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USC: Study: dental offices need to be autism friendly

June 3, 2023, Mirage: Sensory-Adapted Dental Rooms Ease Stress for Autistic Kids https://www.miragenews.com/sensory-adapted-dental-rooms-ease-stress-for-1019481/

University of Southern California

New results from a study led by USC researchers at Children’s Hospital Los Angeles show that a sensory adapted dental clinic environment creates less distressing oral care experiences for autistic children. The open-access article is available today in JAMA Network Open.

“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 behavioral and physiological distress during dental cleanings,” said lead author Leah Stein Duker, assistant professor at the USC Chan Division of Occupational Science and Occupational Therapy….

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 colors). 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 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 behaviors 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….

Adaptations can make all the difference…

Stein Duker and her Tailored Environmental Modifications lab will next study the effectiveness of a modified SADE for typically developing children with dental fear and anxiety, a major challenge in pediatric dentistry experienced by approximately 20 percent of all US children. In the near future, she is also planning to collect preliminary data studying adolescents and adults with intellectual developmental disabilities and/or autism, populations she gets frequently asked about at dental conferences and research meetings.

“Regardless of population, my advice to dental professionals and parents alike is to work together to find ways to improve the overall clinic experience,” Stein Duker says. “There are weighted X-ray bibs in every single dental office that may help calm the child; they can wear sunglasses; they can wear a beanie hat covering the ears to muffle noises — all of these are completely free and easy adaptations that have the potential to improve the clinic experience for those with sensory sensitivities, without negatively impacting dentists’ ability to provide care.”


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