Non-Cochrane · aetiology · PM41659192
Oral hygiene and caries experience in children with down syndrome and autism spectrum disorder: a systematic review and meta-analysis.
Bainazarova Nurzhamal, Zhumabayeva Kuralay, Yermukhanova Gulzhan, et al. · Frontiers in dental medicine · 2025 · PubMed · doi:10.3389/fdmed.2025.1726952
Findings
11 findings
| Population | ||||
|---|---|---|---|---|
| Children aged 0 to 18 years (children with Down syndrome and healthy controls) | Down syndrome (exposure) | Healthy neurotypical controls | Simplified Oral Hygiene Index (OHI-S) Cross-sectional (single assessment) · Clinical and community settings | MD 0.28 [-0.92, 1.47] Low Downgraded: imprecision, inconsistency 3 studies · 306 participants |
| Children aged 0 to 18 years (children with Down syndrome and healthy controls) | Down syndrome (exposure) | Healthy neurotypical controls | Gingival Index (GI) Cross-sectional (single assessment) · Clinical and community settings | MD 12.10 [-138.72, 162.92] Low Downgraded: imprecision, inconsistency 2 studies · 288 participants |
| Children aged 0 to 18 years (children with Down syndrome and healthy controls) | Down syndrome (exposure) | Healthy neurotypical controls | Plaque Index (PI) Cross-sectional (single assessment) · Clinical and community settings | MD 0.53 [-0.13, 1.18] Low Downgraded: inconsistency 5 studies · 262 participants |
| Children aged 0 to 18 years (children with Down syndrome and healthy controls) | Down syndrome (exposure) | Healthy neurotypical controls | dmft (primary teeth caries experience) Cross-sectional (single assessment) · Clinical and community settings | MD -0.14 [-0.61, 0.33] Low Downgraded: imprecision, inconsistency 4 studies · 436 participants |
| Children aged 0 to 18 years (children with Down syndrome and healthy controls) | Down syndrome (exposure) | Healthy neurotypical controls | DMFT (permanent teeth caries experience) Cross-sectional (single assessment) · Clinical and community settings | MD -0.29 [-0.97, 0.39] Low Downgraded: imprecision, inconsistency 6 studies · 834 participants |
| Children aged 0 to 18 years (children with autism spectrum disorder and healthy controls) | Autism spectrum disorder (exposure) | Healthy neurotypical controls | Gingival Index (GI) Cross-sectional (single assessment) · Clinical and community settings | MD 0.33 [-0.13, 0.78] Low Downgraded: imprecision, inconsistency 4 studies · 516 participants |
| Children aged 0 to 18 years (children with autism spectrum disorder and healthy controls) | Autism spectrum disorder (exposure) | Healthy neurotypical controls | Simplified Oral Hygiene Index (OHI-S) Cross-sectional (single assessment) · Clinical and community settings | MD 0.31 [-1.37, 1.98] Low Downgraded: imprecision, inconsistency 2 studies · 420 participants |
| Children aged 0 to 18 years (children with autism spectrum disorder and healthy controls) | Autism spectrum disorder (exposure) | Healthy neurotypical controls | DMFT (permanent teeth caries experience) Cross-sectional (single assessment) · Clinical and community settings | MD 0.29 [-0.53, 1.11] Low Downgraded: imprecision, inconsistency 12 studies · 1937 participants |
| Children aged 0 to 18 years (children with autism spectrum disorder and healthy controls) | Autism spectrum disorder (exposure) | Healthy neurotypical controls | Plaque Index (PI) Cross-sectional (single assessment) · Clinical and community settings | MD 0.28 [-0.05, 0.61] Low Downgraded: inconsistency 7 studies · 1051 participants |
| Children aged 0 to 18 years (children with autism spectrum disorder and healthy controls) | Autism spectrum disorder (exposure) | Healthy neurotypical controls | dmft (primary teeth caries experience) Cross-sectional (single assessment) · Clinical and community settings | MD -0.33 [-1.49, 0.82] Low Downgraded: imprecision, inconsistency 10 studies · 1539 participants |
