Sensory-Adapted Dental Care for Sensory Processing Disorder

Overseen By Noorpreet Kaur, DDS, MPH

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: The University of Texas Health Science Center at San Antonio

Must not be taking: Anticholinergics

Disqualifiers: Uncontrolled epilepsy, Severe behavioral disorders, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 2

32 Participants Needed

Trial Summary

What is the purpose of this trial?

This clinical trial examines the efficacy of a Sensory-Adapted Dental Environment (SADE) in reducing anxiety and improving behavioral outcomes in children with sensory processing disorders during routine dental visits. By modifying the dental setting to accommodate sensory sensitivities-such as using dim lighting, noise-canceling headphones, and non-threatening dental tools-the study aims to create a more comfortable dental experience for these children. This research could potentially inform broader pediatric dentistry practices, making dental care more accessible and less distressing for children with sensory sensitivities.

Will I have to stop taking my current medications?

The trial requires that participants do not use anticholinergic medications, as these can affect the study's outcomes related to stress and anxiety.

What data supports the effectiveness of the treatment Sensory-Adapted Dental Environment (SADE) for Sensory Processing Disorder?

Research shows that a sensory-adapted dental environment (SADE) can significantly reduce anxiety and improve relaxation and cooperation in children with developmental disabilities during dental visits. This approach, which includes calming features like dimmed lighting and soothing sounds, has been effective in making dental care more comfortable for children who are typically anxious in such settings. ^{1 2 3 4 5}

Is sensory-adapted dental care safe for humans?

Research on sensory-adapted dental environments, like the Snoezelen environment, shows they are safe and can help reduce anxiety and improve relaxation in children, especially those with developmental disabilities, without the need for medication. ^{1 2 3 5 6}

How is the Sensory-Adapted Dental Environment (SADE) treatment different from other treatments for sensory processing disorder?

The Sensory-Adapted Dental Environment (SADE) is unique because it modifies the dental setting with sensory elements like dimmed lighting, vibroacoustic stimuli (sound and vibration), and deep pressure to reduce anxiety and improve cooperation in children with developmental disabilities, unlike traditional treatments that often rely on medication. ^{1 3 5 7 8}

Research Team

Nida-e-Haque Mahmud, DDS, BDS

Principal Investigator

UT Health San Antonio

Eligibility Criteria

This trial is for children with Sensory Processing Disorder who struggle with the sensory challenges of dental visits. It's designed to help those who may benefit from a dental environment tailored to their needs, making routine care less stressful.

Inclusion Criteria

A score above the threshold on the Sensory Profile-2 indicating significant sensory processing issues

I can understand and am willing to sign the consent form.

I am willing and able to follow the study plan, including attending two special dental sessions.

Exclusion Criteria

Previous traumatic dental experiences resulting in extreme dental care avoidance

Any condition that, in the opinion of the investigators, may pose a risk to the participant's safety or may affect the study outcomes

I need special dental procedures not offered by this study.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Dental Visit 1

Participants undergo a dental cleaning visit in a standard dental environment

1 day

1 visit (in-person)

Dental Visit 2

Participants undergo a dental cleaning visit in a Sensory-Adapted Dental Environment (SADE)

1 day

1 visit (in-person)

Follow-up

Participants are monitored for changes in anxiety and behavior after dental visits

3-4 months

Treatment Details

Interventions

• Sensory-Adapted Dental Environment

Trial Overview The study tests a Sensory-Adapted Dental Environment (SADE) that includes dim lighting, noise-canceling headphones, and gentle dental tools aimed at reducing anxiety and improving behavior during dental visits for kids with sensory sensitivities.

Participant Groups

Group I: SADE Group: Sensory-Adapted Dental Environment Experimental Treatment 1 Intervention

Participants in this arm will experience dental care in a Sensory-Adapted Dental Environment. Modifications such as dimmed lighting, noise-canceling headphones, and specialized dental tools are used to minimize sensory overload and enhance comfort during dental procedures.

Group II: Control Group: Regular Dental Environment Active Control 1 Intervention

Participants in this arm will receive dental care in a Regular Dental Environment without sensory adaptations, representing standard dental care settings.

Sensory-Adapted Dental Environment is already approved in United States for the following indications:

Approved in United States as SADE for:

• Reducing anxiety in children with sensory processing disorders during dental visits
• Improving behavioral outcomes in children with sensory processing disorders during dental visits

Who Is Running the Clinical Trial?

The University of Texas Health Science Center at San Antonio

Lead Sponsor

Trials

486

Recruited

92,500+

Findings from Research

The study involved 19 children aged 6-11 years and assessed the effectiveness of a Snoezelen sensory adapted dental environment (SDE) in reducing anxiety during dental procedures.

