Parental Perspectives on Oral Health Care for Autistic Children With Medicaid: A Qualitative Study

Abstract

Children with special health care needs and disabilities (CSHCND), particularly those with autism, experience disproportionately high rates of oral health problems, yet the underlying factors remain insufficiently explored. This qualitative study investigated the challenges and effective strategies parents use to support the oral health of autistic children enrolled in Medicaid in one large city. Thirty-one parents were recruited through purposive and snowball sampling from the Oral Health Center for People with Disabilities and the pediatric department and participated in semi-structured interviews conducted via Zoom. Interpretative phenomenological and thematic analyses identified eight key themes: (1) Autism-related Barriers to Oral Hygiene Routines, (2) Challenges in Securing Adequate Dental Care, (3) Denial About Autism and Delay in Early Intervention, (4) Electric Toothbrushes May Help, (5) Sensory Adapted Dental Environments, (6) Use of Social Media and Artificial Intelligence, (7) Support from Allied Health Professionals, and (8) Infrastructure in Education. The findings highlight the complex relationship of individual, social, and systemic factors shaping oral health promotion for this population. Insights from this study can inform the development of tailored interventions, educational initiatives, and policy reforms to improve oral health outcomes for autistic children. As the first study of its kind in New York City, this research amplifies the voices of parents and provides a foundation for future efforts to address persistent oral health disparities in an urban setting.