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Journal Article•DOI•

Dental caries experience, oral health status and treatment needs of dental patients with autism

Mohamed Jaber1•
Ajman University of Science and Technology1
01 Jun 2011-Journal of Applied Oral Science (J Appl Oral Sci)-Vol. 19, Iss: 3, pp 212-217
TL;DR: Children with autism exhibited a higher caries prevalence, poor oral hygiene and extensive unmet needs for dental treatment than non-autistic healthy control group, and oral health program that emphasizes prevention should be considered of particular importance for children and young people with autism.
Abstract: OBJECTIVES: Autism is a lifelong neurodevelopmental disorder. The aims of this study were to investigate whether children with autism have higher caries prevalence, higher periodontal problems, or more treatment needs than children of a control group of non-autistic patients, and to provide baseline data to enable comparison and future planning of dental services to autistic children. MATERIAL AND METHODS: 61 patients with autism aged 6-16 years (45 males and 16 females) attending Dubai and Sharjah Autism Centers were selected for the study. The control group consisted of 61 non-autistic patients chosen from relatives or friends of autistic patients in an attempt to have matched age, sex and socioeconomic status. Each patient received a complete oral and periodontal examination, assessment of caries prevalence, and caries severity. Other conditions assessed were dental plaque, gingivitis, restorations and treatment needs. Chi-square and Fisher's exact test of significance were used to compare groups. RESULTS: The autism group had a male-to-female ratio of 2.8:1. Compared to controls, children with autism had significantly higher decayed, missing or filled teeth than unaffected patients and significantly needed more restorative dental treatment. The restorative index (RI) and Met Need Index (MNI) for the autistic children were 0.02 and 0.3, respectively. The majority of the autistic children either having poor 59.0% (36/61) or fair 37.8% (23/61) oral hygiene compared with healthy control subjects. Likewise, 97.0% (59/61) of the autistic children had gingivitis. CONCLUSIONS: Children with autism exhibited a higher caries prevalence, poor oral hygiene and extensive unmet needs for dental treatment than non-autistic healthy control group. Thus oral health program that emphasizes prevention should be considered of particular importance for children and young people with autism.

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Citations
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Journal Article•DOI•
Food Selectivity in Autism Spectrum Disorders: A Systematic Review

[...]

Salvador Marí-Bauset1, Itziar Zazpe2, Amelia Marí-Sanchis, Agustín Llopis-González1, María Morales-Suárez-Varela1 •
University of Valencia1, University of Navarra2
01 Nov 2014-Journal of Child Neurology
TL;DR: There is empirical evidence and an overall scientific consensus supporting an association between food selectivity and autism spectrum disorders.
Abstract: Autism spectrum disorders are characterized by difficulties with reciprocal social interactions and restricted patterns of behavior and interest; one of these characteristic behaviors is food selectivity. The objective of this study was to perform a systematic review of the literature published between 1970 and 2013 concerning this eating behavior. The articles identified were analyzed in terms of sample size, study design, and criteria for assessment and intervention, as well as the results, level of evidence and grade of recommendation. The main search was conducted in Medline, Cochrane Library, Scielo, ScienceDirect, and Embase). There is empirical evidence and an overall scientific consensus supporting an association between food selectivity and autism spectrum disorders.

170 citations

Therapies for Children With Autism Spectrum Disorder: Behavioral Interventions Update

[...]

