Systematic Reviews
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Sep 9, 2025; 14(3): 106778
Published online Sep 9, 2025. doi: 10.5409/wjcp.v14.i3.106778
Challenges and solutions in managing dental problems in children with autism
Mohammed Al-Beltagi, Abdulrahman Abdullah Al Zahrani, Babu Sandilyan Mani, Ehab Mohamed Hantash, Nermin Kamal Saeed, Adel Salah Bediwy, Reem Elbeltagi
Mohammed Al-Beltagi, Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Algharbia, Egypt
Mohammed Al-Beltagi, Department of Paediatrics, University Medical Center, King Abdulla Medical City, Arabian Gulf University‎, Manama 26671, Bahrain
Abdulrahman Abdullah Al Zahrani, Department of Paediatrics, Alfaisal School of Medicine, Alfaisal University, Riyadh 50927, Saudi Arabia
Abdulrahman Abdullah Al Zahrani, Ehab Mohamed Hantash, Neonatal Intensive Care Unit, Al Rayan Hospital, Dr. Sulaiman Al Habib Medical Group, Riyadh 100266, Saudi Arabia
Babu Sandilyan Mani, Psychological Medicine Service, Royal Berkshire Hospital, NHS Foundation Trust, Reading 38, United Kingdom
Ehab Mohamed Hantash, Faculty of Medicine, Tanta University, Tanta 31511, Algharbia, Egypt
Nermin Kamal Saeed, Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, ‎Governmental Hospitals, Manama 12, Bahrain
Nermin Kamal Saeed, Medical Microbiology Section, Department of Pathology, Royal College of Surgeons in Ireland, Medical University of Bahrain, Busaiteen 15503, Muharraq, Bahrain
Adel Salah Bediwy, Department of Pulmonology, Faculty of Medicine, Tanta University, Tanta 31527, Alghrabia, Egypt
Adel Salah Bediwy, Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University‎, Manama 26671, Bahrain
Reem Elbeltagi, Department of Mediciene, Royal College of Surgeons in Ireland, Medical University of Bahrain, Busaiteen 15503, Muharraq, Bahrain
Co-first authors: Mohammed Al-Beltagi and Abdulrahman Abdullah Al Zahrani.
Author contributions: Al-Beltagi M conceptualized and designed the study, supervised the research process, and drafted the manuscript; Abdulrahman Al Zahrani AA contributed to data collection, literature review, and manuscript editing; Mani BS was responsible for methodology development and statistical analysis; Hantash EM assisted in data interpretation, manuscript revision, and validation of findings; Saeed NK contributed to literature synthesis, manuscript writing, and quality control; Bediwy AS provided critical insights into the discussion, manuscript refinement, and final approval of the version to be published; Elbeltagi R contributed to manuscript formatting, reference management, and proofreading; All authors reviewed and approved the final manuscript.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this study. No financial, personal, or professional relationships influenced the research, analysis, or conclusions presented in this manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammed Al-Beltagi, Chief Physician, MD, PhD, Professor, Department of Pediatrics, Faculty of Medicine, Tanta University, 1 Hassan Radwan Street, Tanta 31511, Algharbia, Egypt. mbelrem@hotmail.com
Received: March 7, 2025
Revised: March 27, 2025
Accepted: April 7, 2025
Published online: September 9, 2025
Processing time: 101 Days and 23.6 Hours
Abstract
BACKGROUND

Children with autism spectrum disorder (ASD) face unique challenges in maintaining oral health due to sensory sensitivities, communication difficulties, and behavioral barriers. These factors, along with limited access to ASD-trained dental professionals, increase their risk of dental caries, periodontal disease, bruxism, and other oral health issues. Despite growing awareness of these challenges, a comprehensive synthesis of evidence-based solutions remains lacking.

AIM

To review synthesizes existing research on dental problems in ASD, barriers to care, management strategies, and future directions for improved oral health outcomes.

METHODS

A systematic search of PubMed, Cochrane Library, and Scopus was conducted using predefined search terms. Related to ASD, dental health, and management strategies. Inclusion criteria encompassed studies focusing on children with ASD, dental health issues, and interventions. Data extraction included study design, participant characteristics, key findings, and intervention outcomes. The quality of studies was assessed using appropriate tools such as the Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale. A narrative synthesis approach, incorporating thematic analysis, was utilized to evaluate the findings.

RESULTS

A total of 165 studies met the inclusion criteria. Children with ASD exhibited a higher prevalence of dental caries, gingivitis, bruxism, and malocclusion compared to neurotypical peers. Barriers to dental care included sensory sensitivities, communication difficulties, financial constraints, and a shortage of ASD-trained dental professionals. Effective interventions included desensitization programs, behavioral therapy, digital applications, and interdisciplinary collaboration. Parental education and professional training were crucial for improving oral health outcomes.

CONCLUSION

Tailored dental care strategies, including sensory adaptations, behavioral interventions, and interdisciplinary collaboration, are essential for children with ASD. Standardized guidelines and long-term studies are needed to refine evidence-based protocols. Future research should explore digital interventions and probiotic applications in ASD dental care.

Keywords: Autism spectrum disorder; Pediatric dentistry; Oral health; Dental care barriers; Behavioral management; Sensory sensitivities; Interdisciplinary Dental care

Core Tip: This systematic review highlights the significant challenges faced by children with autism spectrum disorder (ASD) in maintaining oral health and accessing dental care. Sensory sensitivities, communication difficulties, and behavioral challenges contribute to poor oral hygiene, dental anxiety, and limited cooperation during treatment. The findings underscore the need for tailored interventions, including behavioral desensitization, sensory-friendly dental environments, and interdisciplinary collaboration. Parental education and ASD-specific training for dental professionals play crucial roles in improving outcomes. Future research should focus on developing standardized guidelines, increasing access to ASD-trained dentists, and exploring innovative solutions, such as digital interventions, to enhance dental care for this population.