Effectiveness of picture‐based interventions of toothbrush training on improvement of oral hygiene in children with autism spectrum disorders: A systematic review and meta‐analysis

Background Children with autism exhibit a higher risk of poor oral health due to difficulty in the performance of simple tasks such as toothbrushing. Aim This current systematic review aims to evaluate the effectiveness of Picture based intervention of toothbrush training on improvement of oral hygiene in children with autism spectrum disorders (ASD) Materials and methods Prospero registered (CRD42023450156). PubMed, Cochrane, Scopus databases are searched from years January 1, 1980 to August 1, 2023 using broad search terms (brush) AND (autism). Results The search queries have identified 853 titles, from three databases (PubMed, Scopus, Cochrane), after application of filters for exclusion of systematic reviews and meta‐analysis, duplicate exclusion and removal of irrelevant titles led to the final inclusion of 24 articles for full text screening. From the 24 included studies, 10 studies (four RCTs and six non‐randomized clinical studies) sustained the final rigorous PICO search. Quantitative pooling of data were performed for limited articles. Conclusion Low quality evidence suggest that picture‐based intervention of toothbrush training has significant improvement (p ≤ .05) in improving toothbrushing habit as well as performance as indicated by the Plaque Index score (PI), Gingival index (GI) and Oral hygiene index score (OHI‐S).