Amy S. Weitlauf1, Melissa L McPheeters1, Brittany Peters1, Nila A Sathe1, Rebekah Travis1, Rachel Aiello1, Edwin Williamson1, Jeremy Veenstra-VanderWeele1, Shanthi Krishnaswami1, Rebecca N Jerome1, Zachary Warren1 •
Vanderbilt University1
12 Sep 2014
TL;DR: A prior systematic review of interventions for children (0-12 years) with autism spectrum disorder (ASD) focusing on recent studies of behavioral interventions was published in 2013.
Abstract: Objective We updated a prior systematic review of interventions for children (0–12 years) with autism spectrum disorder (ASD), focusing on recent studies of behavioral interventions. Data sources We searched the MEDLINE® (PubMed®), PsycInfo, and Educational Resources Information Clearinghouse (ERIC) databases as well as the reference lists of included studies and recent systematic reviews. We conducted the search in December 2013. Methods We included comparative studies (with treatment and comparison groups) of behavioral interventions with at least 10 participants with ASD in the update, and made our conclusions based on the cumulative comparative evidence across the original report and update. Two investigators independently screened studies against predetermined inclusion criteria and independently rated the quality of included studies. Results We included 65 unique studies comprising 48 randomized trials and 17 nonrandomized comparative studies (19 good, 39 fair, and 7 poor quality) published since the prior review. The quality of studies improved compared with that reported in the earlier review; however, our assessment of the strength of evidence (SOE), our confidence in the stability of effects of interventions in the face of future research, remains low for many intervention/outcome pairs. Early intervention based on high-intensity applied behavior analysis over extended timeframes was associated with improvement in cognitive functioning and language skills (moderate SOE for improvements in both outcomes) relative to community controls in some groups of young children. The magnitude of these effects varied across studies, potentially reflecting poorly understood modifying characteristics related to subgroups of children. Early intensive parent training programs modified parenting behaviors during interactions; however, data were more limited about their ability to improve developmental skills beyond language gains for some children (low SOE for positive effects on language). Social skills interventions varied in scope and intensity and showed some positive effects on social behaviors for older children in small studies (low SOE for positive effects on social skills). Studies of play/interaction-based approaches reported that joint attention interventions may demonstrate positive outcomes in preschool-age children with ASD when targeting joint attention skills (moderate SOE); data on the effects of such interventions in other areas were limited (low SOE for positive effects on play skills, language, social skills). Studies examining the effects of cognitive behavioral therapy on anxiety reported positive results in older children with IQs ≥70 (high SOE for improvements in anxiety in this population). Smaller short-term studies of other interventions reported some improvements in areas such as sleep and communication, but data were too sparse to assess their overall effectiveness. Conclusions A growing evidence base suggests that behavioral interventions can be associated with positive outcomes for children with ASD. Despite improvements in the quality of the included literature, a need remains for studies of interventions across settings and continued improvements in methodologic rigor. Substantial scientific advances are needed to enhance our understanding of which interventions are most effective for specific children with ASD and to isolate elements or components of interventions most associated with effects.

130 citations

Journal Article•DOI•
Analysis of gut microbiota profiles and microbe-disease associations in children with autism spectrum disorders in China

[...]

Mengxiang Zhang1, Wei Ma, Juan Zhang1, Yi He1, Juan Wang1 •
Peking University1
18 Sep 2018-Scientific Reports
TL;DR: In this microbe–disease network based on microbe similarity of diseases, it is found that ASD is positively correlated with periodontal, negatively related to type 1 diabetes and a human disease network including ASD is constructed using the results.
Abstract: Autism spectrum disorder (ASD) is a set of complex neurodevelopmental disorders. Recent studies reported that children with ASD have altered gut microbiota profiles compared with typical development (TD) children. However, few studies on gut bacteria of children with ASD have been conducted in China. Here, in order to elucidate changes of fecal microbiota in children with ASD, 16S rRNA sequencing was conducted and the 16S rRNA (V3-V4) gene tags were amplified. We investigated differences in fecal microbiota between 35 children with ASD and 6 TD children. At the phylum level, the fecal microbiota of ASD group indicated a significant increase of the Bacteroidetes/Firmicutes ratio. At the genus level, we found that the relative abundance of Sutterella, Odoribacter and Butyricimonas was much more abundant in the ASD group whereas the abundance of Veillonella and Streptococcus was decreased significantly compared to the control group. Functional analysis demonstrated that butyrate and lactate producers were less abundant in the ASD group. In addition, we downloaded the association data set of microbe–disease from human microbe–disease association database and constructed a human disease network including ASD using our gut microbiome results. In this microbe–disease network based on microbe similarity of diseases, we found that ASD is positively correlated with periodontal, negatively related to type 1 diabetes. Therefore, these results suggest that microbe-based disease analysis is able to predict novel connection between ASD and other diseases and may play a role in revealing the pathogenesis of ASD.

127 citations

Journal Article•DOI•
Management of children with autism spectrum disorder in the dental setting: concerns, behavioural approaches and recommendations

[...]

