Abstract/Summary

Dental anxiety is a common and disabling problem for individuals with autism spectrum disorders (ASD). Little is known about the causes of dental anxiety in ASD but the literature suggests it may be related to sensory sensitivity (Stein et al., 2011) and having high rates of anxiety in general (White et al., 2009). The purpose of this research is to examine the factors that predict dental anxiety in children with ASD. The first two qualitative studies were designed to identify relevant factors in dental anxiety using a bottom-up approach. Interviews were carried out with parents of children with ASD and individuals with ASD. The second study interviewed dentists with varying expertise in ASD. Both sets of interviews were analysed using content analysis. Findings from the qualitative studies suggest that dental anxiety is related to parental anxiety, sensory sensitivity, worries about pain, and negative experiences. In the third study 45 children with ASD aged (11 to 17) and their parents, and a comparison group of 50 Typically Developing (TD) children and their parents, completed measures examining dental anxiety and associated factors. The results demonstrate that children with ASD have higher rates of dental anxiety related to their higher overall anxiety level. Correlations show that dental anxiety is related to other forms of anxiety: unusual sensory processing, cognition, past experiences at the dentist, parents’ dental anxiety, and the number of visits that a child has had to the dentist. Regression analysis shows that dental anxiety in children with ASD is determined by their worries about treatment and the number of dental visits. In TD children, dental anxiety was only predicted by their worries about treatment. Nevertheless, despite the aforementioned small differences, this third study showed that children with ASD and TD children are more alike than different, which is an interesting finding that requires further investigation. Overall, this research helps us understand the underlying causes of dental fear in children with ASD and gives insight into interventions to support them with oral care.