Evaluation of the efficacy of a dental plaque control program in autistic patients.

The team ran a 180-day tooth-cleaning program for autistic clients. They used the Fonnes brushing method plus a diet checklist. Staff tracked plaque scores every 30 days.

No control group. Just pre- and post-measures on 30 cooperative and 30 uncooperative clients.

Plaque dropped by half. The biggest gains came from kids who followed directions well. Uncooperative clients still improved, but less.

All scores stayed low at the final check, six months in.

McConnell et al. (2020) adds a next step. They paired the same kind of dental visits with escape extinction. Disruptive behavior fell and exams got done. Sharp et al. (2010) never tackled problem behavior, so the 2020 paper fills that gap.

Levesque-Wolfe et al. (2021) and Tucker et al. (2021) show the same lesson: break the skill into small steps and practice each one. Whether it is refusing stranger lure or brushing teeth, the method works.

Sances et al. (2019) used an activity schedule for beekeeping. You can borrow that tool: make a picture list for brush, rinse, floss. Add a quick reward and you copy their success.

You now have a full 180-day script that cuts plaque in half for autistic clients. Start with the Fonnes steps, add a diet log, and track monthly. If a client tries to escape, bring in McConnell’s extinction plan: give breaks only after cooperation, not after screaming. Combine both studies and you get clean teeth and calm chairs.