How to Reduce Stress for Autistic Children During Dental Visits

Autistic children often encounter difficulties in maintaining good oral health compared to their neurotypical peers. Their struggles arise from sensory issues, which render them hypersensitive to harsh fluorescent lights, loud sounds, strong smells, and physical touch. These sensitivities make it challenging for autistic children to access dental treatments and tolerate clinical environments. 

Unfortunately, the dental industry lacks specific protocols to accommodate their needs, and dentists are often untrained or unwilling to treat autistic children. Consequently, many of these children experience overwhelming anxiety and stress before, during, and after visiting the dentist’s clinic.

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Sensory Adaptations Prove Beneficial

USA: A recent study published in JAMA highlights how modifying the dental environment to suit the sensory needs of autistic children can significantly alleviate their anxiety and behavioural distress during dental treatments. 

The study involved 162 autistic children between the ages of six and twelve, with a majority of them being white. Out of these participants, 83 received dental treatments in a standard office setup, while the remaining 80 visited a dental clinic specifically designed with sensory adaptations.

Transforming the Dental Environment

The sensory-adapted dental clinic employed several modifications to create a more comfortable experience for the autistic children. First, all overhead fluorescent lights, including the dental operatory lamp, were turned off. 

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Windows were covered with darkening curtains, and instead of the traditional lighting, a glass-mounted headlight was used, ensuring that light was directed solely into the child’s mouth, avoiding their eyes. Additionally, a projector displayed slow-moving visual effects, such as bubbles or fishes on the ceiling, chosen by the child. Classic music combined with nature sounds played through a small speaker in the room.

Hugging Sensation and Flexibility

Most of the children received a butterfly wrap, which was weighted with a pediatric dental radiograph vest. The butterfly wrap was positioned around the dental chair, enveloping the child’s shoulders down to their ankles, simulating a deep hugging sensation.

However, if any child felt uncomfortable with any of the sensory stimuli, the dentists promptly discontinued its use. Nonetheless, over 90% of the children utilised the projector, music, and headlamp, while at least 74% found the butterfly wrap beneficial without any complaints.

Positive Outcomes and Future Implications

To evaluate the effectiveness of these adaptations, the researchers video recorded the children during their dental cleanings, observing their behaviors and stress levels.

The results were compelling: children treated in the sensory-adapted dental clinic exhibited significantly reduced distress, remaining calm and relaxed throughout their cleanings. In contrast, those in the regular dental clinics experienced severe distress, often crying, whimpering, or screaming.

Sensory Adaptations are Affordable

The study’s authors emphasise that their findings align with previous research showcasing the efficacy of sensory-adapted dental environments in reducing stress and anxiety among autistic children, as well as individuals with developmental disabilities.

They further highlight that implementing this approach is highly scalable, requiring minimal training and no structural renovations. The cost of setting up the sensory-adapted environment is a one-time expense of under $6000, making it easily affordable. Consequently, the approach holds tremendous potential for nationwide implementation in dental clinics.

The American Academy of Pediatric Dentistry has recognised the significance of sensory adaptations and included them in their best practices for behavioural guidance, specifically targeting dental patients with anxiety or special healthcare needs. Beyond autism, this intervention may also benefit other populations. Enhancing oral care for autistic children remains a critical goal, and the application of sensory-adapted dental environments shows promise in achieving this objective.