Impact of sensory adapted dental environment on children with developmental disabilities

Kim, Gail; Carrico, Caroline K.; Ivey, Carole K.; Wunsch, Patrice Barsamian

doi:10.1111/scd.12360

Cited by 16 publications

(25 citation statements)

References 23 publications

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“…They revealed that children with IDD showed higher levels of relaxation and cooperation in the SADE compared with routine dental environment (RDE). Similarly, two other recent studies observed the efficacy of SADE on dental anxiety of children with IDD ( n = 22) [50] and adults with IDD ( n = 41) [51]. Potter et al [51] added to the evidence with both reduced frequency and duration of agitated behaviours in the SADE condition, whereas Shapiro et al [52] only recorded the duration.…”

Section: Resultsmentioning

confidence: 94%

“…GIC helps to reduce plaque accumulation, although retention of the GIC on tooth surfaces was inadequate. 1d). Dental clinic setting Kim, Carrico, Ivey & Wunsch, 2019 (USA) [50]Crossover RCTExplore impact of a sensory adapted dental environment (SADE) on behavioural and physiological changes when compared to routine dental environment (RDE).Children with developmental disability (male n = 14, female n = 8)No significant difference in physiological scores (heart rate and oxygen saturation) between the two groups. The SADE group had significantly better observed behaviour scores compared to the routine dental environment group. Potter, Wetzel & Learman, 2018 (USA) [51]Cohort studyExamine whether a SADE had an effect on anxiety and agitation in adults with IDD when compared to RDE.Adults with IDD (male n = 22; female n = 19) mainly with severe to profound IDD.There was a significant reduction in the frequency and duration of observed agitation after SADE.…”

Section: Resultsmentioning

confidence: 99%

“…A sensory adapted dental environment (SADE) is where the provision of sensory modifications within the clinical context is modified to reduce dental anxiety for people with IDD. The crossover Randomised Controlled Trial (RCT) by Shapiro et al [50], modified visual, tactile, somatosensory and auditory stimuli in a dental clinic for 16 children with IDD and 19 typically developing children. They revealed that children with IDD showed higher levels of relaxation and cooperation in the SADE compared with routine dental environment (RDE).…”

Section: Resultsmentioning

confidence: 99%

“…Potter et al [51] added to the evidence with both reduced frequency and duration of agitated behaviours in the SADE condition, whereas Shapiro et al [52] only recorded the duration. The study by Kim et al [50] involved pre-appointment sensory/behaviour assessment and individualised sensory modifications, which also received positive feedback from the participants. It is also important for health care workers to be able to identify the verbal and non-verbal cues of emotional distress of these patients promptly.…”

Section: Resultsmentioning

confidence: 99%

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Countering the poor oral health of people with intellectual and developmental disability: a scoping literature review

et al. 2019

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Background: People with intellectual and developmental disability (IDD) have poor oral health and need support to maintain optimal oral health outcomes. Little is known about how, when and where to intervene for this population. Thus the aim of this review was to summarise the existing evidence surrounding improving oral health outcomes for people with IDD. Methods: A scoping literature review was conducted focusing on 'oral health' and 'intellectual disability'. Systematic searches of five electronic databases were conducted in line with the study aims and two authors independently examined all records for relevance, with consensus achieved by a third author. Results: A small number of approaches and interventions were identified to support people with IDD to independently maintain optimal oral hygiene. Identified studies highlighted that caregivers play a vital role in the provision of oral health support, emphasising the effectiveness of educational interventions for caregivers. However, there was uncertainty regarding the efficacy of specific tooth brushing interventions for people with IDD. In cases of more severe IDD and/or dental-related behavioural problems, dental treatment under general anaesthesia was often both a necessary and effective method of oral health care provision. The findings also identified outreach and exclusive oral health services as successful strategies for increasing the limited access of people with IDD to oral care services. Conclusions: A uniform approach to supporting oral health for people with IDD is unlikely to succeed. A systembased approach is needed to address the diverse needs of the population of people with IDD, their caregivers and service context. Further high quality evidence is required to confirm these findings.

