Oral health and quality of life in preschool children with autism: evidence from Kosovo.

PURPOSE: To evaluate differences in oral health status and parent/caregiver-reported oral health-related quality of life (OHRQoL) between preschool children with autism spectrum disorder (ASD) and healthy controls.

METHODS

A cross-sectional study included 90 children aged 4-6 years (45 with ASD and 45 controls). Oral health was assessed using WHO guidelines with Gingival, Plaque, Erosive Wear, and Decayed-Missing-Filled Teeth indices. Parents completed questionnaires covering WHO oral health (Q1-Q14), ASD-specific items (Q15-Q25), and P-CPQ-16. The differences between the groups were assessed using the Mann-Whitney U test. The questionnaire results, represented as percentages, were compared between groups utilizing Pearson's chi-square, Fisher's exact, or the Monte Carlo test. Statistical significance was set at p < 0.05.

RESULTS

No significant differences in oral health status existed between groups. OHRQoL showed significant differences within the ASD group, with higher P-CPQ-16 scores affecting "emotional well-being," "functional limitations," and "social well-being" (p < 0.001), while "oral symptoms" showed no difference. ASD children had fewer dental visits, mainly for toothaches, and brushed teeth less often (p = 0.035), with increased behavioral difficulties during dental visits (p < 0.001). No differences existed in fluoride toothpaste use, gingival condition, toothache experience, or dietary habits. ASD children had more difficulty with hard foods (p = 0.029) and higher self-injurious behavior (p ≤ 0.010).

CONCLUSION

Children with ASD experienced significantly poorer OHRQoL, especially in functional, emotional, and social domains. Promoting oral health through the education of parents and caregivers could help enhance the oral health-related quality of life and well-being of children with ASD.