Skip to main content Skip to main navigation menu Skip to site footer

The Relationship between teeth brushing habits and tooth pain experienced in children with Autism Spectrum Disorder (ASD)

  • Alfini Octavia ,
  • Wustha Farani ,
  • Syaina Azzahra ,
  • Safira Meita Hapsari ,


Introduction: Autism Spectrum Disorder (ASD) is a lifelong developmental disorder that causes difficulty in communicating and socializing. The limitations of communication result in the inability to conduct teeth brush training and lead to poor oral health which might cause tooth decay and pain. This study aims to evaluate the relationship between teeth brushing habits and tooth pain experienced in children with ASD.

Methods: This study used an analytic observational study with a cross-sectional design. The subjects of the study were selected randomly using a cluster sampling method to children with ASD at Specialize School for Disability /Sekolah Luar Biasa (SLB); SLB Bina Anggita, SLB Citra Mulia Mandiri, SLB Dharma Rena Ring Putra II, SLB Negeri 1 Bantul, SLB Samara Bunda, and SLB Tegar Harapan. The data about teeth brushing habits and tooth pain experience were measured by a questionnaire filled out by parents and caregivers and then analyzed using SPSS ver. 23.

Results: This study involved 40 children with ASD, with 30 (75%) were boys and 10 (25%) were girls. The age range were between 6-12 years (23 children; 57.5%), and 13-18 years (17 children; 42.5%). Most children report medium pain in tooth pain (16 children; 40%). The Spearman's test showed a significant inverse correlation between the teeth cleaning habits and the tooth pain experienced (r = -0.464; p=0,003).

Conclusion: There was a significant relationship between the teeth brushing habits and the tooth pain experienced in children with ASD in Specialized schools in Yogyakarta.