Konstantina Delli1, Peter A. Reichart, Michael M. Bornstein, Christos Livas•
University of Groningen1
01 Nov 2013-Medicina Oral Patologia Oral Y Cirugia Bucal
TL;DR: Most of the relevant studies indicate poor oral hygiene whereas they are inconclusive regarding the caries incidence in autistic individuals, and undergraduate dental education appears to determine the competence of dental professionals to treat developmentally disabled children.
Abstract: Objectives: This article reviews the present literature on the issues encountered while coping with children with autistic spectrum disorder from the dental perspective. The autistic patient profile and external factors affecting the oral health status of this patient population are discussed upon the existing body of evidence. Material and Methods: The MEDLINE database was searched using the terms ‘Autistic Disorder’, ‘Behaviour Control/methods’, ‘Child’, ‘Dental care for disabled’, ‘Education’, ‘Oral Health’, and ‘Pediatric Dentistry’ to locate related articles published up to January 2013. Results: Most of the relevant studies indicate poor oral hygiene whereas they are inconclusive regarding the caries incidence in autistic individuals. Undergraduate dental education appears to determine the competence of dental professionals to treat developmentally disabled children and account partly for compromised access to dental care. Dental management of an autistic child requires in-depth understanding of the background of the autism and available behavioural guidance theories. The dental professional should be flexible to modify the treatment approach according to the individual patient needs.

104 citations

Cites background from "Dental caries experience, oral heal..."

  • ...The symptomatology of ASD initiates before the third year of age and generally undergoes a steady course without remission through ageing (5,6)....

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  • ...On the contrary, unfavourable dietary behaviour with persistent preference for sweetened and soft food, and prolonged food retention in the oral cavity has been also described for young autistic patients (5,12)....

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  • ...Oral health and autism Conflicting results have emerged by the limited number of studies that carried out normative oral health assessment in children with ASD (1,5,9-16) (Table 1)....

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  • ...Interestingly, there have been merely two controlled studies with unaffected counterparts that announced statistically significant caries susceptibility for autistic samples, either higher (5) or lower (1)....

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  • ...With respect to oral hygiene, the preponderance of publications (5,9-12,14,16) points to rather poor standards in young autistic patients, reaching as well statistical significance (9-12,14)....

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Journal Article•DOI•
Alterations of oral microbiota distinguish children with autism spectrum disorders from healthy controls.

[...]

Yanan Qiao1, Mingtao Wu1, Yanhuizhi Feng1, Zhichong Zhou1, Lei Chen1, Fengshan Chen1 •
Tongji University1
25 Jan 2018-Scientific Reports
TL;DR: The habitat-specific profile of the oral microbiota in ASD patients is characterized, which might help develop novel strategies for the diagnosis of ASD, and diagnostic models based on key microbes were constructed.
Abstract: Altered gut microbiota is associated with autism spectrum disorders (ASD), a group of complex, fast growing but difficult-to-diagnose neurodevelopmental disorders worldwide. However, the role of the oral microbiota in ASD remains unexplored. Via high-throughput sequencing of 111 oral samples in 32 children with ASD and 27 healthy controls, we demonstrated that the salivary and dental microbiota of ASD patients were highly distinct from those of healthy individuals. Lower bacterial diversity was observed in ASD children compared to controls, especially in dental samples. Also, principal coordinate analysis revealed divergences between ASD patients and controls. Moreover, pathogens such as Haemophilus in saliva and Streptococcus in plaques showed significantly higher abundance in ASD patients, whereas commensals such as Prevotella, Selenomonas, Actinomyces, Porphyromonas, and Fusobacterium were reduced. Specifically, an overt depletion of Prevotellaceae co-occurrence network in ASD patients was obtained in dental plaques. The distinguishable bacteria were also correlated with clinical indices, reflecting disease severity and the oral health status (i.e. dental caries). Finally, diagnostic models based on key microbes were constructed, with 96.3% accuracy in saliva. Taken together, this study characterized the habitat-specific profile of the oral microbiota in ASD patients, which might help develop novel strategies for the diagnosis of ASD.

98 citations

References
More filters
Journal Article•DOI•
Diagnostic and Statistical Manual of Mental Disorders

[...]

