BackgroundPeriodontal status and oral hygiene practices are found to be deficient in autistic children. This is attributed to challenges in oral health practices at home and the ability to provide dental treatment in the clinic. AimThe aim of this research was to identify and understand parental challenges regarding oral health practices of autistic children at home and to identify the barriers related to dental treatment. MethodsThis cross-sectional study included 54 parents of Autism Spectrum Disorder (ASD) children attending autism support group centres in the Western Cape. Data collection was completed through a structured online questionnaire. The questionnaire was comprised of socio-demographics, pharmacotherapeutic treatment of the child, oral health challenges faced by parents at home, and oral health challenges in the dental clinic. ResultsParental assistance of children during daily tooth brushing was reported by 59% of participants and the absence of flossing was particularly evident (90.7%). In the dental clinic, 58% of the parents described the child's behaviour as uncooperative. The majority of parents reported irregular visits to the dentist with extractions being the most commonly performed procedure. Options for treatment under sedation or general anaesthesia were more readily acceptable among parents of autistic children. ConclusionFindings suggest that children with ASD require long-term assistance with daily oral hygiene practices. The clinical environment represents an anxiety-provoking space and the uncooperative behaviour of children with ASD is the main barrier to dental treatment.