| Children aged 0-18 years with Down syndrome or autism spectrum disorder | Down syndrome or autism spectrum disorder (exposure) | Healthy neurotypical children (controls) | Plaque Index (PI) Case-control and cross-sectional studies in children; Asia, Europe and elsewhere · Leave-one-out sensitivity analysis excluding Mahmood 2024 | MD 0.43 [0.17, 0.70] GRADE not reported 11 studies |
Included primary studies 28
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Al-Maweri 2014 Oral lesions and dental status of autistic children in Yemen: A case-control study. PMID:25625079 | 2014 | 1 other review | Plaque Index (PI); Gingival Index (GI); DMFT (permanent teeth caries experience) | not extracted yet |
| AlSarheed 2015 A comparative study of oral health amongst trisomy 21 children living in Riyadh, Saudi Arabia: Part 1 caries, malocclusion, trauma. PMID:26644758 | 2015 | 1 other review | DMFT (permanent teeth caries experience) | not extracted yet |
| Ghaith 2019 Oral Health Status among Children with Down Syndrome in Dubai, United Arab Emirates. PMID:31198694 | 2019 | 1 other review | DMFT (permanent teeth caries experience); dmft (primary teeth caries experience); Simplified Oral Hygiene Index (OHI-S) | not extracted yet |
| Jaber 2011 Dental caries experience, oral health status and treatment needs of dental patients with autism. PMID:21625735 | 2011 | 1 other review | DMFT (permanent teeth caries experience); dmft (primary teeth caries experience) | not extracted yet |
| Andreeva 2020 PREVALENCE OF PERIODONTAL DISEASES IN CHILDREN WITH DOWN SYNDROME DOI:10.5272/jimab.2020264.3383 | 2020 | this review only | Plaque Index (PI) | not extracted yet |
| Andreeva 2020 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Areias 2012 Reduced salivary flow and colonization by mutans streptococci in children with Down syndrome. PMID:23018295 | 2012 | this review only | DMFT (permanent teeth caries experience); dmft (primary teeth caries experience) | not extracted yet |
| Bagattoni 2021 Oral health status of Italian children with Autism Spectrum Disorder. PMID:34544255 | 2021 | this review only | Plaque Index (PI); DMFT (permanent teeth caries experience); dmft (primary teeth caries experience) | not extracted yet |
| Carrada 2016 Salivary Periodontopathic Bacteria in Children and Adolescents with Down Syndrome. PMID:27727287 | 2016 | this review only | Plaque Index (PI) | not extracted yet |
| Daneshvar 2020 Comparison of Oral Health Status and Behaviors Between Children with Autistic Spectrum Disorder and Healthy Children in Rasht City, Iran DOI:10.7126/cumudj.638071 | 2020 | this review only | DMFT (permanent teeth caries experience); dmft (primary teeth caries experience) | not extracted yet |
| Daneshvar 2020 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Dharmadhikari 2016 Comparative evaluation of salivary constituents and oral health status in children with Down′s syndrome DOI:10.4103/2278-9626.179558 | 2016 | this review only | Simplified Oral Hygiene Index (OHI-S) | not extracted yet |
| Dharmadhikari 2016 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Diab 2016 Comparison of Gingival Health and Salivary Parameters among Autistic and Non-Autistic School Children in Riyadh. PMID:27891471 | 2016 | this review only | Plaque Index (PI); Gingival Index (GI) | not extracted yet |
| Fakroon 2015 Dental caries experience and periodontal treatment needs of children with autistic spectrum disorder. PMID:25385711 | 2015 | this review only | DMFT (permanent teeth caries experience); dmft (primary teeth caries experience) | not extracted yet |
