Understanding the link between autism severity, oral hygiene behavior, and oral health-related quality of life in preschoolers with ASD

Abstract

<p><strong>Background:</strong> This research examined the role of oral hygiene behavior as a mediator between autism severity and oral health-related quality of life (OHRQoL).<br><strong>Method:</strong> Parents of 64 children aged 3-6 with ASD completed questionnaires on child OHRQoL (impacts on child across symptom, function, psychology, and social domains), family OHRQoL (impacts on family covering parental distress and family function), child’s oral hygiene behavior, and ASD symptom severity.<br><strong>Results:</strong> Higher ASD symptom severity predicted poorer oral hygiene behaviors (<em>β</em>=-0.156, <em>p</em>=0.016), which in turn hindered child OHRQoL (<em>β</em>=-0.289, <em>p</em>=0.035). Significant indirect effect (<em>β</em>=0.045, 95% CI [0.001, 0.108]) confirmed partial mediation. Family OHRQoL as a covariate strongly predicted child OHRQoL (<em>β</em>=0.646, <em>p</em>=0.001), outweighing the mediation effect. Dental caries showed marginal associations with oral hygiene but not child OHRQoL.</p><p><strong>Discussion:</strong> ASD symptom severity contributed to worsened oral hygiene practices and lower child OHRQoL. The strong family-child impact connection indicated that family adaptation to oral care challenges shaped children’s oral health. Limited direct impact of caries suggested that psychological and behavioral factors might be more central to OHRQoL among children with ASD.<br><strong>Implications:</strong> School psychologists may consider incorporating oral health strategies into behavioral plans for preschoolers with ASD and fostering cross-disciplinary communication to develop family-based interventions.</p>