Vijay A. Mittal1, Elaine F. Walker2•
University of Colorado Boulder1, Emory University2
30 Aug 2011-Psychiatry Research-neuroimaging
TL;DR: An issue concerning the criteria for tic disorders is highlighted, and how this might affect classification of dyskinesias in psychotic spectrum disorders.
Abstract: Given the recent attention to movement abnormalities in psychosis spectrum disorders (e.g., prodromal/high-risk syndromes, schizophrenia) (Mittal et al., 2008; Pappa and Dazzan, 2009), and an ongoing discussion pertaining to revisions of the Diagnostic and Statistical Manuel of Mental Disorders (DSM) for the upcoming 5th edition, we would like to take this opportunity to highlight an issue concerning the criteria for tic disorders, and how this might affect classification of dyskinesias in psychotic spectrum disorders. Rapid, non-rhythmic, abnormal movements can appear in psychosis spectrum disorders, as well as in a host of commonly co-occurring conditions, including Tourette’s Syndrome and Transient Tic Disorder (Kerbeshian et al., 2009). Confusion can arise when it becomes necessary to determine whether an observed movement (e.g., a sudden head jerk) represents a spontaneous dyskinesia (i.e., spontaneous transient chorea, athetosis, dystonia, ballismus involving muscle groups of the arms, legs, trunk, face, and/or neck) or a tic (i.e., stereotypic or patterned movements defined by the relationship to voluntary movement, acute and chronic time course, and sensory urges). Indeed, dyskinetic movements such as dystonia (i.e., sustained muscle contractions, usually producing twisting and repetitive movements or abnormal postures or positions) closely resemble tics in a patterned appearance, and may only be visually discernable by attending to timing differences (Gilbert, 2006). When turning to the current DSM-IV TR for clarification, the description reads: “Tic Disorders must be distinguished from other types of abnormal movements that may accompany general medical conditions (e.g., Huntington’s disease, stroke, Lesch-Nyhan syndrome, Wilson’s disease, Sydenham’s chorea, multiple sclerosis, postviral encephalitis, head injury) and from abnormal movements that are due to the direct effects of a substance (e.g., a neuroleptic medication)”. However, as it is written, it is unclear if psychosis falls under one such exclusionary medical disorder. The “direct effects of a substance” criteria, referencing neuroleptic medications, further contributes to the uncertainty around this issue. As a result, ruling-out or differentiating tics in psychosis spectrum disorders is at best, a murky endeavor. Historically, the advent of antipsychotic medication in the 1950s has contributed to the confusion about movement signs in psychiatric populations. Because neuroleptic medications produce characteristic movement disorder in some patients (i.e. extrapyramidal side effects), drug-induced movement disturbances have been the focus of research attention in psychotic disorders. However, accumulating data have documented that spontaneous dyskinesias, including choreoathetodic movements, can occur in medication naive adults with schizophrenia spectrum disorders (Pappa and Dazzan, 2009), as well as healthy first-degree relatives of chronically ill schizophrenia patients (McCreadie et al., 2003). Taken together, this suggests that movement abnormalities may reflect pathogenic processes underlying some psychotic disorders (Mittal et al., 2008; Pappa and Dazzan, 2009). More specifically, because spontaneous hyperkinetic movements are believed to reflect abnormal striatal dopamine activity (DeLong and Wichmann, 2007), and dysfunction in this same circuit is also proposed to contribute to psychosis, it is possible that spontaneous dyskinesias serve as an outward manifestation of circuit dysfunction underlying some schizophrenia-spectrum symptoms (Walker, 1994). Further, because these movements precede the clinical onset of psychotic symptoms, sometimes occurring in early childhood (Walker, 1994), and may steadily increase during adolescence among populations at high-risk for schizophrenia (Mittal et al., 2008), observable dyskinesias could reflect a susceptibility that later interacts with environmental and neurodevelopmental factors, in the genesis of psychosis. In adolescents who meet criteria for a prodromal syndrome (i.e., the period preceding formal onset of psychotic disorders characterized by subtle attenuated positive symptoms coupled with a decline in functioning), there is sometimes a history of childhood conditions which are also characterized by suppressible tics or tic like movements (Niendam et al., 2009). On the other hand, differentiating between tics and dyskinesias has also complicated research on childhood disorders such as Tourette syndrome (Kompoliti and Goetz, 1998; Gilbert, 2006). We propose consideration of more explicit and operationalized criteria for differentiating tics and dyskinesias, based on empirically derived understanding of neural mechanisms. Further, revisions of the DSM should allow for the possibility that movement abnormalities might reflect neuropathologic processes underlying the etiology of psychosis for a subgroup of patients. Psychotic disorders might also be included among the medical disorders that are considered a rule-out for tics. Related to this, the reliability of movement assessment needs to be improved, and this may require more training for mental health professionals in movement symptoms. Although standardized assessment of movement and neurological abnormalities is common in research settings, it has been proposed that an examination of neuromotor signs should figure in the assessment of any patient, and be as much a part of the patient assessment as the mental state examination (Picchioni and Dazzan, 2009). To this end it is important for researchers and clinicians to be aware of differentiating characteristics for these two classes of abnormal movement. For example, tics tend to be more complex than myoclonic twitches, and less flowing than choreoathetodic movements (Kompoliti and Goetz, 1998). Patients with tics often describe a sensory premonition or urge to perform a tic, and the ability to postpone tics at the cost of rising inner tension (Gilbert, 2006). For example, one study showed that patients with tic disorders could accurately distinguish tics from other movement abnormalities based on the subjective experience of some voluntary control of tics (Lang, 1991). Another differentiating factor derives from the relationship of the movement in question to other voluntary movements. Tics in one body area rarely occur during purposeful and voluntary movements in that same body area whereas dyskinesia are often exacerbated by voluntary movement (Gilbert, 2006). Finally, it is noteworthy that tics wax and wane in frequency and intensity and migrate in location over time, often becoming more complex and peaking between the ages of 9 and 14 years (Gilbert, 2006). In the case of dyskinesias among youth at-risk for psychosis, there is evidence that the movements tend to increase in severity and frequency as the individual approaches the mean age of conversion to schizophrenia spectrum disorders (Mittal et al., 2008). As revisions to the DSM are currently underway in preparation for the new edition (DSM V), we encourage greater attention to the important, though often subtle, distinctions among subtypes of movement abnormalities and their association with psychiatric syndromes.

