedness for individuals with autism spectrum disorder (ASD). ASD is a neurodevelopmental disorder encompassing not only social and communication challenges but also atypical patterns of activities and behaviours. Each and every individual within this spectrum is unique, with none showing identical patterns. While some individuals with autism can live independently, others face severe disabilities and rely on lifelong care and support.

Dr. Najihah Lokman

According to the World Health Organisation (WHO), about 1 in 100 children has autism, a notable increase from the 2012 global prevalence report, which estimated that only 6 in 1,000 children were autism. This upward trend in prevalence may reflect heightened awareness and recognition, resulting in earlier identification and diagnosis. Despite the attention on the behavioural and social challenges faced by individuals with ASD, their oral health is equally important but often overlooked and neglected.

A 2020 study conducted by the Xiamen Children’s Hospital reported that children with ASD have poorer oral hygiene and worse periodontal conditions compared to their neurotypical counterparts. Common oral problems observed in children with ASD include dental caries, oral pain, mouth breathing, biting hard objects, drooling, lip biting, and bruxism.

Individuals with ASD may experience unique challenges in maintaining good oral health. Sensory processing issues especially in a sensitive area of mouth can make brushing teeth and flossing uncomfortable. The sensation of toothbrush bristles or dental floss against their gums may be overwhelming or uncomfortable. Moreover, the texture and flavour of toothpaste or mouthwash might trigger aversive responses in individuals with ASD, further complicating their oral care routine, and potentially leading to reluctance or refusal to engage in these essential oral care.

In addition, certain habits observed in individuals with ASD, such as teeth grinding, tapping or hitting their mouth and teeth, chewing non-food objects, or selective eating behaviour with high sugary foods, can increase the risk of dental problems. They may struggle to verbally express dental pain or discomfort, making it challenging for caregivers and dental professionals to address their oral health needs in a timely manner. As a result, untreated dental issues may persist, leading to prolonged discomfort and potentially serious complications.

Therefore, to address the unique oral health challenges faced by individuals with ASD, it is crucial to implement a range of strategies tailored to their specific needs. Their overwhelmed sensory processing can be gradually desensitized through gentle and consistent exposure to oral care stimuli over time. Moreover, establishing a consistent oral hygiene routine is crucial, facilitated by specialized oral care kits equipped with softer toothbrushes, and a diverse range of flavoured toothpaste options to cater to their unique preferences.

Additionally, the sensory friendly dental environments that minimize overwhelming stimuli like light, crowds, smell or noise can greatly benefit individuals with sensory sensitiveness. as According to The National Autistic Society in the UK, incorporating relaxation techniques such as deep breathing or guided imagery can help them regulate their sensory responses and reduce anxiety or stress during dental visits. Equally important, prioritizing the fulfilment of their

sensory needs before the dental visit, such as chewing or providing physical activities like jumping, can further help them become more calm and relaxed, improving their overall experience and cooperation during dental appointments.

In sum, as we observe Autism Awareness Month, let’s not only strive for understanding but also extend our support to encompass comprehensive care, including oral health equity. By acknowledging and accommodating the unique needs of individuals with autism, we can pave the way for a future where everyone, regardless of their neurodevelopmental differences, can access proper oral care. Let’s advocate for inclusive dental practices and resources, ensuring that the path to a Healthy Smile is accessible to all.

Together, let’s brighten the world, one smile at a time.

The author is a Senior Lecturer at the Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya, and may be reached at najihahlokman@um.edu.my

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