Effectiveness of a picture exchange communication system (PECS) on dental plaque and oral health of children with autism

Background: Children with autism spectrum disorder (ASD) often face challenges in communication and social interaction, impacting their oral health. The Picture Exchange Communication System (PECS) has shown promise in improving communication skills in individuals with ASD. This study aims to investigate the effectiveness of PECS in reducing dental plaque and improving oral health outcomes in children with ASD. Objective: To evaluate the effectiveness of Picture exchange communication system as an intervention strategy on dental plaque and oral health in children with autism spectrum disorder. Methodology: This was a quasi-experimental study. Using PECS as a pictures/cards series showing a structured tooth brushing method, 30 children with ASD and their parents/caregivers were trained on tooth-brushing twice, 2 weeks apart. Data collected after examinations (baseline, 3 months follow up) included gingival and plaque indices (GI, PI) and DMFT score. Results: The mean pre-intervention PI score was 2.32 ± 0.44, which decreased to 1.67 ± 0.42 post-intervention phase. The mean difference in PI was 0.65 ± 0.26. The paired t-test result was 13.794, with a p-value of <0.0001, indicating a highly significant reduction in PI scores post-intervention. The mean pre-intervention GI score was 1.18 ± 0.49, which decreased to 0.85 ± 0.50 post-intervention. The mean difference in GI was 0.33 ± 0.32. The paired t-test result was 5.634, with a p-value of <0.0001, indicating a highly significant reduction in GI scores post-intervention The mean pre-intervention DMFT score was 3.17 ± 3.51, which slightly decreased to 3.13 ± 3.51 post-intervention. The mean difference in DMFT was 0.03 ± 0.18. The z-test (Wilcoxon Signed Ranks Test) result was -1.000, with a p-value of 0.317, indicating no significant change in DMFT scores post-intervention. Conclusion: PECS was useful in improving teeth brushing practices, oral health and gingival and plague indices, indicating improvement in gingival health in children with ASD.