| Habashneh 2012 Oral health status and reasons for not attending dental care among 12- to 16-year-old children with Down syndrome in special needs centres… PMID:22335361 | 2012 | this review only | Gingival Index (GI); DMFT (permanent teeth caries experience) | not extracted yet |
| Hamonari 2024 Salivary Markers of Oxidative Stress and Their Relation to Periodontal and Dental Status Among Children With Down Syndrome. PMID:39559432 | 2024 | this review only | Plaque Index (PI); Gingival Index (GI); DMFT (permanent teeth caries experience); dmft (primary teeth caries experience) | not extracted yet |
| Khatib 2014 Oral health status and behaviours of children with Autism Spectrum Disorder: a case-control study. PMID:24750459 | 2014 | this review only | Plaque Index (PI); Gingival Index (GI); DMFT (permanent teeth caries experience); dmft (primary teeth caries experience) | not extracted yet |
| Kuter 2019 Caries experience, oral disorders, oral hygiene practices and socio-demographic characteristics of autistic children. PMID:31489825 | 2019 | this review only | Plaque Index (PI); DMFT (permanent teeth caries experience); dmft (primary teeth caries experience) | not extracted yet |
| Lee 2004 Dental caries and salivary immunoglobulin A in Down syndrome children. PMID:15367146 | 2004 | this review only | Simplified Oral Hygiene Index (OHI-S) | not extracted yet |
| Leiva-Garcia 2019 Association Between Feeding Problems and Oral Health Status in Children with Autism Spectrum Disorder. PMID:31489541 | 2019 | this review only | DMFT (permanent teeth caries experience); dmft (primary teeth caries experience) | not extracted yet |
| Mahmood 2024 Assessment of Saliva Oxidative Stress Biomarkers and Gingival Health Status in a Sample of High-Functioning Autistic Children in Erbil City. PMID:39677204 | 2024 | this review only | Plaque Index (PI); Gingival Index (GI) | not extracted yet |
| Moorthy 2022 Dietary Sugar Exposure and Oral Health Status in Children with Autism Spectrum Disorder: A Case-control Study. PMID:34218395 | 2022 | this review only | DMFT (permanent teeth caries experience); Simplified Oral Hygiene Index (OHI-S) | not extracted yet |
| Narula 2024 Comparative Evaluation of Oral Health Status and Treatment Needs of Children With Autism Spectrum Disorder: A Cross-Sectional Study. PMID:38774179 | 2024 | this review only | DMFT (permanent teeth caries experience); dmft (primary teeth caries experience) | not extracted yet |
| Prynda 2025 Oral Hygiene Status in Children on the Autism Spectrum Disorder. PMID:40142676 | 2025 | this review only | Simplified Oral Hygiene Index (OHI-S) | not extracted yet |
| Radzuan 2024 DOI:10.22452/jummec.sp2024no1.11 | NR | this review only | DMFT (permanent teeth caries experience); dmft (primary teeth caries experience) | not extracted yet |
| Radzuan 2024 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Subramaniam 2014 Assessment of salivary total antioxidant levels and oral health status in children with Down syndrome. PMID:24188359 | 2014 | this review only | DMFT (permanent teeth caries experience); dmft (primary teeth caries experience) | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children aged 0-18 years; adults excluded | Children aged 3-18 years (10 DS studies, 14 ASD studies; 527 DS, 1,221 ASD, 1,875 controls) |
| Intervention | Children diagnosed with Down syndrome or autism spectrum disorder (exposure); co-occurring DS and ASD excluded | Down syndrome (n=527) or autism spectrum disorder (n=1,221) |
| Comparison | Healthy neurotypical children | Healthy age-matched controls (n=1,875) |
| Outcomes | DMFT, dmft, OHI-S, Plaque Index, Gingival Index | PI, GI, DMFT, dmft, OHI-S mean differences |
| Study designs | Case-control and cross-sectional studies with a comparison group; RCTs, reviews, case reports excluded | 24 studies (case-control and cross-sectional) |
| Timing | Not specified | Not specified |