Dental management in children with autism spectrum disorder: a systematic review

Introduction: In the context of autism spectrum disorder (ASD), this condition represents a complex neurodevelopmental disorder in children and adults. Anxiety and fear of dental treatment are frequently observed in children with ASD, manifesting through difficult behaviors and uncooperative reactions during treatment. Objective: It was to develop a concise systematic review study to highlight the main clinical approaches to dental care in autistic children. Methods: The systematic review rules of the PRISMA Platform were followed. The search was conducted from December 2025 to January 2026 across the Web of Science, Scopus, Embase, PubMed, ScienceDirect, SciELO, and Google Scholar databases. The quality of the studies was assessed using the GRADE instrument, and the risk of bias was evaluated according to the Cochrane instrument. Results and Conclusion: According to the GRADE instrument, most studies presented homogeneous results, with X2 = 79.5% > 50%. A total of 80 articles were found and submitted for eligibility analysis, with 09 final studies selected to compose the results of this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 05 studies with a high risk of bias and 12 studies that did not meet GRADE and AMSTAR-2 standards. It was concluded that children with autism spectrum disorder face unique challenges in maintaining oral health due to sensory sensitivities, communication difficulties, and behavioral barriers. Culturally adapted dental visual aids have demonstrated effectiveness in modifying behavioral patterns in children diagnosed with autism spectrum disorder during dental appointments. Furthermore, it is necessary for children with ASD to undergo a pre-operative psychological evaluation to investigate parental expectations and cooperation and to determine if appropriate dental treatment should be initiated.