Yoga therapy as an adjunct to traditional tooth brushing training methods in children with autism spectrum disorder

Comparative Evaluation of Music and Movement Therapy and Visual Pedagogy as Interventional Tools in Promoting Oral Health in Children With Autism Spectrum Disorder: A Randomized Controlled Trial

AIM

To compare the effectiveness of music and movement therapy (M&MT) and visual pedagogy (VP) as interventional tools in promoting oral health in children with Autism spectrum disorder (ASD).

MATERIALS AND METHODS

Seventy-two children with ASD aged 7-15 years were randomized into two groups (N = 36), Group I received M&MT and Group II received VP. Plaque and gingival indices were recorded at baseline and the end of first, second, and third months. Perception questionnaires and a checklist to evaluate toothbrushing skills were distributed to their parents. An inter-group comparison with independent t-test and Intra group Comparison using paired t-test were performed.

RESULTS

The mean plaque index score for Group I and II at the end of third month (0.27 + 0.71, 0.71 + 0.26), and the mean gingival index score for Group I and II at the end of third month 0.29 + 0.15, 0.62 + 0.26 which was statistically significant (p = 0.001). Significant improvement in toothbrushing skills was observed in children of Group I.

CONCLUSIONS

Children with ASD in Group I learnt toothbrushing skills expeditiously when compared to children in Group II. Therefore, it can be concluded that M&MT could be an effective tool in training toothbrushing skills.

TRIAL REGISTRATION

CTRI/2022/10/046615 (Clinical Trial Registry).

Effectiveness of 'video-based interventions' of toothbrushing over other interventions on improvement of oral hygiene in children with Autism Spectrum Disorders (ASD): a systematic review and meta-analysis

BACKGROUND

Children with Autism exhibit impairment of fine motor co-ordination and sensory sensibilities and hence can directly affect the toothbrushing leading to poor oral hygiene.

AIM

This current systematic review and meta-analysis (SRMA) aims to evaluate the effectiveness of Video-based intervention of toothbrush training over other methods on improvement of oral hygiene in children with autism spectrum disorders (ASD) MATERIALS AND METHODS: Prospero no: (CRD42023450168). 'PubMed', 'Cochrane', 'Ovid' databases were searched from 1 January 1980 to 1 August 2023 using pre-defined search strategy.

RESULTS

212 titles were retrieved after, duplicate exclusion, removal of irrelevant titles led to the final inclusion of 13 articles for full text screening out of which 7 articles were included for the final analysis.

CONCLUSION

Even though video intervention reported better outcomes in individual studies, pooled data showed no significant superiority over other interventions such as social stories and picture-based interventions in relation to toothbrushing in children with ASD as indicated by the Plaque Index score (PI-S) and Oral hygiene index score (OHI-S).

Oral care interventions for autistic individuals: A systematic review

LAY ABSTRACT

Oral care-related challenges are well documented in the autistic community; dental care remains one of the most prevalent unmet health needs among autistic individuals. This review examined interventions designed to improve oral health in autistic individuals from children and adult populations. Through a systematic process, 36 studies were identified. These studies focused on improving home-based oral care skills and routines and reducing fear, anxiety, and/or negative behaviors in the dental clinic. Studies incorporated different types of techniques for facilitating oral care practice, including preparatory interventions to support home-based hygiene activities or improve an approaching dental encounter (n = 29), most often using visual aids, and/or strategies to manage behavioral difficulties exhibited in the dental office (n = 17). Some studies used both approaches (n = 10), combining visual aids prior to a visit with behavior management. Using an evidence-based rubric, we reviewed the methodological quality of the studies and found that most were only "adequate" (n = 8) or "weak" (n = 23) in reporting their evidence. This review has two key findings: (1) there is support for preparatory home-based visual interventions to improve toothbrushing and/or ready patients for dental visits; and (2) distraction or sensory-reducing interventions may also improve experiences in the dental clinic. Only one study purposefully recruited autistic adults, and no studies included intervention elements tailored to race/ethnicity, culture, and/or socioeconomic status. This review highlights the need for more studies investigating the impact of oral care-related interventions for autistic individuals of all ages and identifies a gap in interventions for autistic adults and those from minoritized populations.

Is Visual Pedagogy Effective in Improving Cooperation Towards Oral Hygiene and Dental Care in Children with Autism Spectrum Disorder? A Systematic Review and Meta-Analysis

Visual pedagogy has emerged as a new approach in improving dental care in children with autism spectrum disorders (ASDs). This paper aimed to evaluate and assess the scientific evidence on the use of visual pedagogy in improving oral hygiene skills and cooperation during dental care in children with ASDs. The review protocol was registered on the PROSPERO Register (CRD42020183030). Prospective clinical studies, randomized trials, interruptive case series, before and after comparison studies, and cross-sectional studies following the PRISMA guideline were searched in PubMed, Embase, Scopus, and Google Scholar using ad hoc prepared search strings. The search identified 379 papers, of which 342 were excluded after title and abstract evaluation, and 37 full-text papers were analyzed. An additional four papers were added after consulting reference lists. Eighteen papers were disregarded; 23 were finally included, and their potential bias was assessed using ROB-2 and ROBINS-I tools. The wide heterogenicity of the studies included does not allow for conclusive evidence on the effectiveness of visual pedagogy in oral hygiene skills and dental care. Nevertheless, a significant and unilateral tendency of the overall outcomes was found, suggesting that visual pedagogy supports ASD children in improving both oral hygiene skills and cooperation during dental care.

Oral health education and promotion in special needs children: Systematic review and meta-analysis

OBJECTIVE

To review the effectiveness of oral health education and oral health promotion interventions for children and adolescents with intellectual and developmental disabilities (IDD), in ensuring optimal gingival health, caries experience and oral health-related quality of life, compared to no interventions or alternative interventions.

METHODS

A systematic review was conducted to identify published studies from four databases (Medline, PsycINFO, CINAHL and ERIC). Randomised or quasi-randomised controlled trials were included. Two independent reviewers performed risk of bias and qualitative analysis. Meta-analysis was performed as appropriate.

RESULTS

Eight treatment comparisons were identified. There was low certainty evidence that fluoride interventions provided long-term reductions in caries in those with IDD; and there was some evidence that chlorhexidine albeit with low certainty provided short-term and long-term reductions in plaque and gingivitis. There was moderate certainty evidence for short-term reductions in dental plaque from the use of modified toothbrushes, but not compelling evidence for powered toothbrushes.

CONCLUSIONS

Most studies provided a low quality of evidence, and so any adaptations made to oral health practices of individuals with IDD need to consider their individual needs. PROSPERO registration: CRD42019145784.