Aims
•    To compare a sensory and behaviour focused toothbrushing guidance with traditional guidance for parents of autistic children
•    To explore attitudes of parents of autistic children towards toothbrushing, sugar snacking and dental caries. 

Design
Fifty-two parents with autistic children aged three to 15 years participated. Group 1 parents received 'Delivering Better Oral Health’ toothbrushing guidance. Group 2 parents received the ‘Clinical standard for oral healthcare for autistic children and young people and/or those with a learning disability in special educational settings’ guidance. Randomisation occurred at school-level. Both parent groups received a tooth care product pack, completed a pre-study attitude and experience questionnaire and a toothbrushing performance questionnaire pre- and post-study. The main outcome measures were twice-a-day toothbrushing for two minutes and parental attitude scores. 

Results
Fifty-five percent of parents with children aged 10 years and above reported not finding toothbrushing advice provided at dental visits useful. Although the number of parents brushing twice daily in Group 2 increased post-study, this change was not statistically significant. Parental attitude scores suggest that maintaining good oral health is important to parents of autistic children. Parents provided commentary regarding workshop advice and the challenges of implementing toothbrushing guidance delivered at the workshops. Feedback indicated that for both groups a flexible approach to toothbrushing and access to the products provided in the tooth care pack were valuable.

Conclusions
Results suggest that provision of choice and bespoke toothbrushing guidance based on individual support needs is important when providing parental toothbrushing guidance for autistic children.

Key words:  child, adolescent,  autism, oral health, toothbrushing, parents.

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