Sensory Integration Education

Sensory over-responsivity or oversensitivity, a type of sensory processing difference, occurs in individuals with a variety of diagnoses and disabilities and, in some cases, an individual might present with sensory differences in the absence of any other diagnoses. Studies suggest that up to 16% ^1,2  of the population present with differences in sensory processing and integration that impact on their ability to participate in daily activities. In a dental practice, for example, it is quite likely that some patients will present with sensory over-responsivity or oversensitivity and so it would be beneficial for dental professionals to have a better understanding of this. Individuals who are over-responsive to sensory input will present with over-reactions to sensations that others might not find noxious that can range from mild to severe, depending on the stimuli received and the overall amount of stimuli the individual is being exposed to. 

For individuals with sensory over-responsivity, dentist visits can present with a number of sensory challenges and so it would be helpful for dental professionals to be aware of these and have strategies that will help make the dental visits more pleasant for all involved. Firstly, over-responsivity can mean that the sensation of someone actually touching and working in that individual’s mouth can be too much for them. Secondly, they could be over-responsive to sensations in the environment like the sights, sounds, and smells of a dental practice. As a result, individuals with sensory differences can refuse dental treatment or display behaviours which can include physical withdrawal, blocking of the stimuli, vocal outbursts, aggressive behaviours and tantrums. 

Someone with sensory differences that presents with sensory over-responsivity may display some of the following behaviours as a result of processing sensory information: 

• Tendency to pull away from or over-react to unanticipated touch, particularly touch to the face
• Over-sensitivity to teeth cleaning by the hygienist
• Fear responses to moving backwards in the dental chair
• Difficulty tolerating the bright light above their head
• Fear responses to the noises of the dental equipment such as the polishing brush
• Fear responses to unexpected clinic noises, such as intercoms, door alarms or machines beeping
• Extreme dislike of the polishing paste due to the texture or taste
• Over-reactive gag responses to dental tools or x-ray materials
• Responses to the smell of rubber gloves or other equipment

Fortunately, there are tips and strategies that dentists can use to accommodate these sensory sensitivities in order to make dental visits a more pleasant experience for individuals with sensory differences. This can include environmental adaptations like dimming the lights, or using quieter tools, or slowly introducing new sensations. Another strategy that parents, caregivers and dental staff should be aware of is the use of deep pressure or heavy work.

Deep touch pressure is firm touch provided to the skin and can be done through tight compression clothing, heavy weighted clothing, or lying under something heavy amongst other things. Heavy work includes any activity that provides resistance to the muscles and joints of the body such as pushing or pulling something heavy for example. Using deep touch pressure and/or heavy work before and during events that individuals find distressing like going to the dentist can help calm someone who is over-responsive to sensory input. 

Deep touch pressure can be incorporated during a dental visit by having the individual with sensory over-responsivity wear an X-ray vest during the entire dental appointment to provide extra weight and deep pressure.³ Deep oral pressure (through chewing) before an appointment can also be calming and helpful for some individuals. For others, fidget toys can be helpful and dental staff could allow individuals who are over responsive to bright lights to wear something like an eye mask or similar to block out the light.⁴

Regarding auditory over-responsivity, calming music over headphones can be great for individuals who find the noises of the dental equipment distressing. Providing verbal warnings are also important to prepare individuals with sensory differences, particularly in relation to when sensory input will occur and the duration of the input.

In conclusion, dental visits can be overwhelming for individuals who are over responsive to sensory input and can lead to a lot of stress and anxiety in children, young people and adults who struggle with this. Having a dental professional who is understanding of an individual’s sensory needs and preferences and who attempts to make the experience as comfortable as possible can make the world of difference and also contribute to improved oral health for those who would avoid dental care otherwise.

PS All 8 senses can be affected by visits to the dentist. Check out our free course ‘Discover Sensory Processing and Integration’ to learn more about these 8 senses and functions.  

References 

1. Ben-Sasson A., Hen L., Fluss R., Cermak S. A., Engel-Yeger B., Gal E. A meta-analysis of sensory modulation symptoms in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders. 2009;39(1):1–11. doi: 10.1007/s10803-008-0593-3.
2. Ahn R. R., Miller L. J., Milberger S., McIntosh D. N. Prevalence of parents’ perceptions of sensory processing disorders among kindergarten children. American Journal of Occupational Therapy. 2004;58(3):287–293. doi: 10.5014/ajot.58.3.287.
3. 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.
4. Fallea, A., Zuccarello, R., Roccella, M., Quatrosi, G., Donadio, S., Vetri, L., & Calì, F. (2022). Sensory-Adapted Dental Environment for the Treatment of Patients with Autism Spectrum Disorder. Children, 9(3), 393. https://doi.org/10.3390/children9030393