A Meta-Analysis of Oral Health Status of Children with Autism

Abstract

Purpose: To present a meta-analysis whether the risks of caries and periodontal problems in autistic children are higher than those in healthy children. Study design: A literature search that included PubMed, Embase, Web of Science, Cochrane, China National Knowledge Infrastructure (CNKI), Wan fang, and Chinese Scientific and Technological Journal (VIP) databases was conducted. The primary outcomes of interest included the DMFT index, Plaque index (PI), Gingival index (GI), and Salivary pH. Quality assessment was performed in accordance with the Newcastle-Ottawa Scale (NOS). Dichotomous variables are presented as relative risk (RR), and continuous variables are presented as weighted mean difference (WMD). Results: Eight studies were included in this meta-analysis. Among these 8 studies, six studies compared the DMFT index, three studies compared PI, three studies compared GI, and three studies compared salivary pH. Meta-analysis showed that the mean DMFT index in autistic children was higher than that in healthy children, and the difference was statistically significant {MD = 0.50, 95% CI [0.04–0.96], P<0.00001}. Similarly, PI and GI in autistic children were higher than those in healthy children, and the difference between PI was statistically significant {MD = 0.59, 95%CI [0.36–0.82], P=0.02}, while the difference between GI was not statistically significant {MD = 0.52, 95%CI [0.30–0.75], P=0.08}. But the salivary pH in autistic children was lower than that in healthy children {MD = −0.28, 95%CI [−0.54–−0.02], P = 0.02}, and the difference was statistically significant. Conclusion: The present analysis suggests that children with autism have poorer oral hygiene, higher risk of caries, and a lower salivary pH than healthy children.