Pharmacological and Sensory-Adaptive Interventions for Dental Anxiety in Children with Autism Spectrum Disorder: A Scoping Review of the Parallel Evidence Base

Children with Autism Spectrum Disorder (ASD) frequently experience significant difficulty accessing dental care due to atypical sensory processing, which can trigger acute behavioral crises during routine procedures. Clinicians currently address this through two parallel but largely unconnected approaches: behavioral/environmental modifications led by dental teams (e.g., sensory-adaptive environments, weighted blankets, noise-canceling headphones) and pharmacological anxiolysis led by medical professionals (e.g., benzodiazepines, alpha-2 agonists, nitrous oxide). This scoping review, conducted per PRISMA-ScR guidelines, maps both literatures in parallel rather than requiring studies that combine or compare the two modalities directly — a preliminary screen of 32 records found zero studies meeting that stricter criterion, indicating the evidence base does not yet support it. Instead, the review will (1) systematically map pharmacological interventions, (2) systematically map sensory-adaptive/behavioral interventions, (3) quantify how often studies combine or compare the two, (4) evaluate reported outcomes on procedure completion and distress mitigation within each modality, and (5) identify gaps in drug-environment interaction research to inform a future research agenda. Searches will be executed across PubMed, OpenAlex, Consensus AI, Google Scholar, and ClinicalTrials.gov, with blinded triple-reviewer screening via Rayyan.