Sensory Challenges in the Dental Chair: Helping Neurodivergent Kids Feel Comfortable

Image of dental hygienist giving girl a high five in dentist office with the title of the article in text over the image

Sensory sensitivities, such as heightened reactions to sounds, tastes, textures, and bright lights, affect up 16% of children in the U.S.1 These sensitivities are much more common in neurodivergent kids and consequently they can find dental visits particularly overwhelming.1 Such sensory challenges can also interfere with consistent and effective preventative care at home. In this article, we’ll explore how dental professionals can create more supportive experiences in the clinic, along with helpful strategies for families to improve everyday oral care routines.

What are Sensory Sensitivities?

Sensory processing is part of normal development and is a complex set of behavioral interpretations and reactions to everyday sensory experiences.1  It supports regular functioning by helping us self-regulate, interact socially, and develop adaptive behavioral skills and abilities. However, sensory processing can become a problem when it interferes with one’s functioning in daily life.1

Current estimates indicate that 5% to 16.5% of the general population have symptoms associated with sensory processing challenges. However, these figures are considerably higher for populations such as those with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD).1 In the US, 1 in 36 children have been identified with ASD and around 10% of children and adolescents aged 4–17 have ADHD.3,4

 

69%–93%

Prevalence of sensory symptoms in people with ASD2

 

In neurodivergent children, sensory sensitivities or responsiveness can be classified into three main categories:1,2

  • Hypersensitivity:
    Over-reactivity to sensory input, such as covering ears to a sound

  • Hyposensitivity:
    Under-reacting to the sensory environment such as not turning to a loud noise

  • Sensory seeking:
    Over interest in aspects of the sensory environment including prolonged looking or repetitive touching
Sensory Sensitivity and Dental Visits

For neurodivergent children, a typical dental visit can feel overwhelming compared to neurotypical kids.5 Bright lights, unfamiliar sounds, strong smells, and new textures can easily trigger discomfort or distress. This can lead to dental anxiety, avoidance of appointments, fear of procedures and sub-optimal preventative care at home.

Let’s look at how these sensitivities can affect children and how making small adjustments can make your dental practice less threatening and more welcoming for these young patients:

Sensory Challenges for Young Neurodivergent Patients
Preparing for a Visit

Being familiar with the patient’s medical history is essential. This will help with treatment planning but also indicate if a child needs additional support or adjustments during the consultation.6 A specific sensory questionnaire on likes and dislikes can also provide more detailed information.

Prior to the appointment, your team could:

  • Give parents and children information or links to online resources to prepare them for what to expect and reduce distress7
  • Tell parents to bring items that may help the child relax more at the appointment7
  • Provide a longer appointment time for neurodivergent patients to allow them to become comfortable in unfamiliar surroundings, and as communication may take longer8
  • Make reception staff aware the patient has sensory sensitivities so they can interact in an appropriate way and make allowances such as directing them to a quiet waiting area9
During the consultation

Setting clear expectations in a positive way will help young neurodivergent patients navigate the sensory journey of a dental appointment.7 Let them have their own distracting or comforting items provided they don’t interfere with treatment.8

Agreeing the use of stop signals such as raising a hand can be practised before the procedure, possibly as part of a ‘Tell-Show-Do’ procedure. This is using appropriate language to explain what will happen, demonstrating on a hand or inanimate object before performing the procedure.7

Here are few signs to look out for and how to help support kids:5-10
Sensory Sensitivity and Possible Response
Support and Adaptations
Auditory (sounds):
Hypersensitivity:
  • Pain, discomfort or covering ears at sound of dental instruments
  • Distress and confusion
  • Irritation at background noise
  • Avoiding people or places
Hyposensitivity:
  • Not hearing or appearing unresponsive
  • Unaware of volume of own voice (shouting or whispering)
Sensory seeking:
  • Repeatedly request instruction or asking about equipment or procedures
  • Use or provide ear plugs to block out sounds
  • Headphones or a smart speaker to play own choice of soothing music or a story
  • Ask parent to speak calmy to the child during the visit
  • Shutting doors and windows to reduce external sounds
  • Turning off unnecessary equipment such as extractor fans or radios
  • Providing clear and simple instruction
  • Put a sign on the practice door to avoid unexpected interruptions
Visual / Light
Hypersensitivity:
  • Headaches/migraines, and pain
  • Distress and confusion
  • Avoiding bright light
Hyposensitivity:
  • Inability to see or process visual information
  • Difficulty with depth perception
Sensory seeking:
  • Focus on small details
  • Provide sunglasses
  • Turn off unnecessary lighting
  • Turn down or turn up lighting as required
  • Draw blinds on windows
Smell:
Hypersensitivity:
  • Nausea or feeling unwell as a reaction to strong smells such as antiseptics, latex gloves or fluoride products
  • Refusal to open mouth
Hyposensitivity:
  • May find products taste bland
Sensory seeking:
  • Seeking out stronger tastes and flavors
  • Reducing overpowering smells
  • Opening windows to improve ventilation and dissipate smells
  • Bringing an acceptable or favorite scent or oil on a handkerchief to sniff during appointment
Taste:
Hypersensitivity:
  • Discomfort or extreme reactivity at being touched or the sensation of oral examination
  • Dislike the feel of dental instruments or texture of products such as polishing paste
Hyposensitivity:
  • May find products taste bland
Sensory seeking:
  • Seeking out stronger tastes and flavors
  • Use bland or flavor free products
  • Use water instead of mouth rinse
Touch and Texture:
Hypersensitivity:
  • Discomfort or extreme reactivity at being touched or the sensation of oral examination
  • Dislike the feel of dental instruments or texture of products such as polishing paste
Hyposensitivity:
  • May not react to pain or injury
  • Poor self-awareness of own oral hygiene
Sensory seeking:
  • May seek out oral stimulation such as chewing on dental instruments
  • Explain and gain permission for touching and oral investigation
  • Set boundaries and allow child to feel a sense of control
  • Agree a signal to stop at any time
  • Begin the examination gently to gauge what the child can tolerate
  • Provide a stress ball or comforting toys

