Caregivers’ perceptions, beliefs and behavior influence dental caries experience in children with autism spectrum disorder: A qualitative study

Objectives: While many children with autism spectrum disorders (ASD) experience dental caries, some of them are caries-free. This study aimed to understand the caregivers’ oral health perceptions, beliefs, and behavior that could influence dental caries experience in children with ASD. Methods: The qualitative study was part of a study employing a mixed-methods design conducted to explore the severity and risk factors for caries experience. Individual interviews and two focus group discussions (FGD) involving caregivers of children with ASD aged 5–18 years were conducted. The caregivers’ perception of caries risks, oral care beliefs and behavior were explored. Interviews and FGDs recordings were transcribed and then analyzed thematically by two independent coders. Results: Twenty-two caregivers provided their thoughts. The study found that caries experience was influenced by fatalistic belief, low self-efficacy and control. Caregivers of children with dental caries thought that caries is not dangerous. Caregivers experienced social pressure to provide their ASD children with what they want. Conversely, Caregivers of caries-free ASD children thought that strict commitment from an early age was needed to prevent caries. Conclusions: Our findings support that caregivers’ perceptions, beliefs and behavior influence dental caries experience in children with ASD which might need the clinicians’ consideration.