Caregiver-Mediated Determinants of Oral Health in Children with Autism Spectrum Disorder: A Scoping Review of Home Hygiene, Dietary Practices, Dental Access and Family Impact

Abstract

Background: Children with Autism Spectrum Disorder experience oral-health concerns related to sensory hypersensitivity, behavioral inflexibility, food selectivity, reduced cooperation, and manual dexterity. This scoping review explored the published literature to summarize the evidence regarding caregiver-mediated determinants of oral health in children with ASD. Materials and Methods: We searched PubMed/MEDLINE, Scopus, Embase, and Google Scholar from database inception to April 10, 2026. Additional records were identified through citation tracking, reference list checking, gray literature searching, and manual searching. Studies of primary data on children or adolescents with ASD reporting caregiver-mediated oral health behaviors, barriers, facilitators, or outcomes were included. The charted data were synthesized thematically and presented descriptively. Results: Twenty-three primary studies were included. Evidence has shown that tooth brushing is often facilitated with the help or supervision of a caregiver due to sensory sensitivities, refusal behaviors, poor cooperation, or decreased manual dexterity among children with ASD. Exposure to sugar, food selectivity, and preference for soft or sweet foods are common caregiver-mediated oral health risk behaviors reported among children with ASD.           Conclusion: Childhood ASD-related oral health may be integrally related to caregiver-provided homecare, food-based, access-related, and family-level determinants. The suggested conceptual framework should be viewed as hypothesis-generating and evidence-informed rather than as an established causal pathway. The findings should be interpreted cautiously because of methodological heterogeneity across the included studies, the predominance of cross-sectional designs, and the limited direct measurement of caregiver burden or parental stress.