Prevalence of Dental Trauma in Autism Spectrum Disorder: A Systematic Review and Meta-Analysis

Gustavo Correia Basto da Silva; Ramon Targino Firmino; Waleska Fernanda Souto Nóbrega; Milena Edite Casé de Oliveira; Sérgio d’Ávila

Authors

Gustavo Correia Basto da Silva
Ramon Targino Firmino
Waleska Fernanda Souto Nóbrega
Milena Edite Casé de Oliveira
Sérgio d’Ávila

Keywords:

Autistic Disorder, Tooth Injuries, Observational Study, Prevalence

Abstract

Objective: To compare the prevalence of dental trauma between individuals with Autism Spectrum Disorder (ASD) and those without ASD. Material and Methods: A systematic review was conducted across the MEDLINE/PubMed, Cochrane, Scopus, OpenGrey and Web of Science databases. We included observational and quantitative studies conducted in English, encompassing populations of individuals with ASD, regardless of the level of support required, and without restricting the publication year. Exclusion criteria comprised duplicate articles, qualitative research, animal studies, letters, case reports, editorials, literature reviews, and other systematic reviews. The risk of bias was assessed using ROBINS-I. The certainty of evidence was assessed using the GRADE approach. Meta-analysis was performed to determine the frequency of traumatic dental injuries, estimating odds ratios (ORs) with 95% confidence intervals (CIs) using fixed-effects models. Results: Nine studies were included in the qualitative analysis, and eight were included in the meta-analysis. The findings demonstrated significant heterogeneity, moderate risk of bias, and a moderate level of certainty. Autistic individuals exhibited a higher prevalence of traumatic dental injuries, with subluxation (OR: 3.32; 95% CI: 1.14-9.67) and lateral dislocation (OR: 3.45; 95% CI: 1.42-8.41) being significantly more frequent within this group. Conclusion: The evidence suggests a trend towards a higher prevalence of dental trauma in the autistic group, particularly involving enamel and enamel-dentin injuries. Subluxation and lateral dislocation were more common among autistic individuals. These findings underscore the importance of a tailored approach to oral health in individuals with ASD.

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