Results showed significant improvements in both behavioral and physiological measures of relaxation in the SDE compared to a conventional dental setting, suggesting that the SDE is a practical and effective option for helping anxious children during dental care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavioural and physiological effect of dental environment sensory adaptation on children's dental anxiety. Shapiro, M., Melmed, RN., Sgan-Cohen, HD., et al.[2022]

Implementing Snoezelen multisensory calming strategies in a community dental practice significantly improved patient behavior, cooperation, and satisfaction, particularly for individuals with disabilities.

The calming environment reduced the need for sedation or general anesthesia, suggesting that similar multisensory features in dental clinics could enhance access to care for patients with special needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Multisensory/Snoezelen Environment to Optimize the Dental Care Patient Experience. Sigal, A., Sigal, M.[2022]

A sensory-adapted dental environment (SADE) significantly reduced anxiety and increased cooperation in children with developmental disabilities during dental hygiene procedures, compared to a regular dental environment (RDE).

In the SADE, anxious behaviors were reduced by over 60% in duration and magnitude, and cooperation levels were dramatically higher, suggesting that nonpharmacological approaches can effectively improve dental experiences for these children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of sensory adaptation on anxiety of children with developmental disabilities: a new approach. Shapiro, M., Melmed, RN., Sgan-Cohen, HD., et al.[2011]

A study involving children aged 8-13 with mild intellectual disabilities showed that a sensory-adapted dental environment (SADE) significantly reduced anxiety levels during dental procedures compared to a regular dental environment.

SADE not only decreased anxiety but also improved cooperative behavior in these children, suggesting it could be an effective alternative for managing behavior in dental settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhancing special care dentistry with sensory-adapted dental environment: A comparative study. Kittur, S., Basappa, N., Raju, OS., et al.[2022]

In a pilot study involving 22 children with developmental disabilities, the sensory adapted dental environment (SADE) led to significantly higher cooperation scores during dental cleanings compared to the regular dental environment (RDE).

Despite no differences in physiological measures like heart rate and oxygen saturation, 46% of parents preferred the SADE for future visits, suggesting it may enhance the dental experience for children with developmental disabilities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of sensory adapted dental environment on children with developmental disabilities. Kim, G., Carrico, C., Ivey, C., et al.[2019]

A sensory adapted environment (SAE) significantly reduced anxious behaviors in both children with developmental disabilities and typical children during a stressful dental procedure, with anxious behaviors lasting an average of 5.26 minutes in the SAE compared to 13.56 minutes in the regular environment (P < .001).

Children with developmental disabilities showed a greater improvement in arousal levels when in the SAE, as indicated by lower electrodermal activity measurements before and during treatment, suggesting that they benefit more from sensory adaptations compared to typical children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Influence of adapted environment on the anxiety of medically treated children with developmental disability. Shapiro, M., Sgan-Cohen, HD., Parush, S., et al.[2009]

A playful learning intervention significantly improved oral hygiene in children with hearing impairment, with the simplified oral hygiene index (OHI-S) scores increasing from 12% good status before the intervention to 64% after.

The study highlights the effectiveness of using educational strategies in Mexican Sign Language to promote oral health among children with sensory deficits, suggesting that such approaches can be beneficial in dental care for vulnerable populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Playful Educational Intervention for Improvement of Oral Health in Children with Hearing Impairment. Ávila-Curiel, BX., Solórzano-Mata, CJ., Avendaño-Martínez, JA., et al.[2022]

Parents of children with autism spectrum disorders (ASD) reported significantly more challenges related to sensory experiences during oral care at home and at the dentist compared to parents of typically developing (TD) children, based on responses from 196 ASD and 202 TD families.

Implementing sensory strategies to modify the dental environment could improve the dental experience and overall quality of life for children with ASD and their families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Oral care and sensory concerns in autism. Stein, LI., Polido, JC., Cermak, SA.[2012]

References

1. England pubmed.ncbi.nlm.nih.gov

Behavioural and physiological effect of dental environment sensory adaptation on children's dental anxiety. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

The Multisensory/Snoezelen Environment to Optimize the Dental Care Patient Experience. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Effect of sensory adaptation on anxiety of children with developmental disabilities: a new approach. [2011]

4. India pubmed.ncbi.nlm.nih.gov

Enhancing special care dentistry with sensory-adapted dental environment: A comparative study. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Impact of sensory adapted dental environment on children with developmental disabilities. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Influence of adapted environment on the anxiety of medically treated children with developmental disability. [2009]

7. India pubmed.ncbi.nlm.nih.gov

Playful Educational Intervention for Improvement of Oral Health in Children with Hearing Impairment. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Oral care and sensory concerns in autism. [2012]