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: 9262201
• 负责人: Sharon Andrea Cermak
• 金额: $ 62.2万
• 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/9262201
• 关键词: Age; Anxiety; Area; Auditory; Behavioral; Butterflies; Characteristics; Child; Child Care; 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; Healthcare; Intervention; Intervention Trial; Investigation; Lighting; Measures; Mediating; Modeling; Music; National Institute of Dental and Craniofacial Research; Oral cavity; Oral health; Outcome; Pain; Participant; Perception; 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; Treatment Cost; 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; public health relevance; 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（由适用提供）：基于我们以前的R34 NIDCR计划和可行性研究，该项目旨在检查感官适应的牙齿环境（SADE）以增强儿童口腔护理的有效性。两组将研究：自闭症谱系障碍（ASD）和通常发育（TD）儿童的儿童。当面对牙科探访的专家方面，例如暴露于明亮的荧光照明，嘴中或周围的牙齿或各种口腔护理产品的质地和气味时，患有ASD的儿童和TD儿童的子集和TD儿童的子集表现出感觉过高的反应性。这通常会导致焦虑和负面的行为反应增加，这阻碍了牙医的治疗能力。在拟议的项目中，我们测试了旨在减少儿童动画和口腔护理中负面反应的SADE干预措施。 Sade干预包括改编，例如昏暗的照明，天花板上移动的项目（鱼，气泡），暴露于舒缓的音乐中，以及带有翅膀的蝴蝶背心的应用，这些背心缠绕着孩子，以提供平静的感觉。具体的目的是进行一项随机临床试验，以便以下方式：1。确定Sade相对于常规牙齿环境（RDE）是否相对于定期的牙齿环境（RDE），减少了身体焦虑和负面反应（行为困扰，对疼痛的感知，感觉不适，感觉不适）在患有ASD和TD儿童的儿童的牙科清洁过程中，以及SADE对ASD组的影响是否更大。 2.确定身体动画是否介导干预措施的有益效果，以及ASD和沟通能力的严重程度（ASD组），还是牙科动画，感觉过度反应性和年龄（两组）起作用的变量。 3。评估与Sade相关的牙科清洁的护理质量和成本效益/节省的质量。研究参与者将为6-12岁的220名种族多样化的儿童，110岁的ASD和110 TD。使用随机平衡的研究设计，每个孩子将相隔四个月进行两次牙齿清洁：一台RDE的牙齿清洁和Sade中的一个牙齿清洁。该项目之所以重要，是因为它是旨在减少ASD儿童口腔护理问题的干预措施的首次全面试验。从理论上讲，这很重要，因为它将阐明萨德干预措施影响的机制，并有助于确定哪些儿童亚组TD和ASD都将从这种方法中受益最大。根据研究发现，我们将开发一个模型来通过修改牙科环境的感觉品质来改变小儿牙科护理的标准。该模型有可能在全球牙科诊所中使用。因此，该项目有望在口腔健康，儿童舒适和节省成本的潜在收益中产生重大的公共卫生影响，这可能是戏剧性的，有可能适用于所有儿童中四分之一以上。