Brush up to a healthy smile : developing and testing an oral health education kit for children with autism spectrum disorder

Abstract

INTRODUCTION: Children with Autism Spectrum Disorder (ASD) tend to be resistant towards toothbrushing. Special approaches are required to help them establish oral hygiene routines and maintain good oral health. OBJECTIVES: To develop a toothbrushing oral health education (OHE) kit utilizing behavioural guidance techniques and to evaluate its effectiveness in improving toothbrushing habits and oral hygiene among children with ASD. METHODS: Pre-school children (n=46) with ASD in Hong Kong participated in an oral health promotion programme and were given OHE kits to foster learning of oral hygiene care with their parents and caregivers. Clinical examinations of oral hygiene status (Visible Plaque Index-VPI) and oral hygiene behaviours were recorded before and 2 weeks after the intervention. Effectiveness of the intervention were evaluated. RESULTS: 44 out of 46 (95.7%) children were followed up. Significant improvements in oral health behaviour were found in terms of increased cooperation during brushing (p<0.05) and willingness to brush (p<0.05). A significant improvement in oral hygiene status was observed. Visible plaque existed on approximately half of the tooth surfaces at baseline (44.8%, SD 26.0) and was significantly reduced to approximately a quarter of tooth surfaces post-intervention (23.9%, SD 18.0) (p<0.001). The magnitude of the change was large (effect size = 0.76). CONCLUSION: A community-based oral health promotion initiative among pre-school children with ASD was effective in improving oral health behaviour and oral hygiene status. Further long-term follow up is warranted.