Comparison of Sensory-Adapted and Regular Dental Environments During Professional Oral Hygiene in Children with Mild Intellectual Disability and Moderate Dental Anxiety: A Randomized Clinical Trial

Background and Objectives: Children with mild intellectual disability (MID) frequently experience difficulties during dental treatment due to increased sensitivity to environmental stimuli and limited cooperation. Sensory-adapted dental environments (SADE) have been proposed as a strategy to improve the dental experience of patients with neurodevelopmental conditions; however, evidence regarding their effectiveness in children with MID remains limited. This randomized clinical trial aimed to evaluate the effects of a sensory-adapted dental environment on pain-related behaviors and treatment cooperation during professional oral hygiene procedures in children with MID and moderate dental anxiety. Materials and Methods: A randomized clinical trial was conducted at the IRCCS Oasi Research Institute (Troina, Italy). A total of 200 children were screened for eligibility. Following the application of the predefined inclusion and exclusion criteria, 160 children (76 males and 84 females; age range: 6–7 years) with a diagnosis of mild intellectual disability (MID) and moderate dental anxiety, assessed using the Corah Dental Anxiety Scale (DAS), were enrolled. Participants were randomly assigned to either a sensory-adapted dental environment (SADE; n = 80) or a regular dental environment (RDE; n = 80). All participants underwent a single session of professional oral hygiene using an ultrasonic scaler. Pain-related behaviors were assessed using the Face, Legs, Activity, Cry, Consolability (FLACC) Scale, whereas cooperation during treatment was evaluated using the Frankl Behavior Rating Scale. Owing to the non-normal distribution of the outcome variables, between-group comparisons were performed using the Mann–Whitney U test. Statistical significance was set at p < 0.05. Results: Participants treated in the SADE showed significantly lower FLACC scores compared with those treated in the RDE (3.10 ± 1.86 vs. 5.05 ± 2.36, p < 0.001), indicating reduced pain-related behaviors during treatment. Moreover, children in the SADE group demonstrated significantly higher Frankl scores than those in the RDE group (2.78 ± 0.48 vs. 2.41 ± 0.84, p = 0.006), reflecting improved cooperation. Sex-stratified analyses confirmed significantly lower FLACC scores in both males and females treated in the SADE. No significant Group × Sex interaction was observed for either outcome, suggesting that the beneficial effects of sensory adaptation were independent of sex. Conclusions: SADE significantly reduced pain-related behaviors and improved cooperation during professional oral hygiene procedures in children with mild intellectual disability and moderate dental anxiety. These findings support the implementation of sensory-adapted strategies in pediatric dental settings to improve treatment experiences and facilitate dental care for children with neurodevelopmental disorders.