Oral care interventions for autistic individuals: A systematic review.
Lucía I Floríndez, Dominique H Como, Evelyn Law and 5 others
PMID 39056277WHAT IT FOUND
Visual supports such as social stories, videos and picture schedules, used before and during dental visits, were the strategies most often linked to less anxiety and better cooperation at the dentist.
But only 5 of the 36 studies were judged strong on quality.
Key findings
01Preparation was the review's main message: getting the autistic person ready before dental care, at home by watching videos, reading social narratives and using visual schedules or step-by-step lists of oral care activities, and in the office through desensitisation appointments and gradual exposure to dental activities.
02The evidence base is mostly weak. The majority of the 36 studies were rated weak; of 24 group studies only 6 were adequate and 5 strong, with 13 weak, and of 12 single-subject studies only 2 were adequate and 10 weak. All five strong studies were group designs that included some kind of visual element.
03Autistic adults are almost absent from this literature: only one study deliberately recruited autistic adults, and of the five studies that included anyone over 18, four were paediatric studies running up to age 19.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Most of the 36 included studies were rated weak on quality: 13 of the 24 group studies and 10 of the 12 single-subject studies. Small samples, down to 3 participants, and varying recruitment strategies across the studies. No consistent way of confirming or reporting autism diagnosis; in most studies it came from parent report or from the recruitment site rather than a diagnostic assessment. No uniformity in how interventions or outcomes were reported, so the review describes studies one by one rather than giving a combined estimate of effect. Only one study deliberately recruited autistic adults, so the review says almost nothing about adults; four of the five studies that included anyone over 18 were paediatric studies. No study tailored its intervention to race, ethnicity, culture or socioeconomic status, and only two reported those demographics. The search stopped in October 2022, so any later studies are missing. Interventions were often bundled, for example a yoga class added to a picture-based toothbrushing schedule, so the contribution of any single component cannot be separated.
Declared interests
No funding or competing-interest declaration appears in the text provided, so who paid for the review and what the authors declared is not stated here.
The easy way to misread this
This review is not proof that visual supports, social stories or sensory-adapted dental rooms work. The authors rated most of the 36 included studies as weak evidence, and they describe their own positive conclusion as preliminary. Several studies also used more than one strategy at the same time, so no single one can be credited with the change.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →