Researchers investigated the effectiveness of tracking stress responses in patients with autism spectrum disorder to improve cooperation during dental treatment.
Autism spectrum disorder is characterized by challenges in social interaction, communication, and sensory processing, which can make dental treatment particularly difficult for affected patients. As a result, dental care for pediatric patients with autism spectrum disorder often requires patient-centered approaches that address sensory sensitivities, communication barriers, and behavioral issues.
Electrodermal activity was employed in this research to detect changes in skin conductance levels and responses by measuring sympathetic nervous system changes. Two categories of EDA response were defined: phasic change (rapid skin conductance responses resulting from sympathetic neural activity) and tonic change (smooth, gradual changes in the EDA response signal that occur in the absence of stressful stimuli).
In a case series study, published in Cureus, the investigators explored the use of electrodermal activity to measure physiological stress responses to dental stimuli in three pediatric patients with autism spectrum disorder—with the goal of evaluating strategies designed to enhance cooperation during dental treatments in a sensory-adapted dental environment. The study involved a 12-year-old girl, an 8-year-old boy, and a 6-year-old child, each with moderate autism spectrum disorder.
EDA was measured using pre-gelled electrodes on the non-dominant hand's index and middle fingertips, recorded for three minutes before and during the dental procedure.
The investigators noted that electrodermal activity was an effective tool for monitoring stress responses in these patients. Stressful stimuli were found to elicit increased phasic activity during periods of sudden or bright lights, in unfamiliar settings, and in confined spaces. However, calming stimuli resulted in tonic changes.
Interventions that were tailored to each individual patient's needs helped reduce stress levels and improve both cooperation and comfort during dental treatment. These interventions included:
- Firm pressure
- Dim lighting
- Avoidance of loud noises
- Sensory toys
- Social stories
- Music
- Desensitization and video modeling techniques
- Weighted lap pads
- Oral massagers
- Use of manual scaling instead of ultrasonic scalers to avoid sensory overload
The investigators emphasized that electrodermal activity may be effectively applied to monitor patients' stress responses and allow physicians to react with techniques designed to promote comfort. Dental environments should be adapted to accommodate the unique needs of these patients. The investigators further suggested that physicians collaborate with occupational therapists and dentists to eliminate treatment-related stress.
"These findings highlight the importance of adapting dental environments and protocols to accommodate the unique needs of children with [autism spectrum disorder], with collaborative efforts from occupational therapists and dentists," concluded the study authors.
The study suggests that this approach could potentially benefit not only children with ASD but also those with other disabilities and typically developing children with dental anxiety or sensory processing difficulties.
No conflicts of interest were disclosed.