Supporting autistic patients

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  Posted by: Dental Design      29th September 2024

There are over 700,000 adults and children diagnosed with autism in the UK.[i] Autism is characterised by impairments in communications and social relationships and a repeated, restricted repertoire of activities, behaviours and interests.[ii] It varies widely in symptoms and severity, covering a broad spectrum among those diagnosed with it.[iii]

Among autistic individuals, high levels of oral health complications are prevalent, such as tooth decay.[iv] Finding ways to help maintain positive oral health among autistic patients is crucial to their overall wellbeing.

Hypersensitivity

Many patients with autism find visiting the dentist challenging, with crowded waiting rooms, new staff, bright lights, invasive procedures, and new smells and tastes among some of the stressors that hypersensitive autistic individuals may be discomforted by.i As such, these patients can be difficult to treat, and many can go untreated.

At home, autistic individuals who are hypersensitive to sensory stimuli may struggle to maintain a consistent oral hygiene routine.[v] It is common for autistic children to have their teeth brushed by a parent, ensuring that the job is done effectively.ii The toothbrush and the toothpaste may be too abrasive for them when used on the teeth or tongue, prompting a low adherence to oral care if done independently. This can explain why children with autism have significantly more bacterial dental plaque and dental caries than children without autism.ii

Dangerous diet

Another reason for the poor oral health among autistic individuals is diet – they may have a preference for soft, sticky, or sweet foods.iii This is connected to the notion that eating disorders manifest themselves in children with autism or other autistic spectrum disorders (ASD) at a much higher rate compared to the general population.[vi] These unhealthy foods are frequently high in sugar, increasing the risk of tooth decay. Often fussy eaters who are less likely to participate in any physical activity, autistic individuals are vulnerable to many health-related problems from their diet, such as obesity.v

A healthy mouth and diet are important for overall health and wellbeing, as bad oral hygiene can affect a person’s ability to eat, sleep and talk. Among autistic children, the impact can be magnified, making it particularly important to find solutions.iii Education can help control the diet of some autistic individuals, limiting the sugary, sweet foods that accelerate tooth decay if left uncleaned in the mouth. However, education can only go so far and a superior oral hygiene routine is the practical solution required to offset the damage a poor diet can cause.

Along with tooth decay, periodontal disease is prevalent among autistic patients, with bruxism, tongue thrusting, gingival manipulation and lip biting all becoming common, detrimental oral habits that increase its risk.[vii] Whilst these habits may be challenging to stop, using interdental cleaning methods can lessen both the risk of periodontal disease and tooth decay, with the remnants from unhealthy foods being cleared out from crevices within the mouth.[viii]

A friendly device

A method for interdental cleaning is using a Water Flosser. Unlike the tricky technical problem of using string floss, a Water Flosser can access all parts of the mouth, especially when used by the parent on the child. They emit a steady stream of water to gently clean between and around the teeth and gumline, with the pulsation motion of the device reducing gum inflammation too.[ix] The dual impact of the flushing zone and the impact zone make it an effective tool for enhanced oral hygiene. With the power to adjust water pressure to a comfortable sensitivity, autistic individuals can incorporate it into an oral hygiene routine.

To clean with precision and comfort, encourage your patients to try the Waterpik®. Cordless Advanced Water Flosser. Able to remove up to 99.9% of plaque from treated areas, it comes with four tips, three pressure settings and a 360-degree rotation, making it easily customisable for the patient.[x] By massaging the gums, the Cordless Advanced promotes comfort and care simultaneously, improving circulation and keeping the gums healthy. Up to 50% more effective than string floss at improving gum health, the device is ultra-quiet and cordless, meaning it can be taken and used anywhere.[xi]

The hurdles with helping autistic patients in preserving their oral health are many. However, with perseverance, education and, for children, maybe a parent’s helping hand, autistic individuals can maintain a consistent oral hygiene routine that is less sensitive whilst still removing plaque and keeping their mouths fresh.

For more information on Waterpik® Water Flosser products visit www.waterpik.co.uk. 

Waterpik® products are available from Amazon, Costco UK, Argos, Boots, Superdrug and Tesco online and in stores across the UK and Ireland.

Author: Andrea Hammond

Andrea Hammond is a Dental Hygienist and Waterpik Professional Educator. Andrea has worked in dentistry since 1996, first qualifying as a dental nurse in 1998 – the same year in which she secured a place on the very first dental therapy cohort at the Eastman Dental Hospital. Following this, she was awarded diplomas in both dental hygiene and dental therapy in the year 2000, and became an active member of the GDC fitness to practice panel since 2015. Today, she continues to share knowledge as a Professional Educator for Waterpik and be deeply involved in the industry as a Regional Group Representative for the British Society of Dental Hygiene and Therapy (BSDHT). 

[i] Autistic patients: How can dental professionals help? (2023). BDJ Team, 10(2), pp.20–21. doi:https://doi.org/10.1038/s41407-023-1748-y.

[ii] KALYONCU, I.Ö. and TANBOGA, I. (2017). Oral Health Status of Children with Autistic Spectrum Disorder Compared with Non-authentic Peers. Iranian Journal of Public Health, [online] 46(11), pp.1591–1593. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5696703/.

[iii] National Institute of Mental Health (2024). Autism spectrum disorder. [online] National Institute of Mental Health (NIMH). Available at: https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd#:~:text=Autism%20spectrum%20disorder%20(ASD)%20is.

[iv] www.england.nhs.uk. (n.d.). NHS England» Dental care. [online] Available at: https://www.england.nhs.uk/learning-disabilities/improving-health/eye-care-dental-care-and-hearing-checks/dental-care/.

[v] OUP accepted manuscript. (2021). Public Health Ethics. https://doi.org/10.1093/phe/phab021

[vi] Doreswamy, S., Bashir, A., Guarecuco, J.E., Lahori, S., Baig, A., Narra, L.R., Patel, P. and Heindl, S.E. (2020). Effects of Diet, Nutrition, and Exercise in Children With Autism and Autism Spectrum Disorder: A Literature Review. Cureus, 12(12). doi:https://doi.org/10.7759/cureus.12222.

[vii] Sami, W., Mohammad Shakil Ahmad, Riyaz Ahamed Shaik, Miraj, M., Ahmad, S. and Muhammed Hamza Molla (2023). Oral Health Statuses of Children and Young Adults with Autism Spectrum Disorder: An Umbrella Review. Journal of Clinical Medicine, [online] 13(1), pp.59–59. doi:https://doi.org/10.3390/jcm13010059.

[viii] NHS (2018). Gum disease. [online] nhs.uk. Available at: https://www.nhs.uk/conditions/gum-disease/.

[ix] www.colgate.com. (n.d.). Should You Consider A Water Flosser? | Colgate®. [online] Available at: https://www.colgate.com/en-us/oral-health/selecting-dental-products/should-you-consider-a-water-flosser#.

[x] Gorur, A., Lyle, D.M., Schaudinn, C. and Costerton, J.W. (2009). Biofilm removal with a dental water jet. Compendium of Continuing Education in Dentistry (Jamesburg, N.J.: 1995), [online] 30 Spec No 1, pp.1–6. Available at: https://pubmed.ncbi.nlm.nih.gov/19385349/.

[xi] Rosema, N.A.M., Hennequin-Hoenderdos, N.L., Berchier, C.E., Slot, D.E., Lyle, D.M. and van der Weijden, G.A. (2011). The effect of different interdental cleaning devices on gingival bleeding. Journal of the International Academy of Periodontology, [online] 13(1), pp.2–10. Available at: https://pubmed.ncbi.nlm.nih.gov/21387981/.

 

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