Preventing Oral Health Problems in Children with Autism Spectrum Disorder: A Feasible Mission?

Relevance. Children with autism spectrum disorder (ASD) frequently exhibit poorer oral hygiene and altered oral and gut microbiota, influenced by behavioral features, sensory hypersensitivity, and feeding difficulties. Evidence for non-invasive, home-based caries-prevention strategies in this population remains limited. The evaluation of the clinical efficacy of available preventive agents, including calcium-enriched oral foam and the oral probiotic Streptococcus salivarius K12, is considered a relevant topic of investigation in pediatric dentistry.

Materials and methods. In this prospective controlled study, 122 children with ASD aged 3–9 years received 30-day preventive regimens including a calcium-enriched oral foam (Group 1) or S. salivarius K12 (Group 2). A control group comprised 54 neurotypical children. Oral health status was assessed using the Fedorov–Volodkina Hygiene Index; the presence and severity of black stain plaque (extrinsic discoloration) were recorded clinically; caries experience was quantified as the combined dmft + DMFT score. Oral and fecal microbiota were profiled by GC–MS.

Results. At baseline, children with ASD had significantly poorer oral hygiene and higher caries prevalence than neurotypical controls. GC–MS profiling indicated pronounced dysbiosis in both oral and intestinal samples in the ASD cohort, with correlations across sites for pathogenic taxa (e.g., Streptococcus mutans, Staphylococcus aureus, Helicobacter pylori). A statistically significant decrease in oral hygiene index scores was observed in both younger and older age groups following the use of calcium-enriched oral foam and the Streptococcus salivarius K12 probiotic. After 30 days of preventive use, the proportion of children with elevated levels of S. mutans, S. aureus, and other pathogenic microorganisms decreased in oral and gut samples. No statistically significant between-regimen differences in improvement were observed across age groups. Both interventions demonstrated comparable efficacy.

Conclusion. Calcium-enriched oral foam and S. salivarius K12, used as home-based adjuncts, improved plaque-related indices and favorably modulated microbiota profiles in children with ASD. These non-invasive measures may be recommended as part of comprehensive dental care for this population.

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