67,017 citations

Journal Article•DOI•
Periodontal disease in pregnancy. i. prevalence and severity.

[...]

Harald Löe, John Silness1•
University of Bergen1
01 Dec 1963-Acta Odontologica Scandinavica
TL;DR: (1963).
Abstract: (1963). Periodontal Disease in Pregnancy I. Prevalence and Severity. Acta Odontologica Scandinavica: Vol. 21, No. 6, pp. 533-551.

6,408 citations

Journal Article•DOI•
The simplified oral hygiene index.

[...]

John G. Greene, Jack R. Vermillion
01 Jan 1964-Journal of the American Dental Association

1,999 citations

Journal Article•DOI•
Epidemiology of pervasive developmental disorders.

[...]

Eric Fombonne1•
McGill University Health Centre1
01 Jun 2009-Pediatric Research
TL;DR: There is evidence that the broadening of the concept, the expansion of diagnostic criteria, the development of services, and improved awareness of the condition have played a major role in explaining this increase, although it cannot be ruled out that other factors might have also contributed to that trend.
Abstract: This article reviews the results of 43 studies published since 1966 that provided estimates for the prevalence of pervasive developmental disorders (PDDs), including autistic disorder, Asperger disorder, PDD not otherwise specified, and childhood disintegrative disorder. The prevalence of autistic disorder has increased in recent surveys and current estimates of prevalence are around 20/10,000, whereas the prevalence for PDD not otherwise specified is around 30/10,000 in recent surveys. Prevalence of Asperger disorder is much lower than that for autistic disorder and childhood disintegrative disorder is a very rare disorder with a prevalence of about 2/100,000. Combined all together, recent studies that have examined the whole spectrum of PDDs have consistently provided estimates in the 60-70/10,000 range, making PDD one of the most frequent childhood neurodevelopmental disorders. The meaning of the increase in prevalence in recent decades is reviewed. There is evidence that the broadening of the concept, the expansion of diagnostic criteria, the development of services, and improved awareness of the condition have played a major role in explaining this increase, although it cannot be ruled out that other factors might have also contributed to that trend.

