Sensory Adapted Dental Environments to Enhance Oral Care for Children with Autism Spectrum Disorders: A Randomized Controlled Pilot Study

Abstract

This pilot and feasibility study examined the impact of a sensory adapted dental environment (SADE) to reduce distress, sensory discomfort, and perception of pain during oral prophylaxis for children with autism spectrum disorder (ASD). Participants were 44 children ages 6-12 (n=22 typical, n=22 ASD). In an experimental crossover design, each participant underwent two professional dental cleanings, one in a regular dental environment (RDE) and one in a SADE, administered in a randomized and counterbalanced order three to four months apart. Outcomes included measures of physiological anxiety, behavioral distress, pain intensity, and sensory discomfort. Both groups exhibited decreased physiological anxiety and reported lower pain and sensory discomfort in the SADE condition compared to RDE, indicating a beneficial effect of the SADE.

Parents’ perceptions of dental care challenges in male children with autism spectrum disorder: An initial qualitative exploration

“…If dental professionals are aware of and understand the potential impact of sensory sensitivities on children with ASD, there are many adaptations that can be made to help the child and their family feel more comfortable with care. For example, a recent study sought to adapt the sensory features of the dental environment, suggesting preliminary support for the success of these environmental changes in decreasing negative reactions at the dentist (Cermak et al, 2015). Additionally, disseminating and discussing the implementation of practical guides for dental professionals working with children with ASD, as done by the National Institute of Dental and Craniofacial Research (2009) for oral care or for medical professionals working with individuals with ASD in the emergency room (CARD, n.d.) could benefit this population greatly.…”

“…Some dental literature has reported anecdotally that the use of a papoose board can have a calming effect on children with ASD during dental care (Marshall et al, 2008; Ravel, 2005), based on the work of Temple Grandin (Edelson et al, 1999; Grandin, 2006). Similarly, recent research suggests that the use of a chair wrap designed to provide deep “hugging” pressure has the potential to produce a calming effect in children with ASD when used in conjunction with visual and auditory environmental adaptations (Cermak et al, 2015). …”

“…In fact, one study surveying Special Care Dentistry Association members found that respondents utilized an average of 6.34 accommodations to address difficulties with communication, routine, and social interactions when providing dental care for children with ASD (Weil et al, 2011). As mentioned earlier, a recent study adapted the visual, auditory, and tactile environment of the dental operatory during routine dental cleanings, successfully decreasing the physiological distress, behavioral distress, perception of pain, and sensory discomfort in children with ASD (Cermak et al, 2015). Additionally, another recent study found that electronic screen media technology utilizing video goggles significantly reduced children’s anxiety and behavior scores during dental cleanings (Isong et al, 2014).…”

Impact of sensory adapted dental environment on children with developmental disabilities

“…The previous studies incorporated tactile stimuli with a wrap designed to look like a butterfly, weighted with a regular pediatric dental X‐ray vest. In this pilot study, only a regular X‐ray lead apron was laid on each patient for tactile stimuli . In the background, calming nature sound (Calming Seas #1‐11 Hours Ocean Waves Sound) was played.…”

“…A similar pilot study by Cermak et al examined the efficacy of SADE on children with autism. This study yielded results that supported the previous studies’ findings …”