Sensory-Informed Care in Dentistry: Improving Patient Comfort and Clinical Outcomes

For many patients, a visit to the dentist is routine, but for others, it can feel overwhelming, unpredictable, and even intolerable. Sensory processing differences refer to how the brain takes in and responds to sensory stimuli. These differences play a key role in how patients experience the dental environment. These challenges are common among people with autism, ADHD, dementia, anxiety, PTSD, and other conditions.¹ They are often misunderstood or overlooked in everyday practice.

The dental setting is full of sensory stimuli. There are bright lights, high-pitched handpieces, strong smells, unfamiliar tastes and textures, and constant physical touch, which can easily become overstimulating for patients with sensory sensitivities. When clinicians identify these challenges and adjust their approach, they can greatly improve patients' comfort, cooperation, and overall oral health outcomes.

Sensory processing differences generally fall into two categories: hypersensitivity and hyposensitivity. Patients who are hypersensitive may experience everyday stimuli as intense or even painful. The sound of the suction or the feel of a prophy paste may cause distress. On the other hand, patients who are hyposensitive may be sensory seeking. They may appear restless or need more movement or pressure to feel regulated. Understanding these patterns helps clinicians better recognize and understand patient behaviors.

It is important to rethink what is often labeled as “noncompliance” or “misbehavior.” A patient who pulls away, becomes rigid, or refuses treatment is not necessarily being difficult. These behaviors are often a response to sensory overload. When we start to see behavior as communication instead of non-cooperation, it can change how we approach care and improve outcomes for both the patient and the dental team. I have worked with patients who were labeled “noncompliant,” but once we slowed down, addressed their sensitivities and concerns, gave them a greater sense of control, and they were able to successfully complete treatment.

Common sensory triggers in dentistry include sounds from handpieces and suction, bright lights and quick movement, and the feel of instruments and gloves. Smells from materials and disinfectants can also be distressing.² I have had patients who could tolerate everything except the suction, which immediately triggered distress. Additionally, procedures such as reclining the chair, water accumulation, and unexpected touch can increase discomfort. For many patients, the loss of control during treatment can further intensify these sensory challenges.

Dental hygienists are uniquely positioned to identify and respond to these needs. Small adjustments can make a considerable difference. Preparation before the appointment is key. When possible, gathering information from patients or caregivers about sensory sensitivities and past experiences allows for a more individualized approach. A simple pre-visit questionnaire can be incredibly helpful. Desensitization strategies, such as mock visits at home, office tours, or meeting staff on a date other than the actual visit, can be helpful. Using visual aids can also help patients feel better prepared.

Simple changes to the environment can make a noticeable difference. Using lower lighting or offering dark sunglasses can reduce visual discomfort. Noise-canceling headphones or calming music can help minimize overstimulating sounds. Minimizing strong smells and keeping the operatory as calm and uncluttered as possible may further support sensory regulation. Even the use of a weighted blanket, weighted lap pad, or lead apron can provide calming proprioceptive input for some patients.

Communication plays a key role in sensory-informed care. Using clear, simple language and explaining each step before it happens can reduce anxiety. Using a tell-show-do approach at a slower pace allows patients time to process the information. Offering choices, even small ones like the toothbrush color, can restore a sense of control. Having a stop signal gives patients a way to let you know when they need a break. For some patients, just knowing they can stop the procedure if needed makes all the difference.

During treatment, moving at the patient's pace and staying flexible is key. Slow transitions, particularly when moving the dental chair, can prevent disorientation. Frequent breaks and shorter appointments may be necessary. Watch for signs of distress, such as changes in breathing, body tension, or withdrawal, and respond quickly.

Creating a sensory-friendly dental environment does not require a complete overhaul of the office. Instead, it involves a shift in awareness and a commitment to patient-centered care. When dental clinicians understand sensory processing differences and adjust their approach, they can improve the patient experience and increase access to care for populations who often face significant barriers.³

This goes beyond comfort; it’s about dignity, trust, and giving every patient access to care. Recognizing and addressing sensory challenges can make a vast difference in the experience for vulnerable patients.

References:

1. Patil O, Kaple M. Sensory processing differences in individuals with autism spectrum disorder: a narrative review of underlying mechanisms and sensory-based interventions. Cureus. 2023;15(10):e48020. doi:10.7759/cureus.48020
2. Stein LI, Polido JC, Mailloux Z, Coleman GG, Cermak SA. Oral care and sensory sensitivities in children with autism spectrum disorders. Spec Care Dentist. 2011;31(3):102-110. doi:10.1111/j.1754-4505.2011.00187.x
3. Nelson LP, Getzin A, Graham D, Zhou J, Wagle EM, McQuiston J, McLaughlin S, Govind A, Sadof M, Huntington NL. Unmet dental needs and barriers to care for children with significant special health care needs. Pediatr Dent. 2011;33(1):29-36.

Lisa Curbow, BAAS, RDH
[email protected], 1024 Hudnall Dr. Tyler, TX 75701, 903-571-0948