Experiência de cárie dentária e consequências clínicas de cárie dentária não tratada de crianças e adolescentes com transtorno do espectro autista

Abstract

The presented study aimed to assess the dental caries experience and the clinical consequences of untreated dental caries in children/adolescents with Autism Spectrum Disorder (ASD), as well as to identify the socioeconomic characteristics and oral health habits of these individuals. This study received approval from Research Ethics Committee of the Federal University of Minas Gerais (Brazil) (approval #3.434.537) and was developed at the public outpatient clinic for individuals with ASD of the Department of Child’s and Adolescent’s Health of Juiz de Fora. Data collection was performed between November 2019 and March 2020. Forty-four (44) dyads of patents/caregivers and their children/adolescents with ASD participated in this cross-sectional study, with ages between three and 16 years. Children/adolescents with ASD registered at the outpatient clinic for individuals with ASD were included and whose parents/caregivers consented to their participation and that of their children by signing the Informed Consent Form. Parents/caregivers answered a structured self-administered questionnaire about socioeconomic information including sex, age and number of siblings of the child/adolescent, as well as maternal and paternal age and education, monthly family income and number of individuals in the household. They also answered an instrument about their children's oral health habits including previous visits to the dentist, daily frequency of tooth brushing, use of fluoride toothpaste and who performed tooth brushing. The children/adolescents with ASD were submitted to an intraoral examination, in a private room of the outpatient, by a single researcher, to assess the dental caries experience (DMFT/dmft) and clinical consequences of untreated dental caries (PUFA/pufa). The researcher was trained and calibrated to perform the clinical examination. For each oral condition evaluated, the inter-examiner (k = 0.97 and k = 0.79) and intra-examiner (k = 0.99 to k = 0.82) agreements were determined. Kappa coefficients proved to be satisfactory for the study. The collected data were stored and analyzed using the Statistical Package for Social Sciences-SPSS and a descriptive analysis was done based on the prevalence of the collected variables. Most children/adolescents were male (90.9%) and the average age was 6.4 (± 3.2) years. Most families (86.4%) had an average monthly family income less than or equal to two minimum wages According to information from parents/caregivers, most children/adolescents (63.6%) never visited the dentist and had a daily frequency of tooth brushing of one to two times a day (59.7%) performed by parents/caregivers (70.5%). The prevalence of dental caries experience was 43.2%. The mean DMFT/dmft was 1.52 ± 2.46, with the mean of the decayed component being highest (1.2 ± 1.9), followed by filled (0.3 ± 1.1), and missing (0.1 ± 0.5). Most of the individuals did not present clinical consequences of untreated dental caries (95.5%). It was concluded that children/adolescents with ASD need treatment concentrated on teeth with untreated cavitated lesions and that most of these individuals have never been to the dentist.