1,815 citations

"Dental caries experience, oral heal..." refers methods or result in this paper

  • ...Examination Following a complete medical history, all subjects were examined by one examiner for oral hygiene status and dental caries while seated on a dental chair using dental mirror, explorer and a periodontal probe with William’s markings. The examination of the soft and hard tissues was done under flash light and regular room light. each child accompanied by his/her teacher was brought to the examination room and is seated on an adjustable chair. “TellShow-Feel and Do” technique was used with all the children. The dmft/DMFT index was used, with codes and criteria established by the WHO29 (1997). Met Need Index (MNI), an indication of treatment received by an individual is determined using the ratio of the mean missing (M) plus filled (F) teeth to mean decayed, missing and filled teeth (DMF) that is M+F/DMF....

    [...]

  • ...Examination Following a complete medical history, all subjects were examined by one examiner for oral hygiene status and dental caries while seated on a dental chair using dental mirror, explorer and a periodontal probe with William’s markings. The examination of the soft and hard tissues was done under flash light and regular room light. each child accompanied by his/her teacher was brought to the examination room and is seated on an adjustable chair. “TellShow-Feel and Do” technique was used with all the children. The dmft/DMFT index was used, with codes and criteria established by the WHO29 (1997). Met Need Index (MNI), an indication of treatment received by an individual is determined using the ratio of the mean missing (M) plus filled (F) teeth to mean decayed, missing and filled teeth (DMF) that is M+F/DMF. While Restorative Index (RI) which reflects the restorative care of those who have suffered the disease is measured by the ratio of filled (F) to filled plus decayed teeth (F+D) percent that is F/F+D percent as described by Jackson12 (1973). This methodology was used systematically for all autistic and healthy control children examined. The gingival status was evaluated according to the gingival index of Loe and Silness15 (1963). Gingival status was recorded as generalized or localized gingival inflammation depending on the amount of gingival redness and bleeding during the examination. Oral hygiene was recorded as good, fair or poor according to the Simplified Oral Hygiene Index (SOHI)10. Before examinations, intraobserver agreement for the diagnosis of caries was checked: one in every 10 children was re-examined to test for intraexaminer agreement. The kappa test was adopted on a tooth by tooth basis in order to check the intraexaminer agreement in caries diagnosis, in agreement with the methodology described by Peres, et al.21 (2001). examiner agreement was high....

    [...]

  • ...216 caries prevalence in autistic children16,18. The higher caries index value in permanent dentition compared with that of primary dentition is in accordance with previous studies18. However, in a recent study from Brazil Bassoukou, Nicolau and Santos4 (2009) reported that autistic individuals compared with non-autistic healthy controls, have neither a higher salivary flow rate nor a better buffer capacity of the saliva and a similar dental caries experience was observed in both primary and permanent dentitions. The percentage of decayed, missing and filled teeth increased with advancing age. The increase attributed to the effects of time on the increased number of teeth susceptible to decay such as the second permanent molars, which erupt during adolescent period19. In general, children with autism prefer soft and sweetened foods and they tend to pouch food inside the mouth instead of swallowing it due to poor tongue coordination, thereby increasing the susceptibility to caries14. Moreover, the risk for dental caries can be expected to be higher in these patients due to difficulties in brushing and flossing. Non-institutionalized children with autism had caries rates that were similar to the rates in functionally independent peers in a study conducted by Shapira, et al.28 (1998). Rajic and Dzingalasevic24 (1989) reported that a combined treatment, provided by a dental team and a pedopsychiatric team working together, resulted in a decreased prevalence of caries in a group of children with autism as compared to another group who did not receive any treatment. Addressing the high prevalence of dental caries among autistic children in UAe will require increased oral health promotion for parents and caregivers both at primary school age and at the preschool stage to enable them to implement effective preventive regimes for their children. Dental health education should include information/ guidance on reducing the frequency of sugary foods and drinks in the diet, good oral hygiene, use of fluoride toothpaste, and early attendance at the dentist or dental nurse for advice and care. Improving access to dental care and encouraging uptake of dental services should also form part of any health promotion strategy for autistic children. In this study the majority of autistic children had poor oral hygiene, and almost all of them had gingivitis. These changes could be related to irregular brushing habits because of the difficulties the trainers and the parents encountered when they brushed the children’s teeth. It could also be due to lack of the necessary manual dexterity of autistic children, which result in inadequate tooth brushing. Furthermore, the findings of this study reflect poor dental awareness, a lack of dental education and deficiency in receiving oral hygiene instructions from dental staff. Another possible explanation of the presence of generalized gingivitis might be the side effects of medications used to control the manifestations of autism such as psychoactive drugs or anticonvulsants, with the most common drug classes being antidepressants, stimulants, and antipsychotics25. However, Pilebro and Bäckman23 (2005) in a prospective study which included clinical examinations and structured interviews produced a series of pictures that showed a structured method and technique of tooth brushing. The pictures were placed in the bathroom or wherever tooth brushing was performed. Fourteen children with autism aged between 5 and 13 years were involved, after 12 months, the amount of visible plaque was reduced. After 18 months, most parents found maintaining good oral hygiene easier than before the study and concluded that visual pedagogy is a useful tool in helping people with autism to improve their oral hygiene. Met Need Index (MNI) and Restorative Index (RI) of the studied autistic children were low compared with healthy control subjects. Met Need Index (MNI), an indication of treatment received by an individual is determined using the ratio of the mean missing (M) plus filled (F) teeth to mean decayed, missing and filled teeth (DMF) that is M+F/ DMF. While Restorative Index (RI) which reflects the restorative care of those who have suffered the disease is measured by the ratio of filled (F) to filled plus decayed teeth (F+D) percent that is F/F+D percent as described by Jackson12 (1973). These results indicate the provision of dental services to this unique group of patients with high prevalence of dental caries and more treatment need compared with non-autistic healthy patients....