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Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Countering the poor oral health of people with intellectual and developmental disability: a scoping literature review

et al. 2019

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“…Generally, these may involve facilitating communication, reducing anxiety associated with unfamiliar providers and routines, and sensory-based approaches to reduce triggers and use helpful soothing strategies. [77][78][79] A more detailed discussion of these strategies can be found in a 2019 review in Psychosomatics by Thom and colleagues. 73 Pharmacologic interventions for pediatric inpatients with ASD include management of comorbid psychiatric symptoms, such as anxiety or hyperactivity, identifying medications, such as corticosteroids, that have the potential to exacerbate behavioral difficulties, and preventing and treating disruptive behaviors.…”

Section: Autism Spectrum Disordermentioning

confidence: 99%

Pediatric Consultation-Liaison Psychiatry: An Update and Review

2020

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Background: In recent years, there has been an increasing burden of child and adolescent mental illness recognized in the United States, and the need for pediatric mental health care is growing. Pediatric consultation-liaison (C-L) psychiatrists are increasingly playing a role in the management of medical and psychiatric disease for pediatric patients. The field is a fast-moving one, with understanding of new neuropsychiatric disease entities; reformulation of prior disease entities; and new interdisciplinary treatments and models of care. Methods: In this study, we aim to review recent advances in the field of pediatric C-L psychiatry, including new diagnostic entities, updated management of frequently encountered clinical presentations, and developments in systems of care. Conclusion: The advances in pediatric C-L psychiatry are broad and serve to promote more streamlined, evidence-based care for the vulnerable population of psychiatrically ill pediatric medical patients. More work remains to determine the most effective interventions for the wide array of presentations seen by pediatric C-L psychiatrists.

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Sensory Adaptations to Improve Physiological and Behavioral Distress During Dental Visits in Autistic Children

Stein Duker,

Como,

Jolette

et al. 2023

JAMA Netw Open

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ImportanceAutistic children have poorer oral health and greater oral care challenges, which are often associated with sensory overresponsivity, than neurotypical peers. It is important to identify innovative solutions enabling dentists to successfully perform standard clinic-based procedures for this population.ObjectiveTo determine whether a sensory-adapted dental environment (SADE) reduces physiological and behavioral distress in autistic children undergoing dental cleanings, compared with a regular dental environment (RDE).Design, Setting, and ParticipantsThis randomized crossover trial was conducted at a pediatric dentistry clinic in a large urban children’s hospital between May 2016 and April 2022. Coders were blinded to study condition for physiological but not behavioral measurements. Autistic children aged 6 to 12 years were identified and invited to participate. Interested families were enrolled consecutively; after confirmation of autism diagnosis, children were randomized. Analysis for this per-protocol study were conducted from April to October 2022.InterventionEach child underwent 1 RDE and 1 SADE dental cleaning, administered in randomized and counterbalanced order approximately 6 months apart. SADE included modified visual, auditory, and tactile stimuli.Main Outcomes and MeasuresThe primary outcome was physiological stress, assessed by electrodermal activity. The secondary outcome was behavioral distress measured from video recordings.ResultsAmong 452 families invited to participate, 220 children were enrolled, and 162 children (mean [SD] age, 9.16 [1.99] years; 136 [84.0%] male) with confirmed autism were randomized, with 83 children receiving RDE first and 80 children receiving SADE first. Most children (94 children [58.0%]) had moderate autism severity. Children had significantly lower physiological stress during dental care in SADE compared with RDE (mean difference in skin conductance level, −1.22 [95% CI, −2.17 to −0.27] μS), suggesting decreased sympathetic activity and increased relaxation during SADE dental care. No significant differences were found in nonspecific skin conductance responses (mean difference, −0.30 [95% CI, −0.86 to 0.25] per min). Video-coded frequency and duration of behavioral distress (but not questionnaire) measures were significantly lower in SADE vs RDE (Cohen d = −0.84 to −1.19). Physiological stress was associated with behavioral distress during the dental cleaning (eg, nonspecific skin conductance responses associated with the Frankl Scale: β = −0.29; 95% CI, −0.39 to −0.19); age, IQ, and expressive communication moderated the intervention’s success. No participants withdrew due to adverse effects.Conclusions and RelevanceIn this randomized crossover trial of autistic children, using SADE was safe and efficacious in decreasing physiological and behavioral distress during dental care. This is important because enhancing oral care is critical for autistic children; this intervention may also be beneficial for populations beyond autism.Trial RegistrationClinicalTrials.gov Identifier: NCT02430051

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Impact of sensory adapted dental environment on children with developmental disabilities

Cited by 16 publications

References 23 publications

Countering the poor oral health of people with intellectual and developmental disability: a scoping literature review

Countering the poor oral health of people with intellectual and developmental disability: a scoping literature review

Pediatric Consultation-Liaison Psychiatry: An Update and Review

Sensory Adaptations to Improve Physiological and Behavioral Distress During Dental Visits in Autistic Children

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