Autism spectrum disorders- caries and periodontal disease levels high?

boy with autism

Studies conducted in patients with autism spectrum disorders (ASD) have had inconsistent findings with some suggesting a high prevalence of caries others suggesting low or even caries free status. Similar variations are also seen in relation to periodontal disease.

The aim of this review was to verify the prevalence of dental caries and periodontal disease in individuals with ASD, especially children and young adults.


Searches were conducted in the Medline/PubMed, Web of Science, Scopus and OpenSigle/OpenGrey databases.  Cross-sectional, or longitudinal observational studies evaluating the oral health status of individuals with ASD reporting prevalence data or providing data to allow its calculation were considered.

Two reviewers independently selected studies, abstracted data and assessed risk of bias using the Newcastle-Ottawa Scale.


  • 7 studies involving a total of 780 patients were included.
  • 3 studies were conducted in India, 2 in Japan,one in the United Arab Emirates and the USA.
  • The studies were considered to have a moderate to low risk of bias.
  • Meta-analysis found a pooled prevalence of
    • Caries [ 7 studies] = 60.6% (95%CI; 44.0 – 75.1)
    • Periodontal disease [ 3 studies] = 49.4% (95%CI; 47.6 – 85.0)


The authors concluded

The pooled prevalence of dental caries and periodontal disease in children and young adults with ASD can be considered high, as more than half of assessed individuals with ASD presented at least one of these oral conditions. This points to the need of oral health policies for this specific population.


Only 7 studies met the reviewers’ criteria and most these are relatively small with sample sizes range from 22-483, and only two studies having more than 100 participants.  The authors highlight that the studies have used convenience samples with all the surveys being undertaken in institutions. While the review demonstrated a high level of caries and periodontal disease in those with ASD the findings need to be viewed carefully owing the limits of the available data and the degree of heterogeneity between the studies.  The authors highlight the need for future well-designed studies involving both institutionalised and non- institutionalised individual along with greater consideration of other factors such as social-economic status and age etc. in order to provide better data about the oral health status of this patient group.


Primary paper

da Silva SN, Gimenez T, Souza RC, Mello-Moura AC, Raggio DP, Morimoto S, Lara JS, Soares GC, Tedesco TK. Oral health status of children and young adults with autism spectrum disorders: systematic review and meta-analysis. Int J Paediatr Dent. 2016 Oct 31. doi: 10.1111/ipd.12274. [Epub ahead of print] PubMed PMID: 27796062.

Other references

Dental Care and Autism (National Autistic Society)

Autism Speaks – Dental Tool Kit



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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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