Dental caries is a significant public health problem for children with special healthcare needs (CSHCN). 1 A recent study from North Carolina showed that CSHCN have a higher caries risk and caries burden than healthy children. 2 Another study reported that among low-income Head Start enrolees, children with developmental delays had significantly higher caries prevalence. 3 In terms of aetiology, dental caries is a multifactorial disease linked to three main oral health behaviours: high carbohydrate diet, inadequate fluoride exposure and poor access to dental care. Dental caries is associated with added sugar intake. Children with autism spectrum disorders consume significantly more sugar-sweetened beverages servings per day (eg juice, punch, soda) than healthy children without autism (2.6 vs 1.7, respectively; P = .03) and snack foods like candy, chips, cookies and crackers (4.0 vs 3.0; P = .01), and significantly fewer daily servings of fruits and vegetables (3.1 vs 4.4; P < .01). 4 Additional diet-related risk factors for CSHCN include delayed feeding skills and feeding problems, which can lead to increased intake of soft foods, nutritional supplements with
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