Children’s Responses to Sensory Stimuli and their Behavior in the Dental Office

Objectives: To evaluate children's behavior during dental examinations, their reactions to various selected sensory stimuli and the association between them. Study design: Sixty-three children (28 boys and 35 girls) aged 5–12 years (mean age 7.9 ± 1.6 years) participated in the study. Their parents were asked to complete a questionnaire while in the dentist's waiting room. The dentists evaluated the children's behavior in the dental office using Frankl's behavioral scale and noted the children's reactions to the sensory stimuli of touch, noise, smell and backward tilting of the examination chair. Results: Most of the children cooperated during the dental examination. Lack of cooperation was associated with adverse reactions to all selected sensory stimuli. There was also an association between resistance to brushing teeth and adverse reaction to touch. Children who reacted negatively to sensory stimuli during dental examinations were more likely to have needed advanced management techniques during past dental treatment. Conclusions: Children's behavior during dental examinations is known to be affected by many factors, including age, previous experiences, anxiety and fear and others. This investigation demonstrates that it is also associated with their reactions to various sensory stimuli.

Children; Sensory stimuly; Behavior; Dentistry

1. Baier K, Milgrom P, Russell S, Mancl L, Yoshida T. Children’s fear and behavior in private pediatric dentistry practices. Pediatr Dent;26(4):316- 321. 2004.

2. Rud B, Kisling E. The influence of mental development on children’s acceptance of dental treatment. Scand J Dent Res;81(5):343-352. 1973.

3. Brill WA. The effect of restorative treatment on children’s behavior at the first recall visit in a private pediatric dental practice. J Clin Pediatr Dent;26(4):389-394. 2002.

4. Allen KD, Hutfless S, Larzelere R. Evaluation of two predictors of child disruptive behavior during restorative dental treatment. J Dent Child;70(3):221-225. 2003.

5. Cunha RF, Delbem ACB, Percinoto C, Melhado FL. Be havioral evaluation during dental care in children ages 0 to 3 years. J Dent Child;70(2):100- 103. 2003.

6. Klingberg G, Broberg AG. Temperament and child dental fear. Pediatr Dent;20(4):237-243. 1998.

7. Arnup K, Broberg AG, Berggren U, Bodin L. Lack of cooperation in pediatric dentistry: The role of child personality characteristics. Pediatr Dent;24(2):119-128. 2002.

8. Radis FG, Wilson S, Griffen AL, Coury DL. Temperament as a predictor of behavior during initial dental examina-tion in children. Pediatr Dent 1994;16(2):121-7.

9. Lochary ME, Wilson S, Griffen AL, Coury DL. Tempera ment as a predictor of behavior for conscious sedation in dentistry. Pediatr Dent;15(5):348- 352. 1993.

10. Jensen B, Stjernqvist K. Temperament and acceptance of dental treatment under sedation in preschool children. Acta Odontol Scand;60(4):231-236. 2002.

11. Arnup K, Broberg AG, Berggren U, Bodin L. Treatment outcome in subgroups of uncooperative child dental patients: an exploratory study. Int J Paediatr Dent;13(5):304-319. 2003.

12. Holst A, Hallonsten AL, Schroder U, Ek L, Edlund K. Prediction of behavior-management problems in 3-year-old children. Scand J Dent Res;101(2):110-114. 1993.

13. Klingberg G, Berggen U, Carlsson SG, Noren JG. Child dental fear: cause related factors and clinical effects. Eur J Oral Sci;103(6):405-412. 1995.

14. Johnson R, Baldwin DC. Maternal anxiety and child behavior. J Dent Child;36(2):87-92. 1969.

15. Peretz B, Nazarian Y, Bimstein E. Dental anxiety in a students’ pediatric dental clinic: children, parents and students. Int J Paediatr Dent;14(3):192- 198. 2004.

16. Ben-Sasson A, Carter AS, Briggs-Gowan MJ. Sensory over-responsivity in elementary school: prevalence and social-emotional correlates. J Abnorm Child Psychol;37(5):705–716. 2009.

17. Dunn W. Sensory processing as an evidence-based practice at school. Phys Occup Ther Pediatr;28(2):137-140. 2008.

18. Ahn RR, Miller LJ, Milberger S, McIntosh DN. Prevalence of parents’ perceptions of sensory processing disorders among kindergarten children. Am J Occup Ther;58:287–302. 2004.

19. Gouze KR, Hopkins J, LeBailly SA, Lavigne JV. Re-examining the epidemiology of sensory regulation dysfunction and comorbid psychopathology. J Abnorm Child Psychol;37(8):1077-1087. 2009.

20. Lane SJ, Miller LJ, Hanft BE. Toward a consensus in terminology in sensory integration theory and practice: Part 2: Sensory integration patterns of function and dysfunction. Sensory Integration Special Interest Section Quarterly;23(2):1-3. 2000.

21. Dunn W. The impact of sensory processing abilities on the daily lives of young children and their families: a conceptual model. Infant Young Child;9(4):3-35. 1997.

22. Miller LJ, Anzalone ME, Lane SJ, Cermak SA, Osten ET. Concept evolution in sensory integration: a proposed nosology for diagnosis. Am J Occup Ther;21:135-140. 2007.

23. Bar-Shalita T, Vatine J, Parush S. Sensory modulation disorder: a risk factor for participation in daily life activities. Dev Med Child Neurol;50(12):932– 937. 2008.

24. Spira G, Kupietzky A. Oral defensiveness: children with a dysfunction of sensory regulation. J Clin Pediatr Dent;29(2):119-122. 2005.

25. Miller-Kuhaneck H. http://www.spdfoundation.net/library/dentist.html

26. Shapiro M, Melmed RN, Sgan-Cohen HD, Eli I, Parush S. Behavioural and physiological effect of dental environment sensory adaptation on children’s dental anxiety. Eur J Oral Sci;115(6):479-483. 2007.

27. Shapiro M, Sgan-Cohen HD, Parush S, Melmed RN. Influence of adapted environment on the anxiety of medically treated children with developmental disability. J Pediatr;154(4):546-550. 2009.

28. Shapiro M, Melmed RN, Sgan-Cohen HD, Parush S. Effect of sensory adaptation on anxiety of children with developmental disabilities: a new approach. Pediatr Dent;31(3):222-228. 2009.

29. 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;45(9):2876-2888. 2015.

30. http://www.asahq.org/For-Members/Clinical-Information/ASA-Physical-Status-Classification-System.aspx

31. Frankl SN, Shiere FR, Fogels HR. Should the parent remain with the child in the dental operatory? J Dent Child;29:150-163. 1962.

32. Howenstein J, Kumar A, Casamassimo PS, McTigue D, Coury D, Yin H. Correlating parenting styles with child behavior and caries. Pediatr Dent;37(1):59-64. 2015.

33. Kyritsi MA, Dimou G, Lygidakis NA. Parental attitudes and perceptions affecting children’s dental behaviour in Greek population. A clinical study. Eur Arch Paediatr Dent;10(1):29-32. 2009.

34. Birardi V, Pasini F. Study about the effects of dental noises on the emotional experiences of children aged 6 to 10 years. A pilot study. Eur J Paediatr Dent;12(4):236-238. 2011.

35. Yu JF, Lee KC, Hong HH, et al. Human amygdala activation by the sound produced during dental treatment: a fMRI study. Noise Health;17(78):337- 342. 2015.