Date Presented 03/23/24
Oral health is integral to well-being. Use of an OT-created sensory-adapted dental environment significantly decreases distress in autistic children. This presentation will describe the cost, quality, and satisfaction with this type of adapted care.
Primary Author and Speaker: Leah I. Stein Duker
Contributing Authors: Sharon A. Cermak, Jose Polido, Cynthia Gong
PURPOSE: A sensory adapted dental environment (SADE) is efficacious to reduce the physiological and behavioral distress commonly exhibited by autistic children during dental cleanings. However, successful translation of research interventions into clinical practice is complex, requiring careful consideration of multiple factors. Therefore, this study’s purpose was to examine cost, quality, and satisfaction of SADE.
METHOD: Children (n=162, 6-12yrs) underwent 2 dental cleanings 6mo apart (1 each in SADE & regular dental environment [RDE]) in a randomized & counterbalanced order. Outcomes included resource utilization metrics as cost proxies (e.g., duration, staffing); scored intraoral photographs (quality of care); & child/parent satisfaction with SADE (5-pt Likert-scale & open-ended items). Multivariate linear regressions & repeated measures ANOVA assessed cost & quality measures respectively. Descriptive statistics & content analysis of open-ended statements described satisfaction data.
RESULTS: No significant differences in cost or quality measures for care in SADE vs RDE. High satisfaction for SADE as reported by caregivers (M=4.6) and children (M=4.2). Parents stated that SADE improved child experience (M=4.4). Qualitative statements were overwhelmingly positive, illustrating positive experiences & describing adaptations that improved the encounter.
CONCLUSION: Enhancing oral care is critical for autistic children. Cleanings can be provided at the same quality in SADE vs RDE with no additional treatment-related costs, but with greater satisfaction. Interdisciplinary collaboration with dentistry is a new and evolving area for OT practice and research.
IMPACT: This study contributes knowledge about the use of sensory integration concepts in dentistry. OTs can be key players in oral health, spearheading collaborations to investigate adapting the dental experience for this population. The use of SADE has the potential to improve oral care for children.
References
Stein Duker, L. I., Como, D. H., Jolette, C., Vigen, C., Gong, C. L., Williams, M. E., Polido, J. C., Floríndez-Cox, L. I., & Cermak, S. A. (2023). Sensory adaptations to improve physiological and behavioral distress during dental visists autistic children: A randomized crossover trial. JAMA Network Open, 6, 1–14. 10.1001/jamanetworkopen.2023.16346
Como, D. H., Stein Duker, L. I., Polido, J. C., & Cermak, S. A. (2021). Oral health and autism spectrum disorders: A unique collaboration between Dentistry and Occupational Therapy. International Journal of Environmental Research and Public Health, 18, 1–10. https://doi.org/10.3390/ijerph18010135
Stein Duker, L. I. (2019). Adapting oral care protocols to support children with sensory sensitivities: Occupational Therapy and Dentistry. In T. Nelson & J.R. De Bord (Eds.), Dental care for children with special needs: A clinical guide (pp. 77–98). Switzerland: Springer.
Stein Duker, L. I., Floríndez, L. I., Como, D. H., Tran, C. F., Henwood, B. F., Polido, J. C., & Cermak, S. A. (2019). Strategies for success: A qualitative study of caregiver and dentist approaches to improving oral care for children with autism. Pediatric Dentistry, 41, 4E–12E.
