# Association Between Parental Oral Health Literacy and Oral Health-Related Quality of Life in Children with Autism Spectrum Disorder: A Comparative Cross-Sectional Study

## TL;DR

The study found that parents' oral health knowledge affects the oral health quality of life in children with autism.

## Contribution

It shows a link between parental oral health literacy and children's oral health outcomes in autism.

## Key findings

- ASD children's parents had lower oral health literacy than controls.
- Higher parental literacy was linked to better oral health quality of life in ASD children.
- The association remained significant after adjusting for other factors.

## Abstract

Background/Objectives: Children with autism spectrum disorder (ASD) may have difficulty maintaining effective and routine oral hygiene practices because of sensory sensitivities, behavioral challenges, and barriers to dental care. These difficulties may adversely affect oral health-related quality of life (OHRQoL). Parental oral health literacy may also influence oral health outcomes in this population. This study compared parental oral health literacy and OHRQoL between children with ASD and typically developing children and examined the association between parental oral health literacy and OHRQoL in the ASD group. Higher POQL scores indicate poorer OHRQoL. Methods: This cross-sectional study included 72 children with ASD and 70 typically developing children aged 3–15 years. Data were collected using the Sociodemographic and Oral Health Behaviors Questionnaire, the Turkish version of the Oral Health Literacy Assessment Task for Pediatric Dentistry (TOHLAT-P), and the parent-report Pediatric Oral Health-Related Quality of Life measure (POQL). Group differences were analyzed using the Mann–Whitney U test. Associations were evaluated using Spearman correlation and multivariable linear regression. Results: Parental oral health literacy scores were significantly lower in the ASD group than in the control group (26.89 ± 7.94 vs. 31.61 ± 10.98; p = 0.002). Significant between-group differences were found in the POQL total score and the social functioning subscale (p = 0.025 and p = 0.003, respectively). In the ASD group, higher parental oral health literacy was associated with lower POQL total scores (Spearman r = −0.239; p = 0.043). In multivariable linear regression, parental oral health literacy remained significantly associated with the POQL total score in children with ASD (B = −0.589; p = 0.029; R2 = 0.117). Conclusions: Parental oral health literacy was associated with OHRQoL in children with ASD, although the explained variance was modest. These findings support the potential value of family-centered oral health education in this population.