Enhancing Pulp Therapy Outcomes in Children with Autism: A Sensory-adapted Dental Environment Approach

Children with autism spectrum disorder (ASD) exhibit heightened dental anxiety and uncooperative behavior due to sensory sensitivities and communication challenges. Pulp therapy (pulpotomy/pulpectomy) is a common, time-consuming procedure that is largely dependent on patient compliance.

This observational study was done to assess the effect of a sensory-adapted dental environment (SADE) on improving the outcomes of pulp therapy in children with autism aged 5-14 years, in comparison with conventional dental setting.

A total of 60 ASD patients, requiring pulp therapy, were randomly allocated into two groups: SADE (n = 30) and conventional environment (n = 30). Outcome measures included cooperation scores, anxiety ratings, treatment completion rates, procedure time, caregiver satisfaction, and physiological stress [heart rate (HR)].

Children in SADE showed significantly higher compliance and lower anxiety: mean cooperation scores (1-5 scale) were 4.6 ± 0.3 in SADE vs 3.2 ± 0.5 in controls (p < 0.001), and visual anxiety ratings (-10 scale) were 2.1 ± 1.0 vs 5.8 ± 1.2 (p < 0.001). Procedure completion was achieved in 93% of SADE cases vs 67% under conventional conditions (p = 0.01). HR increases during treatment were smaller in SADE (mean +5 bpm) than in controls (+15 bpm, p < 0.001). Caregiver satisfaction (Likert 1-5) averaged 4.7 in SADE vs 3.1 in controls (p < 0.001).

A multisensory-adapted environment markedly enhanced patient compliance and procedural efficiency in ASD children's pulp therapy, suggesting that SADE is a feasible nonpharmacologic strategy to mitigate anxiety and improve dental care outcomes.

Panigrahi A, Mohapatra A. Enhancing Pulp Therapy Outcomes in Children with Autism: A Sensory-adapted Dental Environment Approach. Int J Clin Pediatr Dent 2026;19(2):195-199.