 

The Impact of Sensory Sensitivity on Preventative Care

Children with sensory challenges may find toothbrushing uncomfortable or even painful, leading to avoidance or sub-optimal oral hygiene habits at home. For example, the texture of toothbrush bristles, the taste or foaming of toothpaste, or the sensation of brushing itself can all be off putting.

 

Up to 73%

Of parents of ASD children reported difficulty
with their child’s toothbrushing on a daily basis11

 

Also, over 50% of parents of children with ASD reported that their child required “some or complete” physical assistance with toothbrushing compared to 28% of parents of neurotypical children.10

What can we do to help neurodivergent kids with sensory sensitivities when they’re away from the practice?

The AAPD recommends establishing a “Dental Home” for kids, especially those with special care needs. This provides coordinated and personalized oral care through an ongoing relationship between the dental professional and the patient and their family.6

Utilizing automation can help neurodivergent children with more effective brushing. Willo is the fully automated toothbrush that makes brushing easy: 

  • Proven to remove 7X MORE plaque in hard-to-reach areas12
  • A controlled, consistent clean without over-stimulation, every time
  • State-of-the-art OtpiClean brush head delivers correct brushing technique at the push of a button 
  • Sensory-friendly toothpaste that’s SLS-free and minimal flavor and texture
  • Mess-free: Dispenses the perfect amount of toothpaste and built-in suction system removes excess liquid—no spitting, no mess
  • Motivational app tracks brushing and rewards healthy habits
Summary

Sensory sensitivities can make oral hygiene more challenging, both in the dental practice and at home. However, with thoughtful planning, small adjustments, and your supportive preventive care, neurodivergent children can absolutely achieve the same standard of oral health as their neurotypical peers!

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References:
1. Miller L, et al. Identification of Sensory Processing and Integration Symptom Clusters: A Preliminary Study. Occup Ther Int. 2017;Nov:1–10. 
2. McCormick C, et al. Sensory symptoms in children with autism spectrum disorder, other developmental disorders and typical development: A longitudinal study. Autism. 2016;20(5):572–579. 
3. CDC. Data and Statistics on Autism Spectrum Disorder
Available at: https://www.cdc.gov/autism/data-research/?CDC_AAref_Val=https://www.cdc.gov/ncbddd/autism/data.html Accessed April 2025.
4. Yanmei L, et al. Prevalence and Trends in Diagnosed ADHD Among US Children and Adolescents, 2017-2022. AMA Network Open. 2023;6(10):e2336872.
5. Treating Children with Autism Spectrum Disorders. Autism Treatment Network. Available at: https://echoautism.org/wp-content/uploads/2025/01/Dental-Professionals-Tool-Kit.pdf Accessed April 2025.
6. American Academy of Pediatric Dentistry. Management of dental patients with special health care needs. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2023:337-44.
7. Langridge M, et al. Supporting anxious children through dental care. Dental Health. 2023;62(6):42–46.
8. National autistic society. Making dental practices more autism friendly. Available at: https://www.autism.org.uk/advice-and-guidance/professional-practice/dental-practice Accessed April 2025.
9. American Academy of Pediatric Dentistry (AAPD). Behavior guidance for the pediatric dental patient. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2024:358-78.
10. NHS Sensory-friendly resource pack. Available at: https://www.england.nhs.uk/long-read/sensory-friendly-resource-pack/#_edn1 Accessed April 2025.
11. Stein L, et al. Oral care experiences and challenges in children with autism spectrum disorders.  Pediatr Dent. 2012;34:387-91.
12. Willo. Data on File.

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