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

Duker, Leah I. Stein; Grager, Mollianne; Giffin, Willa; Hikita, Natasha H.; Polido, José C

doi:10.3390/ijerph19042380

Cited by 19 publications

(9 citation statements)

References 250 publications

(335 reference statements)

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“…The present IR clearly shows that to date, only five articles directly link PSD and clinical practices to pediatric dentistry [1,[7][8][9][10]. Nevertheless, all articles specifically discuss autism spectrum disorder (ASD), although some studies associate SPD with other diagnoses, such as attention deficit hyperactivity disorder (ADHD), Down syndrome and anxiety [11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Does the Pediatric Dentistry Know About Sensory Processing Disorder? An Integrative Review

Roriz

2023

OJDOH

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Background: Sensory processing disorder (SPD) is a limitation or difficulty in the interpretation of sensory information with reflection in the daily activities of an individual. Its clinical manifestations are represented by decreased social interaction, crying, sleep and changes in eating habits. Dental settings and clinical interventions, particularly in children, may contribute to triggering or exacerbating SPD. Methods and Results:An integrative review (IR) was performed to evaluate the knowledge of pediatric dentistry about SPD. Conclusion:It was possible to infer that pediatric dentistry has little knowledge on the subject and that studies and literature reviews with strong scientific evidence should be conducted to encourage the use of SPD in pediatric dentistry.

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Section: Discussionmentioning

confidence: 99%

Does the Pediatric Dentistry Know About Sensory Processing Disorder? An Integrative Review

Roriz

2023

OJDOH

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“…Sensory processing patterns and alexithymia are also associated with pain catastrophizing [14,[19][20][21][22], which in turn is associated with dental anxiety [23,24]. Catastrophic thinking is known to contribute to the experience of pain by negative ruminating, and by magnifying and capturing the experience of pain [23].…”

Section: Introductionmentioning

confidence: 99%

Associations of sensory sensitivity, pain catastrophizing, and alexithymia with dental anxiety

Ogawa,

Saito,

Karukivi

et al. 2024

European J Oral Sciences

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We aimed to reveal interrelationships between alexithymia, catastrophic thinking, sensory processing patterns, and dental anxiety among 460 participants who were registrants of a Japanese research company. Measures used were the Modified Dental Anxiety Scale, the Adult Sensory Profile, the Pain Catastrophizing Scale, and the 20‐item Toronto Alexithymia Scale. The interrelationships among the constructs were analyzed using structural equation modeling, adjusting for age, gender, and negative dental treatment experience. Data from 428 participants were used in the analyses. Sensory sensitivity and pain catastrophizing were independently associated with anticipatory and treatment‐related dental anxiety, while difficulty identifying feelings was not. In the mediation model, sensory sensitivity and pain catastrophizing served as full mediators between difficulty identifying feelings and the dimensions of dental anxiety (indirect effects were between 0.13 and 0.15). The strength of the associations was 0.55 from difficulty identifying feelings to both pain catastrophizing and sensory sensitivity, and between 0.24 and 0.26 to anticipatory and treatment‐related dental anxiety. The association between trait‐like phenomena, such as alexithymia, and dental anxiety may be mediated by neurophysiological and cognitive factors such as sensory sensitivity and pain catastrophizing. These findings could be crucial for new and innovative interventions for managing dental anxiety.

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“…9,10 Attention to sensory sensitivities' effect on oral care is becoming more prevalent in dentistry for autistic children, children with other disabilities, 9,13,[18][19][20][21] and neurotypical individuals. 22 Shapiro and colleagues 23,24 first proposed adapting the sensory characteristics of the dental office to reduce anxiety and enhance cooperation to facilitate oral care for children with developmental disabilities.…”

Section: Introductionmentioning

confidence: 99%

“…Attention to sensory sensitivities’ effect on oral care is becoming more prevalent in dentistry for autistic children, children with other disabilities, 9 , 13 , 18 , 19 , 20 , 21 and neurotypical individuals. 22 Shapiro and colleagues 23 , 24 first proposed adapting the sensory characteristics of the dental office to reduce anxiety and enhance cooperation to facilitate oral care for children with developmental disabilities. Including the studies by Shapiro et al, 23 , 24 several pilot studies have examined the preliminary efficacy of adapting the sensory environment of the dental office to improve care for individuals with special needs, with promising results.…”

Section: Introductionmentioning

confidence: 99%

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

Cited by 19 publications

References 250 publications

Does the Pediatric Dentistry Know About Sensory Processing Disorder? An Integrative Review

Does the Pediatric Dentistry Know About Sensory Processing Disorder? An Integrative Review

Associations of sensory sensitivity, pain catastrophizing, and alexithymia with dental anxiety

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

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