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Enhancing oral care in autistic kids with sensory-adapted dental environments

Modifying the sensory environment can help dentists facilitate oral care for children with ASD. (Image: Canva)

Sat. 18 November 2023


Autistic children face diverse challenges in maintaining optimal oral health. These challenges encompass difficulties in adhering to standard oral hygiene practices in their home environment and experiencing considerable discomfort during dental visits. A major cause behind this stems from their heightened sensory stimuli.

Sensory processing challenges are a widely acknowledged aspect of autism, with reports suggesting that as many as 95% of children with autism spectrum disorder experience some form of sensory processing difficulty.1

Today dentists recognise the importance of making dental visits inclusive for everyone, including kids with autism, developmental disabilities, and neurotypical children. Researchers propose using a sensory-adapted dental environment (SADE) to help ease anxiety and encourage better cooperation among children on the autism spectrum.2

Managing an autistic child in the dental chair: A challenging situation

During dental procedures, autistic children face challenges in communicating and interacting. They might find it hard to manage their emotions, engage in repetitive movements, or show hyperactivity due to attention issues. This can lead to frustration, irritability, and unusual sounds.

These challenges often come with sensitivity to sights, sounds, smells, tastes, and textures. Even small changes in the environment can be overwhelming for them, and they prefer things to stay consistent. They often notice things in their peripheral vision, so it's important to avoid moving objects or toys around them as it can distract them and affect how they behave.3

A trip to the dentist can be tough for autistic children because there's so much happening at once. The bright lights, loud sounds, and strange smells can be overwhelming. It's no surprise they might feel super anxious in the dentist's chair, which can make them act out or even avoid going to the dentist altogether. This makes it hard for them to get the care they need. That's why making the dental office more calm and sensory-friendly is crucial. It's all about making sure their visit is a good experience.

SADE: a breakthrough in managing autistic children

A sensory-adapted dental environment aims to reduce patient anxiety and discomfort during dental procedures by addressing spiking sensory impulses. The science behind sensory adaptation aligns with the current trend in healthcare towards holistic, patient-centered approaches that consider psychological and sensory aspects of care.

Research highlights that adapting the dental environment to suit the sensory needs of patients can improve their comfort, enhancing the overall dental experience. Sensory adaptations can also reduce the perception of pain during dental procedures. Studies confirm that patients tend to be more satisfied with their dental experience in sensory-adapted environments, increasing the likelihood of regular dental visits.

Modifying your dental clinic to create and foster a sensory-adapted dental experience

Dental surgeons and pediatric dentists have a unique opportunity to enhance their clinics by proactively incorporating controlled lighting, soothing music, and calming scents. These adjustments empower them to create environments that effectively modulate sensory experiences, significantly reducing stress for their autistic patients. Here are some simple ways to modify your dental clinic into an autism-friendly set-up.4

  1. Altering the dental chamber: Sensitive adjustments to the dental clinic environment can help alleviate this discomfort. For instance, softer lighting, the use of darkening curtains on the windows rhythmic music, and a less decorated operatory provide a sense of security and is a feasible approach. A wrap papoose extended from the child's shoulders to their ankles, delivering firm "hugging" pressure helps to induce a soothing effect.  Having a designated operating room solely for the treatment of autistic children can be advantageous.
  2. The expertise of the dental surgeon and team: It's best to train the assisting team to understand the autistic child. They should be guided to avoid sudden movements, and sudden sounds during therapy.  The use of brief, clear, and simple oral instructions should be encouraged. Maintaining consistent communication during and after the visit is important. A  dental surgeon, trained to deal with autistic children,  can lead the treatment in the best possible way.
  3. Keeping appointments short: Appointments should be kept concise and well-organized, ensuring they are short. It's crucial to minimize waiting times to no more than 10 to 15 minutes, as patients with limited attention spans can become upset if kept waiting for longer periods.
  4. Providing sensory tools: Noise-canceling headphones block out the loud drills and motors in the dental operatory, thus creating a more comfortable dental setting. Using things like favorite cartoons, music, or special toys can help distract autistic patients and keep their focus away during dental procedures.

Take-home message

Designing a dental clinic that caters to sensory needs isn't just about making patients comfortable—it's a smart move. When people feel good about the space, they're more likely to tell others about it. That means more patients visit the clinic, spread the word, and give the clinic a great reputation. Being more inclusive improves the dentist-patient relationship. Patients who trust their dental professionals are more inclined to engage in open communication, leading to improved care delivery. This strengthened bond enhances the overall experience for both patients and the dental team, promoting better outcomes and long-term success.

Editorial note:


1. Cermak SA, Stein Duker LI, Williams ME, Dawson ME, Lane CJ, Polido JC. Sensory Adapted Dental Environments to Enhance Oral Care for Children with Autism Spectrum Disorders: A Randomized Controlled Pilot Study. J Autism Dev Disord. 2015 Sep;45(9):2876-88. doi: 10.1007/s10803-015-2450-5. PMID: 25931290; PMCID: PMC4554774.

2. Stein Duker LI, Como DH, Jolette C, Vigen C, Gong CL, Williams ME, Polido JC, Floríndez-Cox LI, Cermak SA. Sensory Adaptations to Improve Physiological and Behavioral Distress During Dental Visits in Autistic Children: A Randomized Crossover Trial. JAMA Netw Open. 2023 Jun 1;6(6):e2316346. doi: 10.1001/jamanetworkopen.2023.16346. PMID: 37266941; PMCID: PMC10238943.

3. Panju S, Brian J, Dupuis A, Anagnostou E, Kushki A. Atypical sympathetic arousal in children with autism spectrum disorder and its association with anxiety symptomatology. Mol Autism. 2015 Dec 11;6:64. doi: 10.1186/s13229-015-0057-5. PMID: 26693000; PMCID: PMC4676885.

4. Chandrashekhar S, S Bommangoudar J. Management of Autistic Patients in Dental Office: A Clinical Update. Int J Clin Pediatr Dent. 2018 May-Jun;11(3):219-227. doi: 10.5005/jp-journals-10005-1515. Epub 2018 Jun 1. PMID: 30131645; PMCID: PMC6102426.

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