Abstract
Previous international research has shown that autistic people have difficulty accessing dental care due to sensory processing, anxiety and communication issues. However, it is not known whether autistic adults in the United Kingdom are experiencing similar dental care barriers. The current study investigated autistic adults' dental experiences in the United Kingdom. A mixed methods survey was given to self-selecting autistic (n=37) and non-autistic adults (n=43) to compare whether autistic individuals had more negative experiences than non-autistic individuals. Closed questions asked about anxiety, patient-practitioner communication, satisfaction and the dental environment. Open questions asked about autism-specific dental challenges, what works well at the dentist, and improving autistic individuals' experiences. Responses were analyzed using thematic analysis. Overall, results demonstrated that autistic adults in the United Kingdom have more negative dental experiences than non-autistic adults. These predominantly related to interactions with dental practitioners, a challenging sensory environment, anxiety, pain, and disclosure. Participants recommended sensory environment adaptations, ways to increase preparedness, longer appointments, and individual accommodations. This study offers best-practice strategies for working with autistic patients and highlights the importance of dentists working with autistic individuals to maximize the quality of care and outcomes for this underserved population.
Highlights
Autism Spectrum Disorders (ASD) are a group of lifelong neurodevelopmental differences that manifest as social communication difficulties and restricted, repetitive behaviors.[1]
The existing data on oral health of autistic people is mixed: while an international review (India, Japan, the United States, United Arab Emirates) showed a high occurrence of dental caries and periodontal disease in autistic children,[9] a review from the United States of autistic and non-autistic children’s records found non-autistic children were more likely to have dental caries, though autistic children were considered less cooperative at the dentist.[10]
While it cannot be claimed that all autistic individuals have poorer oral health than non-autistic individuals, the challenges associated with autism may impede dental care for a number of reasons
Summary
Autism Spectrum Disorders (ASD) are a group of lifelong neurodevelopmental differences that manifest as social communication difficulties (e.g., establishing and maintaining relationships) and restricted, repetitive behaviors (e.g., insistence on routines and sensory differences).[1] Autistic people comprise approximately 1.1% of the UK’s. While it cannot be claimed that all autistic individuals have poorer oral health than non-autistic individuals, the challenges associated with autism may impede dental care for a number of reasons. Differences in sensory processing can result in autistic people finding certain stimuli distressing, including loud noises, intense light, and unexpected touch-characteristic features of dental care settings.[12,13] In the United States, parents reported that sensory stimuli including bright lights, touch near the mouth and dental products’ smell/taste were unpleasant for their autistic children and seemed linked to uncooperative behaviors.[14,15,16]
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