    [...]

  • ...Examination Following a complete medical history, all subjects were examined by one examiner for oral hygiene status and dental caries while seated on a dental chair using dental mirror, explorer and a periodontal probe with William’s markings. The examination of the soft and hard tissues was done under flash light and regular room light. each child accompanied by his/her teacher was brought to the examination room and is seated on an adjustable chair. “TellShow-Feel and Do” technique was used with all the children. The dmft/DMFT index was used, with codes and criteria established by the WHO29 (1997). Met Need Index (MNI), an indication of treatment received by an individual is determined using the ratio of the mean missing (M) plus filled (F) teeth to mean decayed, missing and filled teeth (DMF) that is M+F/DMF. While Restorative Index (RI) which reflects the restorative care of those who have suffered the disease is measured by the ratio of filled (F) to filled plus decayed teeth (F+D) percent that is F/F+D percent as described by Jackson12 (1973). This methodology was used systematically for all autistic and healthy control children examined....

    [...]

  • ...Examination Following a complete medical history, all subjects were examined by one examiner for oral hygiene status and dental caries while seated on a dental chair using dental mirror, explorer and a periodontal probe with William’s markings. The examination of the soft and hard tissues was done under flash light and regular room light. each child accompanied by his/her teacher was brought to the examination room and is seated on an adjustable chair. “TellShow-Feel and Do” technique was used with all the children. The dmft/DMFT index was used, with codes and criteria established by the WHO29 (1997). Met Need Index (MNI), an indication of treatment received by an individual is determined using the ratio of the mean missing (M) plus filled (F) teeth to mean decayed, missing and filled teeth (DMF) that is M+F/DMF. While Restorative Index (RI) which reflects the restorative care of those who have suffered the disease is measured by the ratio of filled (F) to filled plus decayed teeth (F+D) percent that is F/F+D percent as described by Jackson12 (1973). This methodology was used systematically for all autistic and healthy control children examined. The gingival status was evaluated according to the gingival index of Loe and Silness15 (1963). Gingival status was recorded as generalized or localized gingival inflammation depending on the amount of gingival redness and bleeding during the examination....

    [...]

Journal Article•DOI•
Neuroanatomy of autism

[...]

David G. Amaral1, Cynthia M. Schumann2, Christine Wu Nordahl1•
University of California, Davis1, University of California, San Diego2
01 Mar 2008-Trends in Neurosciences
TL;DR: It is suggested that the heterogeneity of both the core and co-morbid features predicts a heterogeneous pattern of neuropathology in autism, and defined phenotypes in larger samples of children and well-characterized brain tissue will be necessary for clarification of the neuroanatomy of autism.

1,369 citations

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