Question:  Hi, I am a dental hygienist looking for ideas on treating patients with SPD in the dental setting.  Can you give me some suggestions?  Thank you!

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If the patient has sensory issues in the mouth, then they may require a lot of desensitizing before they could even go to a dentist and/or tolerate anything in their mouth.  This oral sensitivity is also known as oral defensiveness.  For more background on this plus some ideas to help de-sensitize, click here.  And for some ideas on how to make toothbrushing more comfortable for individuals with oral defensiveness, click here.

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Most importantly, the individual would likely have to see a speech therapist and an occupational therapist with sensory experience to work on normalizing their sensitivities both inside and outside of the mouth (oftentimes when there are sensitivities inside the mouth, there are sensitivities outside the mouth throughout the body, too.  And typically you need to work on desensitizing the body before you can really do the mouth).

Aside from oral defensiveness (or in addition to it), there may also be other sensory triggers.  They may not like certain lights, sounds, smells, the feel of the chair, etc. for instance.  So you’ll need to figure out what the trigger(s) are to try to make them as minimal as possible, and also figure out what calms the child down.  For example, having a TV on may be too much for one child, but calming for the next.  Noise-canceling headphones would likely be a good staple to have in your office.  Even the sound of lights humming can be overstimulating for some kids, so the sound of dental tools would be much worse (and scary).  Weight and heavy proprioceptive input to the body can be very calming, so a weighted blanket (or even the weighted vest you use to take x-rays with) would likely be another staple.

On a related note, some children with sensory needs  chew on non-food items to calm down.  Oftentimes they will chew on whatever is within reach to get the oral input they need - pencils, fingernails, knuckles, their shirt, grinding their teeth, etc.  So you may want to recommend a safe outlet for them to meet that need, and/or some of these oral sensory strategies.

Keep in mind that you may have to take baby steps - for some clients just getting to the reception area will be a big achievement to celebrate.  Be sure to praise them for each milestone!  For others, skipping the reception area and going straight back may be less stressful.  Each child will be different.

I hope this is helpful.  Thank you for looking into this and trying to make dental hygiene more sensory-friendly!

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All my best, 

Debbie

Debra C. Lowsky, MS, CCC-SLP

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