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Dental utilization and expenditures by children and adolescents with autism spectrum disorders: A population‑based cohort study

Kai‑Chun Changa, Ling‑Yi Wangb, Jen‑Hung Wangb, Cheng‑Kuang Shawa, Ming‑Jay Hwanga, Chih‑Hao Wua, Huai‑Kuan Huanga*


aDepartment of Dentistry, Buddhist Tzu Chi General Hospital, Hualien, Taiwan, bDepartment of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan


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Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation



Objectives: It is understood that children and adolescents with autism spectrum disorders (ASDs) have difficulty in receiving dental treatment. This study explores the differences in dental utilization and expenditure between two groups: children and adolescents with and without ASD. Different conditions that affect these results will be examined, including area of residence, category of treatment, and preferences concerning type of dental institution in Taiwan. Materials and Methods: The health service research database of the National Health Research Institutes, which features population‑based, randomly selected samples collected from 2001 to 2010, was utilized in this study. In particular, we recruited samples from 2005 in accordance with the codes of the International Classification of Diseases, 9th revision, Clinical Modification from 299.0 to 299.9. The population‑based cohort study measured mean expenditures and mean numbers of medical visits with regard to different dental institution classifications, areas of residence, and categories of dental treatment for children (under 18 years old) with and without ASD. Results: The mean number of annual visits was 6.58 and 5.70 for children and adolescents with and without ASD, respectively, with mean annual visit expenditures of NT$2401.20 and NT$1817.99, respectively. A higher percentage of children (91.32%) and adolescents (72.66%) with ASD had experienced dental treatment than those without ASD. Children (93.23%) and adolescents (90.83%) without ASD visited dental clinics more often than those with ASD. The percentage of dental visits to academic medical centers in Eastern Taiwan was significantly lower for the ASD group than visits to other types of dental institutions. The use of restorative treatment was significantly higher among all samples, with periodontology having the lowest percentage. Conclusions: Children and adolescents with ASD had greater dental utilization, expenditures, and preferences for high‑level dental institutions. The discrepancies in dental utilization indicate differences in the distribution of medical resources in different dental institution levels and residence areas in Taiwan.

Keywords: Autism spectrum disorder, Children and adolescents, Dental expenditures, Dental utilization, Health insurancein

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