Relationship between Gingivitis and Autism in Children: A Matched Case-control Study

Abstract

Autism is a neurodevelopmental disorder diagnosed in early childhood. Studies have shown that autistic children have poorer gingival health and hence chances of higher incidence of gingivitis may occur in autistic than non-autistic children. Gingivitis is characterized by gingival inflammation without loss of attachment due to continuous exposure to dental plaque. Studies on the gingival health of autistic children in Malaysia are lacking. Hence, this study aims to evaluate and compare the gingival health status of autistic and non-autistic children. Materials and Methods: A total of 86 children were recruited and an oral assessment was performed on each child to assess the degree of calculus, plaque accumulation and gingival inflammation using the calculus, plaque and gingival indices respectively. Pooled dental plaque (supragingival margins and gingival crevices of the buccal surface of the anterior maxillary molar and lingual of mandibular molar teeth) samples were collected and transferred to Stuart transport media. Samples were diluted and 100 µl aliquots were cultured on Columbia agar with 5% sheep blood. Plates were incubated in an anaerobic environment at 37ºC for 7 days. Colonies were Gram stained and examined for cellular morphology followed by indole and catalase test. Bacterial identification was done using the Rapid ID 32 A kit. Kolmogorov-Smirnov, Chi-square, Mann-Whitney U, Odds ratio and Spearman’s correlation analyses were used to analyze the data. Results: The prevalence of dental calculus was significantly elevated in the autistic group with 43 sample size in each group (p = 0.001). However, the prevalence of gingivitis and plaque were not significantly different between the two groups. The presence of plaque (p = 0.001) and calculus (p = 0.004) were significantly associated with the development of gingivitis. Conclusion: While the autistic children had significantly more calculus, the occurrence of gingivitis and plaque were similar between autistic and control groups. Measures to control dental plaque and calculus among the autistic children should be improved to prevent gingivitis.