Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition in children that typically involves challenges in cognition, behavior, and communication. While many children with ASD exhibit significant impairments in both verbal and non-verbal communication, the severity and nature of these difficulties can vary widely. In addition to its impact on overall health, ASD also affects oral health, leading to increased vulnerability to dental disease. Aim: This narrative review aims to summarize key oral health challenges and care strategies for children with ASD, focusing on clinical risks, behavioral barriers, caregiver roles, and effective interventions. Materials and Methods: A comprehensive literature search was conducted using four databases—PubMed, Scopus, Web of Science, and Google Scholar—as well as relevant study registries where applicable. Peer-reviewed articles published in English between 2010 and 2024 were identified using keywords and their synonyms, such as autism spectrum disorder, children, oral care, dental practitioners, and parents. Studies were included based on relevance to oral health challenges and interventions in children diagnosed with ASD. Results: Children with ASD experience a range of sensory sensitivities, attention deficits, hyperactivity, and behavioral resistance, which significantly hinder the performance of adequate oral hygiene practices. These challenges contribute to a lack of effective dental prophylaxis and limited access to regular preventive care, ultimately resulting in poorer oral health outcomes and reduced oral health-related quality of life. Conclusion: Due to the multifaceted characteristics of ASD, children with this condition face significant barriers in accessing appropriate and individualized oral care. This increases their risks of developing oral health disorders, underscoring the need for coordinated efforts between caregivers and dental professionals to improve oral health outcomes in this vulnerable population.

Tongue coating is an essential predictor of a number of systemic diseases of bed-ridden patients. Their gen­eral status puts limitations on the diagnostic facilities and calls for the use of an easily applicable tongue coating criteria/index. The authors’ objective was to propose a modified index for the extent of tongue coat­ing based on a conventional method study performed on bed-ridden chronic kidney disease (CKD) pa­tients and CKD patients undergoing regular renal treatment. The units of observation were 70 patients, aged 60±28.5 years. All patients underwent thorough extra- and intraoral examinations. Tongue coating was tested by two methods: using the Tongue Coating Index as per Kojima et al. (1985), and using the au­thors’ modified index. The data analysis showed that coating of varying degrees was observed in 100% of patients. The chi-square test of independence (incorporating Yates’s correction for continuity) revealed that there was not a statistically significant correlation between the extent of tongue coating and patients’ gen­der (χ2 (df=1, n=70) = 0.826, p=0.36), however, there was a dependency on patients’ age. The second set of tests based on the proposed index matched the results of the first examination using Kojima’s Index. The χ2 test of independence proved a strong statistically significant correlation between the two indices (χ2 (df=3, n=70)=44.877, p<0.01, Kendall’s coefficient (tau-b) = 0.714, Spearman’s coefficient = 0.772). Conclusion: The modified Tongue Coating Index is easily accessible and applicable in common dental practices.

Introduction: The faculty of speech in humans is a distinguishing trait that sets them apart from all other biological species. Speech production is typically achieved through the processes of phonation and articulation. The acoustic method of studying speech is an individual auditory approach based on hearing as a biological analyzer. Aim: The present study aims to conduct a speech assessment of patients with single frontal maxillary defects, divided into two stages: an initial speech assessment before prosthetic treatment and a secondary speech assessment after temporary prosthetic restorations. The study will also investigate the factors influencing the improvement of sound articulation. Materials and methods: A total of 40 patients (17 men and 23 women) with diastema and healthy vocal cords were included in the study for primary and secondary speech assessments. 60 speech therapy indicators were examined. Results: In our study, improvement was observed in 30 out of 60 speech therapy indicators. The greatest improvement was noted in the pronunciation of alveolodental consonants (‘S’, ‘TS’, ‘L’). A moderate negative linear correlation suggested that as age increased, the degree of improvement decreased (p=0.343). Conclusions: The distortion of consonants in Bulgarian among patients with diastema remains within normal parameters. The richness of sounds in the Bulgarian language, in conjunction with the capabilities of contemporary dental prosthetics, underscores the necessity for subsequent in-depth studies of speech function following prosthetic rehabilitation in future research with a larger sample size.

Introduction: A maxillary diastema (MD) is identified when the gap between the central incisors exceeds 0.5 mm. It poses an a and phonetic concern, often seen in mixed dentition and occasionally continuing into permanent dentition. Aim: The aim was to conduct a retrospective study on the epidemiology of maxillary diastema among patients in northeastern Bulgaria. Materials and methods: We analyzed 149 diagnostic plaster models of individuals with maxillary diastema with a mean age of 39.50±1.70 years. To ensure accuracy, we divided the patients into two age groups. People 35 years of age or younger were in the first age group. The second group consisted of those who were older than 35. Results: Size of maxillary diastema according to sex: the derived 95% confidence interval shows that in the group of patients who met the selection criteria in the study, with 95% certainty, the width of the maxillary diastema was expected to be in the range of 1.389 mm to 1.754 mm. The median maxillary diastema width in males was 1.45±0.78 mm. The median maxillary diastema width in females was 1.41±0.24 mm. Size of maxillary diastema according to age: data analysis indicates that the average size of a maxillary diastema was 1.43±0.24 mm among those under 35. In such individuals, the maxillary diastema width ranged from 1.07 mm to 2.20 mm, with 1.07 mm being the lowest recorded value. Maxillary diastema in those over 35 had a maximum measurement of 7.88 mm and a minimum of 1.05 mm. The median width of maxillary diastema in the analyzed 149 models was 1.46±0.23 mm. Conclusion: Patients’ smiles and dental as are subject to the strict a standards set by modern society. This causes one to examine small details like the distance between one’s central incisors and feel compelled to have them adjusted. Examining the maxillary diastema width in relation to age and sex facilitates a prompt selection of materials and fabrication methods, leading to outstanding functional and a results from the treatment that is performed.

Chronic kidney disease (CKD) is a condition defined by the progressive loss of renal function and damaging, in the course of months or years. Its rising incidence on a global scale compels doctors of dental medicine to be aware of the oral manifestations and symptoms affecting the soft and hard dental tissues, which are related to the underlying condition or its treatment. The objective of this review is to look into the oral changes affecting some of the patients with terminal kidney failure receiving chronic dialysis treatment.