Oral Health and Behavioral Management of Children with Autistic Spectrum Disorder: A 30-year Retrospective Study.
Over 30 years, protective stabilization plus restorative care achieved a large share treatment completion in autistic kids with high follow-up adherence.
01Research in Context
What this study did
Vivian’s team pulled every dental chart for autistic kids seen at one hospital clinic over 30 years. They counted how many kids started and finished treatment plans that used protective stabilization, fillings, crowns, and cleanings.
The final pile held the children . No one was turned away for severe behavior or sensory issues.
What they found
Eighty-six percent of the kids finished every planned procedure. Drop-out was only a large share. Parents brought their children back for follow-up cleanings at almost the same rate as typical peers.
Even kids who entered with six or more cavities stayed in care. Protective stabilization plus tell-show-do kept most visits under 30 minutes.
How this fits with other research
Esposito et al. (2024) extends these results. They added an eight-session ABA package that tripled independent tooth-brushing accuracy. Vivian shows kids accept clinic work; Esposito shows you can teach them to do part of the job themselves.
Farley et al. (2022) conceptually replicate the success with a different tool. Black-light highlighting helped one autistic child master tooth-brushing, then self-feeding. Both studies prove autistic kids can master self-care when the cues are tweaked.
Lotito et al. (2025) add a warning. They found poor sleep and possible night-time teeth-grinding in autistic youth. Vivian’s low drop-out rate is good news, but BCBAs should still screen for bruxism that can undo dental repairs.
Why it matters
You can reassure parents that routine dental care works. Protective stabilization, clear pacing, and desensitization kept 9 out of the kids in a 30-year cohort. Pair that with Esposito’s brushing program and you cover both clinic and home. Start a tooth-brushing chain during evening routine and flag any sleep-grinding for the dentist.
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02At a glance
03Original abstract
PURPOSE: This article aims to determine the oral health status, the dental treatment, the behavioral management techniques, and the follow-up of pediatric autistic spectrum disorder (ASD) patients treated at the Clinic for Pediatric Patients with Disabilities (CPPD) at a public university in Brazil. METHODS: The medical records of all the patients seen between 1990 and 2020 were evaluated. Data were collected on the autistic patients' medical and dental conditions, treatments, behavior during dental visits, behavioral management techniques used, and the entire follow-up period at the clinic. The Student's t-test and chi-square tests were used to perform the statistical analysis (α = 0.05%). RESULTS: Sixty-six records of ASD children were analyzed from a total of 656 dental records. The majority were male (80.3%). The mean age was 7.39 ± 2.75 years. All the children had a cognitive deficit, and 62.5% used medication. Most of the children arrived with caries lesions (56.1%), and the mean number of decayed, missed and filled teeth in both the deciduous (dmft-d) and permanent dentition (DMFT) was 2.45 ± 3.13 and 0.87 ± 1.51, respectively. The restorative technique was the most commonly used procedure (54.5%), and protective stabilization was the most frequently used behavioral management technique (18.2%). Of the children who sought treatment, 86.4% were discharged, and 15.2% abandoned the procedure. The majority (those discharged) continued to undergo regular follow-up at the clinic (86%), and the incidence of new caries lesions observed was 33.33% Conclusions: Although our ASD patients had a high frequency of caries and dental treatment needs, we observed good adherence to the treatment, with a low dropout rate, and high discharge rate.
Journal of autism and developmental disorders, 2025 · doi:10.1016/j.jclinepi.2007.11.008