Sensory integrative dysfunction

My son was just diagnosed with sensory integrative dysfunction. I have read this can lead to dental problems. How will this condition affect his teeth?

Question:

Senses include touch, smell, taste, vision and hearing. Sensory integration is the ability to combine information from these senses with prior information and knowledge to form an appropriate response.

With sensory integrative dysfunction, sensory responses vary. Some patients with this condition may lose all ability to function normally, while other reactions may be so subtle, they may go unrecognized. Dr. A. Jean Ayres was an occupational therapist who first discussed sensory integration in detail. More information about sensory integration dysfunction can be found in her book, "Sensory Integration and the Child".

If your son has a sensory defensiveness, he may have a highly aroused nervous system. His nervous system may not recognize common sensory input as non-threatening. For example, he may not tolerate daily routines such as shampooing hair, cutting fingernails or brushing teeth. It may be difficult for your son to tolerate daily oral hygiene habits. He may react with tantrums when his teeth are flossed. If you are having difficulty brushing his teeth, you might try different brands of toothbrushes or different sizes of toothbrushes. Extremely soft bristles are often tolerated. Try running the toothbrush under warm water before brushing his teeth. Try different brands and types of toothpastes. Different flavors or different consistencies may make brushing more bearable. If not, try brushing without toothpaste. This alternative is better than not brushing at all.

Sensory integrative dysfunction may also cause difficulties during dental visits. Oral-motor defensiveness may cause the same intolerance to dental instruments that is present during tooth brushing. Auditory defensiveness may cause negative responses to certain sounds including the high speed handpiece (also know as the dental drill). I think everyone finds that sound irritating! Visual defensiveness may cause intolerance to the overhead dental lamp. Olfactory defensiveness may trigger a gagging reflex or lead to distress when certain odors are encountered.

Most dentists are unfamiliar with this relatively rare dysfunction. It is important for you to mention your son's condition to his dentist and discuss the dental implications. Feel free to share this message with him to begin a constructive dialog. Extra care and patience will be required when new dental instruments, smells, sounds and procedures are introduced to your son. If your dentist has difficulty making a proper diagnosis or completing a procedure, sedation or general anesthesia may be the most viable alternative.

Hopefully, you are working with a qualified and competent professional such as an occupational or physical therapist. He or she should be able to make a proper evaluation of the disorder and assist with treatment.

For more information about sensory integrative disorder, you can call The Ayres Clinic at 1-310-320-2335. The following article may also be helpful:

Ottenbacher K., et al., "Sensory integrative dysfunction in children: A review of theory and treatment" Advances in Developmental and Behavioral Pediatrics (1985) 6:287-330.

I hope this information is helpful for you, your son, and your dentist!

References:

Stephens, Linda, "Sensory integrative dysfunction in young children" AAHBEI News Exchange, Vol. 2, No. 1, Winter 1997.

Ayres, A. Jean, "Sensory integration and the child" Los Angeles: Western Psychological Services (1994).

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