Sensory adapted dental rooms significantly reduce autistic children’s physiological stress during teeth cleaning

autistic children dentistry
In the SADE research clinic at Children’s Hospital Los Angeles, a traditional lead X-ray bib placed on the child’s chest and a “butterfly” wrap secured around the dental chair provided participants’ a deep pressure hugging sensation from shoulder to ankle during dental cleanings. Credit: Phil Channing

New results from a study led by US researchers show that a sensory adapted dental clinic environment creates less distressing oral care experiences for autistic children. 

The open-access article is available in JAMA Network Open.

Compared to typically developing peers, autistic children experience greater oral health care challenges, which are often associated with heightened responses to sensory input. The dentist’s office is filled with potentially overwhelming stimuli such as bright fluorescent lighting, whirring electric hand tools and reclining chairs. 

USC researchers at Children’s Hospital Los Angeles are identifying and testing innovative approaches that can help alleviate those challenges in order to increase access and efficacy of oral care.

In this study, autistic children received cleanings in both a standard clinic environment and an adapted one. In the adapted setting, the dentist wore a surgical loupe with attached lamp, blackout curtains were hung over the windows and a slow-motion visual effect was projected onto the ceiling (children could choose between a “Finding Nemo” underwater scene or lava lamp-style abstract colours). A portable speaker played calming nature sounds and quiet piano music. 

A traditional lead X-ray bib placed on the child’s chest and a ‘butterfly’ wrap secured around the dental chair provided a deep pressure hugging sensation from shoulder to ankle, which has been shown to calm the nervous system.

Electrodes placed on the child’s fingers measured electrodermal activity, a physiological correlate of sympathetic nervous system activation akin to the fight-or-flight response. The researchers also observed the frequency and duration of distressed behaviours exhibited by the child during the cleaning, such as jerking away from the dentist, clamping down with the jaw, intentionally trying to bite the dentist or keep tools out of the mouth, crying and screaming.

“We’ve shown that the combination of curated visual, auditory and tactile adaptations—all of which are easily implemented, relatively inexpensive and don’t require training to safely use—led to statistically significant decreases in autistic children’s behavioural and physiological distress during dental cleanings,” lead author Leah Stein Duker said.

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