Oral Defensiveness
and
Oral Dysfunction
The most common signs of oral defensiveness, which are a symptom of sensory processing disorder, include gagging and avoidance of strong tasting foods. Of course this doesn't seem that much different than just your typical picky eater! However, depending on severity, this particular disorder is likely to affect an individual’s diet, possibly leading to weight management difficulties. They will have an extremely limited number of foods they are willing to eat and getting them to try something new is like asking them to do the impossible.
If a child has oral dysfunction with hyposensitivity, he/she may often put things into the mouth that are inedibles, also known as PICA. Chewy tubes or chewelry can help a child fulfill their desire for oral sensations in a more appropriate manner. An occupational therapist may also put together a sensory diet to help with these as well as other sensory processing disorder symptoms.
Individuals with oral defensiveness typically tend to avoid fruits and vegetables because they may taste very bitter, leading to a higher risk of certain disease as a result of nutritional deficiencies. Individuals that are under-reactive or hyposensitive to food are more prone to overeating sweets leading to excessive weight gain and higher risk of diabetes or heart disease. Symptoms may also be accompanied by tactile defensiveness, an auditory dysfunction, or proprioceptive dysfunction.
What does research show about oral defensiveness?
Research shows that about 25% of the population struggles with hypersensitivity to food and 25% of the population has a difficulty with hyposensitivity to food as the result of tongue related genetics. One way to determine whether this is contributing to you or your child’s oral defensiveness or hyposensitivity to food is by doing the blue tongue test.
The Blue Tongue Test: Dab a small amount of blue food coloring on an area of you or your child’s tongue. Then take a piece of paper with a hole the size of a three-ring paper hole punch and place it over the blue area of your tongue. Using a magnifying glass, you will see small circles of pink colored tissue that polka-dot the blue area of your tongue. These are called the papillae.
Count the little pink dots you see in the hole. If you count fewer than five dots, it means you are an undertaster and likely suffer from hyposensitivity to food. If you count more than 30 dots, you or your child most likely struggle with oral defensiveness and can be referred to as a supertaster.
Personally, I find myself to be an undertaster and I have a horrible sweet tooth! For me it’s really all or nothing when it comes to sweets because just one turns into a downward spiral of many more. Depending on your results, this does not necessarily indicate you or your child has a sensory disorder in relation to oral dysfunction.
I don’t experience all of the symptoms below to indicate a sensory disorder. However, these tongue genetics may be a contributing factor for an individual that does have a sensory disorder. It may also explain for some individuals why they have a difficult time staying away from sweets or incorporating fruits and vegetables into a diet.
Symptoms of Oral Defensiveness and Dysfunction
Oral Defensiveness
• Picky eater based on textures, temperatures of food and new flavors.
• May gag at times or only desire to eat pureed foods
• Difficulty sucking, chewing, or swallowing
• May have frequent choking incidents
• Avoids spicy, extra sweet, sour, or salty foods
• Oversensitive to toothpaste and mouthwash and dislikes going to the dentist
• Dislikes licking envelopes, stamps or stickers because of taste
Hyposensitivity to oral input
• Symptoms of PICA – putting inedible objects in the mouth to lick, taste or chew
• Prefers flavorful food including very spicy, sweet, sour, or salty
• Drooling past the teething stage
• Chewing on hair, shirt or fingers
• Difficulty distinguishing between different tasting foods
• Loves condiments and seasonings
• Likes vibrating toothbrushes and trips to the dentist
Treatment
SPD treatments, such as sensory integration therapy, certain sensory toys and occupational therapy can be very effective in helping to reduce the symptoms of oral defensiveness and input dysfunction. This type of therapy combines sensory input with motion to help the child engage in appropriate movements following input they get from different senses. If a child is eating a very limited number of foods, feeding therapy is another great option to help expand variety in the diet. I highly recommend SOS feeding therapy for oral defensiveness as one of the best ways to tackle extremely picky eating.
You may also want to check out the pages about compliance strategies for defiant children or my page with helpful strategies for picky eaters that provides lots of tips for incorporating more foods and textures into a child’s diet. Children that aren't eating a wide variety of foods are more likely to have delays in speech due to inadequate muscle tone in the mouth from lack of chewing different textures. Therefore, speech therapy may be necessary to help strengthen the muscles in the mouth and jaw.
Applied Behavior Analysis and desensitization procedures for oral defensiveness are likely to be very helpful in decreasing the symptoms associated with hypersensitivity to food. Some oral sensory toys, such as the chewy tubes shown are often used in treatment as well. Overall, an occupational therapist with experience in sensory integration therapy would decide what sensory treatment will work the best.
Some additional pages you may find helpful:
• Sensory Modulation Disorder (subtype of SPD)
• Sensory Seeking
• Tactile Dysfunction
• Olfactory Dysfunction
References
1. Roizen, M.F. & Oz, M. C. (2006).You on a Diet: The Owner’s Manual for Waist Management. New York: Free Press.
2. Sensory Processing Disorders. Sensory Processing Disorder Checklist. www.sensory-processing-disorders.com. 1-16-10.