Exploring factors influencing autistic children and young people's access to dental care in Southwest England: a qualitative study of children, parents, and dental professionals.

BACKGROUND

Autistic children and young people (CYP) experience inequalities in oral health. They are at higher risk of dental caries and periodontal disease and are more likely to have teeth extracted under general anaesthetic than their non-autistic peers. Poor oral health among autistic CYP results from multiple factors, including sensory sensitivities, communication differences, and difficulties accessing appropriate dental care. This qualitative study explored factors influencing autistic CYP’s access to dental care from the perspective of CYP, parents/carers, and dental health professionals (DHPs).

METHODS

A qualitative design using semi-structured interviews was adopted. Purposive sampling was used to recruit autistic CYP, parents/carers, and DHPs in Southwest England. Data were collected online, by telephone, or face-to-face according to participant preference and accessibility needs. Interviews followed co-produced topic guides covering daily oral care, challenges and enablers, dental visit experiences, and views on improving support for autistic CYP. Audio recordings were transcribed verbatim and analysed thematically using inductive and deductive coding within NVivo 12.

RESULTS

Nineteen autistic CYP (aged 5–18 years), 20 parents/carers, and 16 DHPs were interviewed. Analysis revealed a complex interplay of individual, provider, and organisational factors shaping access to dental care. Sensory, communicative, and systemic challenges intersected, affecting how care was experienced, delivered, and sustained. Three overarching domains were identified: (1) CYP-related factors, including sensory sensitivities, communication differences, anxiety, and transition challenges; (2) provider-related factors, such as awareness of autism, rapport, flexibility, and time constraints; and (3) organisational influences, including NHS contract limitations, poor information sharing, and the need for autism-focused training.

CONCLUSIONS

Autistic CYP face distinct barriers to dental care, compounded during transition to adulthood. NHS dental professionals often lack the time, flexibility, and continuity required for individualised support. Enhancing information-sharing, referral pathways, integrated care, and autism-informed training could improve equity and accessibility. Findings highlight the need for system- and professional-level interventions to ensure dental care is inclusive and responsive to autistic CYP.