Oral Health Interventions in Children With Autism Spectrum Disorder: A Systematic Review and Meta-Analysis of Interventional Studies.

Abstract

<h4>Objectives</h4>Children with autism spectrum disorder (ASD) exhibit a higher prevalence of oral health diseases. These oral health issues significantly impair quality of life and increase caregiver burden. Despite emerging interventions like specialized behavioral guidance and caregiver training, a comprehensive evaluation of their effectiveness remains absent. This systematic review and meta-analysis was designed to pool the effectiveness of Oral health interventions in children with ASD.<h4>Materials and methods</h4>In this systematic review, some international databases, including PubMed, ISI/WOS, CENTRAL, and Scopus, were searched via appropriate keywords until January 1, 2025. All clinical trials that assessed the effect of interventions on oral health indices including Simplified Oral Hygiene Index (OHI-S), plaque index (PI), and gingival index (GI) without any language or time restrictions were included in the study. Search strategy process, screening, data extraction, and quality assessment were performed by two experts independently. Heterogeneity between studies was assessed using I² and Q-Cochrane test. Random effect meta-analysis was performed to pool the standardized mean difference (SMD) with 95% confidence intervals (CIs).<h4>Results</h4>Overall, 27 studies with 1918 participants were included in this study. Interventions are categorized into the educational (visual, verbal, booklet/leaflet) and procedural approaches. Random effect meta-analysis showed significant improvements for PI (SMD = -0.73, 95% CI: [-1.02 to -0.44]) and OHI-S (SMD = -1.44, 95% CI: [-2.79 to -0.08]), with video interventions notably effective for PI (SMD = -0.69, 95% CI: [-1.2 to -0.14]). The GI index also improved (SMD = -0.74, 95% CI: [-1.34 to -0.14]).<h4>Conclusions</h4>Visual pedagogy, particularly videos, and parental involvement significantly improved oral health in children with ASD. Video-based interventions should be added to traditional methods such as verbal or picture-based approaches to improve oral health interventions in ASD.