Access to dental care for autistic children and adolescents: A cross-sectional study

To analyze the perceived difficulty in accessing dental treatment among children and adolescents with Autism Spectrum Disorder(ASD) and the associated factors. A cross-sectional study was conducted in Brazil through an open, anonymous online survey administered between September 1 and 16, 2020, to caregivers of autistic children and adolescents aged 3–18 years. Characteristics of ASD (reported severity and sensory sensitivity) and variables related to dental care were investigated, including reason for the dental visit and the need for oral sedation and protective restraint. Descriptive analysis and multivariable logistic regression were performed to estimate odds ratios (ORs) and 95 % confidence intervals (95 % CIs). Most caregivers did not report perceived difficulty in accessing dental treatment. However, greater ASD severity (OR = 1.78; 95 % CI: 1.27–2.49), moderate sensory sensitivity (OR = 1.60; 95 % CI: 1.14–2.25), treatment-motivated visits (OR = 2.06; 95 % CI: 1.45–2.91), the need for protective restraint (OR = 1.66; 95 % CI: 1.12–2.47), and oral sedation (OR = 3.02; 95 % CI: 1.82–5.01) were associated with greater perceived difficulty in access. Although access to dental care was reported by most caregivers, the main barriers were concentrated in situations involving greater clinical and behavioral complexity, indicating that perceived difficulty in access is related to the interaction between individual ASD-related factors and limitations in the organization and provision of health services. • Large national online sample provides robust data on dental access barriers in autistic youth. • Greater support needs, sensory sensitivity, and sedation increase dental access difficulties. • High demand for stabilization and sedation highlights need for trained dental teams. • Prevention is main visit reason, yet many autistic patients remain without care. • Findings support policies and training to reduce dental care inequalities in ASD.