Association of sensory sensitivities and toothbrushing cooperation in autism spectrum disorder

Abstract

BackgroundSensory over‐responsivity (SOR) is common in autistic spectrum disorder (ASD), and it leads to a more intense response to sensory stimuli.AimTo compare toothbrushing cooperation at home and in a dental office between SOR and sensory not over‐responsivity (SNOR) children with ASD.DesignThis cross‐sectional observational study was conducted with 51 children with ASD aged 4‐17 years. Caregivers assessed each subject's sensory response by completing a back‐translation questionnaire listing eight sensitivities. Subjects who had three or more of the sensitivities were considered SOR subjects. Toothbrushing cooperation in the dental office was recorded on videos. Statistical analysis used the Spearman correlation coefficient, chi‐square test, Fisher's exact test, and Mann‐Whitney U test.ResultsSNOR subjects (n = 10) had significantly higher scores in toothbrushing cooperation at home and in the dental office than did SOR subjects (n = 41) (P < .05). Oral sensitivity was significantly associated with toothbrushing cooperation at home, whereas oral, light, sound, and touch (face) sensitivities were significantly correlated with toothbrushing cooperation in the dental office (P < .05).ConclusionsSOR subjects showed less toothbrushing cooperation than SNOR subjects both at home and in the dental office.

Association between oral care challenges and sensory over‐responsivity in children with Down syndrome

“…Although parents frequently note the presence of sensory sensitivities in their children with Down syndrome, 17–20 the presence of sensory over‐responsivity and the strong link between sensory sensitivities and difficulties with oral care previously reported in children with other special healthcare needs 21–28 were not as clearly evident as in our study results. For example, approximately 39% of our DS sample was categorized as sensory over‐responsive, as compared to 79% of our previous ASD sample 23 .…”

“…The survey was crafted by the authors, reviewed and edited by an expert paediatric dentist, and then pilot‐tested with parents of children with special healthcare needs and parents of typically developing children (not included in this study sample). The Dental Care in Children Survey, although not a standardized tool, has face validity and has been previously used in other research examining the oral care experiences of children with special healthcare needs and typically developing children 23,25,29,31,32 …”

“…One of the many daily life areas affected by sensory challenges is oral care. The literature suggests that sensory processing difficulties, specifically over‐responsivity to sensory stimuli, are linked to challenges with oral care in the home and dental office in children with disabilities 21–28 . Parents of children with Down syndrome have reported similar sensory over‐responsivities in their children, 17,18,29 as well as uncooperative behaviors during oral care, 29,30 but the link between these two factors is yet to be explored in this population.…”

The Relationship between Dental Fear and Anxiety, General Anxiety/Fear, Sensory Over-Responsivity, and Oral Health Behaviors and Outcomes: A Conceptual Model

“…Historically, dental research examining SOR and oral health behaviors and outcomes has focused on clinical populations, including children with autism spectrum disorder, Down syndrome, and attention-deficit/hyperactivity disorder. In these groups, sensory sensitivities have been linked to dental-related challenges in the home and/or clinic environments [ 42 , 43 , 44 , 221 , 222 , 223 , 224 , 225 , 226 , 227 , 228 , 229 , 230 , 231 , 232 , 233 ], with the National Institute of Dental and Craniofacial Research [ 234 ] suggesting that minimizing sensory stimuli in the dental environment may support the reduction of uncooperative behaviors in children with autism spectrum disorder.…”

“Mom Let’s Go to the Dentist!” Preliminary Feasibility of a Tailored Dental Intervention for Children with Autism Spectrum Disorder in the Italian Public Health Service

“…Although there is no specific relationship between ASD and oral disease, it is well-recognized that many individuals with ASD have much worse oral health than non-autistic people [ 5 , 6 , 7 , 8 , 9 , 10 ]. This may be related to barriers to dental services, sensory sensitivities and heightened levels of stress and anxiety during care; these factors may affect the level of cooperation of individuals with ASD in regard to daily hygiene routines, oral exams, and dental care [ 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. The presence of comorbid self-injurious behaviors, poor oral care at home and specific dietary habits that can favor tooth decay should also be considered [ 17 , 18 ].…”