Sensory Adapted Dental Environments to Enhance Oral Care for Children

感官适应牙科环境可增强儿童口腔护理

• 批准号: 9059069
• 负责人: Sharon Andrea Cermak
• 金额: $ 61.79万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-01 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9059069
• 关键词: Age; Anxiety; Area; Auditory; Behavioral; Butterflies; Characteristics; Child; Childhood; Clinic; Communication; Communities; Cost Savings; Crossover Design; Dental; Dental Anxiety; Dental Care; Dental Clinics; Dental Offices; Dentists; Diagnosis; Distress; Environment; Esthesia; Exhibits; Exposure to; Feasibility Studies; Fishes; General Anesthesia; Goals; Health; Healthcare; Intervention; Investigation; Lighting; Measures; Mediating; Modeling; Music; National Institute of Dental and Craniofacial Research; Oral cavity; Oral health; Outcome; Pain; Participant; Perception; Personal Satisfaction; Physiological; Population; Prevalence; Procedures; Protocols documentation; Public Health; Quality of Care; Randomized; Randomized Clinical Trials; Reaction; Research; Research Design; Sample Size; Savings; Sedation procedure; Sensory; Severities; Smell Perception; Subgroup; Tactile; Taste Perception; Testing; Texture; Touch sensation; Translating; U-Series Cooperative Agreements; Visit; Visual; Wing; Work; age group; aged; autism spectrum disorder; base; behavioral response; cost; cost effectiveness; design; disparity reduction; ethnic diversity; experience; innovation; intervention effect; novel; oral care; practical application; psychologic; response; sound; successful intervention; therapy design

 DESCRIPTION (provided by applicant): This project, which builds upon our previous R34 NIDCR Planning and Feasibility study, is designed to examine the efficacy of a sensory adapted dental environment (SADE) to enhance children's oral care. Two groups will be studied: children with autism spectrum disorders (ASD) and typically developing (TD) children. Children with ASD, and a subset of TD children, exhibit sensory over-responsivity when confronted with experiential aspects of dental visits such as exposure to bright fluorescent lighting, touch in or around the mouth, or the texture and smell of various oral care products. This often results in increased anxiety and negative behavioral responses, which hinder the dentist's ability to perform treatment. In the proposed project, we test a SADE intervention designed to reduce children's anxiety and negative responses during oral care. The SADE intervention includes adaptations such as dimmed lighting, moving projections on the ceiling (fish, bubbles), exposure to soothing music, and application of a butterfly vest with wings that wrap around the child to provide calming sensations. The specific aims are to conduct a randomized clinical trial in order to: 1. Determine if SADE, relative to a regular dental environment (RDE), reduces physiological anxiety and negative responses (behavioral distress, perception of pain, sensory discomfort) during dental cleaning for children with ASD and TD children and test whether SADE's effect is greater for the ASD group. 2. Identify whether physiological anxiety mediates the beneficial effects of the intervention and whether severity of ASD and communication ability (ASD group), or dental anxiety, sensory over-responsivity, and age (both groups) act as moderating variables. 3. Assess the quality of care and cost effectiveness/savings of the dental cleaning associated with SADE. Research participants will be 220 ethnically diverse children aged 6-12 years, 110 with ASD and 110 TD. Using a randomized counterbalanced study design, each child will undergo two dental cleanings four months apart: one dental cleaning in RDE and one dental cleaning in SADE. This project is significant because it is the first full-scale trial of an intervention designed to reduce oral care problems in children with ASD. It is theoretically important because it will elucidate the mechanisms that underlie the effects of the SADE intervention and help to identify which subgroups of children, both TD and with ASD, which will benefit most from this approach. Based on the study findings, we will develop a model to transform the standard of pediatric dental care by modifying the sensory qualities of the dental environment; this model will have the potential to be utilized in dental clinics worldwide. As such the project promises to have a major public health impact insofar as the potential gains in oral health, child comfort, and cost-savings will be dramatic, potentially applying to more than one-fourth of all children.

 描述（由申请人提供）：该项目以我们之前的 R34 NIDCR 规划和可行性研究为基础，旨在检查感觉适应牙科环境 (SADE) 对增强儿童口腔护理的功效。将研究两组：患有自闭症谱系障碍（ASD）的儿童和典型发育（TD）的儿童。患有自闭症谱系障碍 (ASD) 的儿童和一部分 TD 儿童在面对看牙医的体验时，例如暴露在明亮的荧光灯下、触摸口腔内部或周围，或各种口腔护理产品的质地和气味时，会表现出感觉过度反应。这通常会导致焦虑和负面行为反应增加，从而阻碍牙医进行治疗的能力。在拟议的项目中，我们测试了一项 SADE 干预措施，旨在减少儿童在口腔护理期间的焦虑和负面反应。 SADE 干预措施包括调暗灯光、天花板上移动投影（鱼、气泡）、聆听舒缓的音乐以及使用带有翅膀的蝴蝶背心包裹孩子以提供镇静的感觉。 具体目标是进行一项随机临床试验，以便： 1. 确定相对于常规牙科环境 (RDE)，SADE 是否可以减少 ASD 和 TD 儿童在洗牙过程中的生理焦虑和负面反应（行为困扰、疼痛感、感觉不适），并测试 SADE 对 ASD 组的效果是否更大。 2. 确定生理焦虑是否介导干预的有益效果，以及自闭症谱系障碍的严重程度和沟通能力（自闭症谱系障碍组），或牙科焦虑、感觉过度反应和年龄（两组）是否充当调节变量。 3. 评估与 SADE 相关的牙齿清洁的护理质量和成本效益/节省。 研究参与者将是 220 名 6 至 12 岁的不同种族儿童，其中 110 名患有自闭症谱系障碍 (ASD) 和 110 名 TD。采用随机平衡研究设计，每个孩子将间隔四个月接受两次牙齿清洁：一次在 RDE 中清洁牙齿，一次在 SADE 中清洁牙齿。 该项目意义重大，因为它是旨在减少自闭症谱系障碍儿童口腔护理问题的干预措施的首次全面试验。它在理论上很重要，因为它将阐明 SADE 干预效果的机制，并有助于确定哪些儿童亚组（TD 和 ASD）将从这种方法中受益最多。根据研究结果，我们将开发一个模型，通过改变牙科环境的感官质量来改变儿科牙科护理的标准；该模型将有可能在全球牙科诊所中使用。因此，该项目有望对公共卫生产生重大影响，因为口腔健康、儿童舒适度和成本节约方面的潜在收益将是巨大的，可能适用于超过四分之一的儿童。