Non-traumatic Dental Condition-Related Emergency Department Visits and Associated Costs for Children and Adults with Autism Spectrum Disorders.

Nakao et al. (2015) looked at U.S. emergency-department records for dental pain that was not caused by injury. They compared autistic and non-autistic people on how many visits they made and how much each visit cost.

The team split the data into children and adults. They wanted to see if autism changed the odds of landing in the ER for a tooth problem.

Kids with autism visited the ER for tooth pain just as often as other kids. Their bills per visit were about the same too.

Adults with autism showed a different pattern. They showed up less often, but when they did, the price tag for each visit was higher.

Koegel et al. (2014) saw the same adult pattern one year earlier: fewer ER trips for the wider IDD group, but no extra visits for kids. The two studies line up, giving us a two-year signal that adults with developmental disabilities avoid the dentist until trouble is severe.

Mammarella et al. (2022) give us a fix. Their brief behavioral rehearsal in a fake dental office let almost half of adults with IDD get a real exam without sedation. If we copy that model for autistic adults, we may keep them out of the ER in the first place.

Zhao et al. (2023) widen the lens to all hospital care in Beijing. They also find costs rising with age for autistic people, but their data include every service, not just teeth. Together the papers paint the same picture: autistic adults rack up higher bills per event because they skip routine care.

You can’t fix a cavity over Zoom, but you can spot dental pain early. Add a quick mouth check to your intake or day-hab routine. Ask about eating, chewing, and sleep. If the person can’t point to pain, watch for new food refusal or hand-mouth tapping. A simple referral to a sedation-free behavioral dental program can prevent the high-cost ER loop that Sy et al. uncovered.