  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders [Internet]. DSM Library. 2015. Available from:
  2. Maenner MJ, Shaw KA, Baio J. Prevalence of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites, United States, 2016. MMWR Surveill Summ. 2020;69(4):1–12. DOI: 10.15585/mmwr.ss6904a1
  3. Simbolon CG, Putro JD, Alhamdani MR. Autis Center dengan Pendekatan Healing Environment. JMARS J Mosaik Arsit. 2020;8(2):505–19. DOI:
  4. Wolraich ML, Dworkin PH, Drotar DD, Perrin EC. Developmental-Behavioral Pediatrics: Evidence and Practice E-Book. Elsevier Health Sciences; 2007. 518–560.
  5. Daneshvar SH, Kavianfar A, Masoomi SH, Daneshvar MM. Comparison of oral health status and behaviors between children with autistic spectrum disorder and healthy children in Rasht City, Iran. Cumhur Dent J. 2020;23(1):38–44. DOI:
  6. Du RY, Yiu CKY, King NM. Oral Health Behaviours of Preschool Children with Autism Spectrum Disorders and Their Barriers to Dental Care. J Autism Dev Disord. 2019 Feb;49(2):453–9. DOI:
  7. Prakash J, Das I, Bindal R, Shivu ME, Sidhu S, Kak V, et al. Parental perception of oral health-related quality of life in children with autism. An observational study. J Fam Med Prim Care. 2021;10(10):3845–50. DOI: 10.4103/jfmpc.jfmpc_439_21
  8. da Silva SN, Gimenez T, Souza RC, Mello-Moura ACV, Raggio DP, Morimoto S, et al. Oral health status of children and young adults with autism spectrum disorders: systematic review and meta-analysis. Int J Paediatr Dent. 2017;27(5):388–98. DOI:
  9. Koh S, Li C, Loh J, Wong M, Loh V. Managing tooth pain in general practice. Singapore Med J. 2019 May;60(5):224–8. DOI: 10.11622/smedj.2019044
  10. Yam MF, Loh YC, Tan CS, Khadijah Adam S, Abdul Manan N, Basir R. General Pathways of Pain Sensation and the Major Neurotransmitters Involved in Pain Regulation. Int J Mol Sci. 2018 Jul 24;19(8):2164. DOI: 10.3390/ijms19082164
  11. Fukuda K ichi. Diagnosis and treatment of abnormal dental pain. J Dent Anesth Pain Med. 2016;16(1):1–8. DOI:
  12. Freire M do CM, Corrêa-Faria P, Costa LR. Effect of dental pain and caries on the quality of life of Brazilian preschool children. Rev Saude Publica. 2018;52(30):1–10. DOI:
  13. Escoffié-Ramirez M, Ávila-Burgos L, Baena-Santillan ES, Aguilar-Ayala F, Lara-Carrillo E, Minaya-Sánchez M, et al. Factors associated with dental pain in Mexican schoolchildren aged 6 to 12 years. BioMed Res Int. 2017;2017:1–10. DOI:
  14. Alsubaie ASR. Oral health-related behaviors and dental pain among children in Saudi Arabia. J Int Oral Health. 2019;11(1):1–7. DOI: 10.4103/jioh.jioh_253_18
  15. Mehta A, Pradhan S, Pradhan S, Pradhan S. The oral hygiene habits and general oral awareness in public schools in Mumbai. Int J Laser Dent. 2013;3(2):60–7. DOI:10.5005/jp-journals-10022-1039
  16. Oktay EA, Alper A, Topçu FT, Tort H. The Correlation between tooth brushing habit and familial education level in Turkish young population. Gülhane Tip Derg. 2016;58(4):329–33. DOI:10.5455/gulhane.184485
  17. Zimmermann H, Zimmermann N, Hagenfeld D, Veile A, Kim TS, Becher H. Is frequency of tooth brushing a risk factor for periodontitis? A systematic review and meta-analysis. Community Dent Oral Epidemiol. 2015;43(2):116–27. DOI: 10.1111/cdoe.12126
  18. Zeng L, Zeng Y, Zhou Y, Wen J, Wan L, Ou X, et al. Diet and lifestyle habits associated with caries in deciduous teeth among 3-to 5-year-old preschool children in Jiangxi province, China. BMC Oral Health. 2018;18(1):1–9. DOI:
  19. Balhaddad A. The effect of flossing on dental caries: a critique of current literature. JOJ Case Stud. 2017;4(1):1–2. DOI: 10.19080/JOJCS.2017.02.555629.
  20. Alhabdan YA, Albeshr AG, Yenugadhati N, Jradi H. Prevalence of dental caries and associated factors among primary school children: a population-based cross-sectional study in Riyadh, Saudi Arabia. Environ Health Prev Med. 2018;23(1):1–14. DOI:
  21. Krause L, Seeling S, Prütz F, Wager J. Toothache, tooth brushing frequency and dental check-ups in children and adolescents with and without disabilities. J Health Monit. 2022;7(1):48–60. DOI: 10.25646/9565
  22. Han K, Park JB. Association between oral health behavior and periodontal disease among Korean adults: The Korea national health and nutrition examination survey. Medicine (Baltimore). 2017;96(7):1–7. DOI: 10.1097/MD.0000000000006176
  23. Bakar A, Ningrum V, Lee A, Hsu WK, Amalia R, Dewanto I, et al. Structural equation modelling of the complex relationship between toothache and its associated factors among Indonesian children. Sci Rep. 2020;10(1):1–9. DOI:
  24. Hage SRV, Lopes-Herrera SA, Santos THF, Defense-Netvral DA, Martins A, Sawasaki LY, et al. Oral hygiene and habits of children with autism spectrum disorders and their families. J Clin Exp Dent. 2020 Aug 1;12(8):e719–24. DOI: 10.4317/jced.56440
  25. Qiao Y, Shi H, Wang H, Wang M, Chen F. Oral health status of chinese children with autism spectrum disorders. Front Psychiatry. 2020;11(398):1–9. DOI:

How to Cite

Octavia, A., Farani, W., Azzahra, S., & Safira Meita Hapsari. (2023). The Relationship between teeth brushing habits and tooth pain experienced in children with Autism Spectrum Disorder (ASD). Bali Medical Journal, 12(1), 707–711.




Search Panel