title: Comparison of Gingival Health and Salivary Parameters among Autistic and Non-Autistic School Children in Riyadh.
abstract: BACKGROUND
  Autism is a neuro-developmental disorder which is manifested as impairment of social interaction, communication and a repetitive behaviour. Autism can obscure dental treatment for the affected patients; furthermore, children with autism commonly have destructive oral habits.
  
  
  OBJECTIVE
  The aims of this study were to evaluate the Modified Gingival Index (MGI), Plaque Index (PI), salivary pH and buffering capacity of the saliva among autistic children compared to normal children in Riyadh City that may provide baseline data to enable comparison and future planning of dental services for autistic children.
  
  
  METHODS
  A total of 50 children diagnosed with autism (mean age 8.5 years) were selected from Azzam Autism School, Riyadh City. The control group consisted of 50 non-autistic school children (mean age 8.7 years), gender matched, selected from Outpatient Clinic, Riyadh Colleges of Dentistry and Pharmacy. MGI, PI, salivary pH and salivary buffer capacity tests were done for all participants. The buffering capacity of the stimulated saliva was grouped under 'very low', 'low' and 'normal'. Pearson's Chi square and one way ANOVA were used to find statistical significance if any among the autistic and the normal control group.
  
  
  RESULTS
  The results of the study showed that the mean ± standard deviation of MGI, PI and pH of unstimulated resting saliva for autistic group were 1.82 ± 0.65, 1.92 ± 0.35 and 6.8 ± 0.5 respectively. Normal control group had values 1.35 ± 0.85, 1.44 ± 0.43 and 7 ± 0.4 respectively. A statistically significant difference between both groups for all parameters was found. Salivary buffering capacity was found to be normal for the majority among both groups. However, 60% children among the autistic group presented with normal buffering capacity of the stimulated saliva as compared to 70% among the normal control group. However, this difference was not statistically significant (p = 0.544).
  
  
  CONCLUSIONS
  Children with autism appear to have higher gingival inflammation, poor oral hygiene and a slightly lower salivary pH as compared to healthy control group. Special oral health programmes regarding treatment and maintenance of good oral health should be taken in consideration for autistic children.
authors.affiliation: Professor, Department of Periodontology, Riyadh Colleges of Dentistry and Pharmacy , Riyadh, Saudi Arabia; Faculty of Dentistry, Tanta, University, Egypt .
authors.forename: Hafez M
authors.initials: HM
authors.lastname: Diab
authors.affiliation: General Dental Practitioner, VIP Clinic Riyadh Colleges of Dentistry and Pharmacy , Riyadh, Saudi Arabia .
authors.forename: Suha Saeed
authors.initials: SS
authors.lastname: Motlaq
authors.affiliation: General Dental Practitioner, Riyadh, Saudi Arabia .
authors.forename: Amal
authors.initials: A
authors.lastname: Alsharare
authors.affiliation: General Dental Practitioner, Riyadh, Saudi Arabia .
authors.forename: Ashwaq
authors.initials: A
authors.lastname: Alshammery
authors.affiliation: General Dental Practitioner, Riyadh, Saudi Arabia .
authors.forename: Nadia
authors.initials: N
authors.lastname: Alshammery
authors.affiliation: Lecturer, Paediatric Dentistry Division, Department of Preventive Dental Sciences, College of Dentistry, Dar Al Uloom University , Riyadh, Saudi Arabia .
authors.forename: Shabnam Gulzar
authors.initials: SG
authors.lastname: Khawja
authors.affiliation: Associate Professor, Department of Preventive Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh; Fellow, Pacific Academy of Higher Education and Research (PAHER) University , Udaipur, India .
authors.forename: Altaf H
authors.initials: AH
authors.lastname: Shah
keywords: Autism; Buffering capacity; Gingival index; Plaque; Saliva