Parental function in the dental management of pediatric patients with autistic spectrum disorder: A systematic review

Parental function in dentistry refers to the decisions made by parents regarding care, development, and attention to their children's oral health. Pediatric patients with Autism Spectrum Disorder (ASD) often present motor and cognitive disorders, communication difficulties, fear, anxiety, and obsessive resistance to change, which can interfere with proper dental treatment. With 1 in 36 children diagnosed with ASD in the United States, international health organizations recommend parental involvement in the comprehensive care of this population. Despite this, there is a lack of comprehensive synthesis of specific recommendations directed at parents in the dental context. Therefore, this systematic review (PROSPERO registration number CRD42023476265) critically examines available evidence to highlight the role of parents in the dental care of pediatric patients with ASD and improve their oral health. Thirteen studies were included, revealing recommendations across various parental domains, including physical care, guidance and discipline, emotional support, education, role modeling, socialization, sense of identity, and safety and protection. The main findings suggest that parents should familiarize children with dental visits through structured routines, social stories, and sensory-friendly materials. Assisted brushing and fluoride application are essential. Techniques like sedation, motivational interviewing, and educational programs enhance cooperation and reduce anxiety, while visual cues and dietary guidance support oral care. While providing valuable insights, the review also highlights limitations in the quantity and quality of available evidence, emphasizing the need for further research and tailored interventions to enhance parental involvement in the dental management of pediatric patients with ASD.