Challenges and solutions in managing dental problems in children with autism

Table 11 The developmental teeth disorders in children with autism spectrum disorders

Developmental teeth disorder	Description	Causes	Prevalence in ASD	Consequences
Enamel hypoplasia	Thin, pitted, or discolored enamel due to defective enamel formation	Genetic mutations (e.g., AMELX, ENAM), prenatal stressors (maternal infections, nutritional deficiencies), postnatal nutrient deficits (low calcium/vitamin D)	Higher prevalence compared to neurotypical peers	Increased cavities, tooth sensitivity, rapid decay
Delayed tooth eruption	Primary/permanent teeth emerge later than typical timelines	Systemic developmental delays, endocrine imbalances (e.g., hypothyroidism), nutritional deficiencies from selective eating	More common in ASD, especially with comorbid growth/hormonal disorders	Misalignment, crowding, chewing/speech difficulties
Malocclusion	Misaligned teeth or jaws (e.g., overbite, crowding)	Oral motor dysfunction (hypotonia), persistent habits (thumb-sucking, pacifier use), bruxism (teeth grinding)	Higher rates reported in ASD	Difficulty chewing, speech impediments, increased risk of dental trauma
Supernumerary/Missing teeth	Extra teeth (supernumerary) or congenital absence of teeth (hypodontia)	Genetic syndromes overlapping with ASD (e.g., Smith-Magenis syndrome)	Occurs more frequently in syndromic ASD cases	Crowding, impaction, functional gaps requiring prosthetics
Taurodontism	Molars with enlarged pulp chambers and shortened roots ("bull-like" teeth)	Associated with neurodevelopmental disorders; exact cause unclear	Observed more frequently in ASD	Structural weakness, increased fracture risk, challenges during root canals

ASD: Autism spectrum disorder.