Every year's 2 April is the internationally recognised World Autism Awareness Day. Autism spectrum disorder (ASD) is not uncommon around the globe and in Hong Kong. It refers to a neurodevelopmental condition that affects how a person socializes and interacts with the surrounding world. According to the epidemiological study 2007 by The University of Hong Kong, 49 children in every 10,000 is diagnosed with the disorder in Hong Kong. Report from Education Bureau indicated that autistic students in mainstream schools exceeded 10,000 in the 2017/18 academic year.
From the perspective of oral health, there are few reasons why people believed autistic children are more prone to oral diseases. Firstly, the medication prescribed to children with Autism Spectrum Disorder (ASD) can cause dry mouth and is usually a form of sweetened liquid, leading to a higher risk of tooth decay. Secondly, ASD children might differ in sensory processing and react differently to normal sensations in daily life. Thus, not only parents and caretakers have difficulties in helping them to maintain oral cleanliness; dentists also face challenges to provide oral examination or treatment to them. Thirdly, their dietary habits such as slow eating and preference for soft and sweet food might also create unfavourable oral environment that causes tooth decay.
The abovesaid induced postgraduate students from Faculty of Dentistry of the University of Hong Kong to reflect if ASD children are really having poorer oral health. Under the supervision of Professors, the team conducted a systematic review to look into the oral health conditions of both autistic and normally developing children and adolescents.
The team thoroughly searched the literature and found 15 articles comparing the oral health status of children diagnosed with Autistic Spectrum Disorder with other normally developing children. They found no differences between the two groups in terms of caries, oral hygiene, gum diseases, tooth malalignment and trauma, salivary flow and buffering capacity. What is dissimilar is the salivary pH value for which ASD children have a slightly lower salivary pH value. Nevertheless, that is not of clinical significance that might influence their chances of having more tooth decay. They also found weak evidence suggesting more ASD children grind their teeth.
Overall, their findings did not support the assumption that ASD will lead to more oral diseases. Instead, other social and behavioural factors, for instance inadequate oral hygiene and sugary diet, may play a more important role.
The findings suggest that with proper oral hygiene maintenance and good dietary habits, everyone can enjoy good oral condition and a healthy smile." Hence, including parent, caretaker, teacher, medical, and dental personnel; everyone should work hand in glove to help our children.
The team included supervisors Professor Cynthia Yiu, Clinical Professor in Paediatric Dentistry and Professor Colman McGrath, Clinical Professor in Dental Public Health; Dr Simin Peng, Clinical Assistant Professor in Paediatric Dentistry, as well as postgraduate students, Dr Rennan Du and Dr Phoebe Lam.
To learn more about the team project, please watch the video:
Media enquiry:
Faculty of Dentistry, The University of Hong Kong
Senior Communications Officer, Ms Melody Tang
(Tel: 2859 0494; Email:
melodytang@hku.hk)
4月2日乃每年一度的「世界自閉症關注日」。自閉症譜系障礙在全球和香港並不少見。它是一種神經的發育狀況，會影響一個人如何與周圍的社交和互動。根據香港大學2007年的流行病學調查報告，每10,000名香港兒童當中，有5.49名兒童確診患有自閉症*。而教育局的報告指出在主流學校的自閉症學生在2017/18學年突破一萬。
在口腔健康上，人們一直認為患有自閉症的兒童更容易患口腔疾病。首先，給患有自閉症兒童服用的藥會導致口乾，因唾液不足較易導致更高的蛀牙風險。其次，自閉症兒童的感觀與常人有所不同，一般日常生活中被認爲是正常的感覺，對他們來說可會引起獨特的反應，因此，家長或照顧者要求他們保持口腔清潔可能有困難，牙醫為他們做口腔檢查或治療也面臨挑戰。第三，他們的飲食習慣，如進食較緩慢，偏愛軟甜的食物等方面也可能造成不良的口腔環境，引致蛀牙。
上述原因促使香港大學牙醫學院的研究生反思一個問題: 自閉症兒童的口腔健康情況是否較一般兒童差。 團隊在教授的指導下進行了系統審查，調查比較患自閉症和正常發育兒童和青少年的口腔健康情況。
研究團隊深入研究各種文獻，對比了15篇談及患有自閉症兒童與其他兒童的口腔健康情況的文章。他們發現，兩組兒童在蛀牙、口腔衛生、牙齦疾病、牙齒錯位和創傷、唾液流動方面並沒有差異。唯一的區別是他們的唾液酸鹼值，自閉症兒童有較低的值，然而暫時沒有任何臨床測試證明這會令他們患更多蛀牙，此外有一些證據顯示自閉症兒童或有磨牙的習慣。
總括而言，調查的發現，並不支持自閉症兒童會有更多口腔疾病的假設。相反，其他社會和行為因素，例如口腔衛生不足和含糖飲食可能是更重要的因素。
研究結果表明，只要保持口腔衛生和培養良好飲食習慣，每個人都可以享有良好的口腔狀況。因此，家長、照顧者、教師和牙科人員應攜手合作，保持孩子口腔健康，讓他們擁有健康的微笑。
團隊成員包括香港大學牙醫學院兒童齒科臨床教授姚嘉榕醫生和公共衛生臨床教授麥浩明醫生，以及兒童齒科和矯齒學臨床助理教授彭思敏醫生和研究生杜妍霖醫生及林珮盈醫生。
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