Oral Sensitivities:
Signs, Symptoms, Causes, And Treatment

When talking about children with SPD, we refer to two different types of oral sensitivities... hypersensitivity and hyposensitivity.

As you may have already seen from the Sensory Processing Disorders Checklist, children with oral hypersensitivities - also called oral defensiveness - will exhibit many, or all, of the following characteristics:

  • dislikes having teeth brushed and/or face washed

  • has a limited food repertoire and/or may avoid certain food textures - especially mixed textures

  • will take their food off the fork or spoon using only their teeth, keeping their lips retracted

  • will gag easily when eating and may only get food down by taking a drink with it

  • may exhibit signs of tactile defensiveness such as; disliking being touched, avoiding messy play - glue, play doh, mud, sand, finger paints, etc. - , or, may not pick up eating utensil or food with a grasp that involves the palm of his hand

    When Working With These Oral Defensive Children, You Need To:

  • understand the mouth is an "extension of the body"

  • let the child know what you are doing and what you will do next, and use firm pressure with slow even strokes... the more predictable the better

  • once you have reached the face, start with his cheeks, then jaw, lips, and lastly inside his mouth... progressing from least sensitive to most

  • take it slow and do not force stimulation on any part he is not "ready" for... try it, just don't force it - severe anxiety or fear and gagging are signs of distress, not effective therapy - gently work your way through this no matter how long it takes

  • lastly, remember oral motor programs and therapy for oral sensitivities may not be able to be worked on, or effective, until underlying sensory issues are addressed and sensory stimulation is tolerated

  • In Contrast, Children With Hyposensitivities Will Exhibit Many, Or All, Of The Following Characteristics


  • they love and crave intense flavors, i.e., sweet, sour, salty, spicy and usually become "condiment kids"

  • may actually avoid mixed textures as well since it is difficult to chew and swallow properly when you can't "feel" the food in your mouth correctly

  • they are the messy eaters; getting food all over their face and/or leaving bits of food in their mouths at the end of a meal

  • they often take large bites and stuff their mouths, or even "pocket" food in their cheeks

  • are inclined to not chew their food thoroughly before swallowing (at risk for choking)

  • drool excessively beyond the teething stage

  • and, they always seem to have something in their mouths; toys, pens, pencil tips, gum, candy, or inedible objects (i.e., paper clips, rubber bands, shirt sleeves and collars, strings...anything!)

  • When working with these hyposensitive children, you need to:



  • give them MORE oral stimulation activities and "appropriate" things to chew on; they will need to chew to feel calm and organized

  • Chewy Tubes - Chewy tubes help children to keep from chewing on their hands and crayons and and help them focus and for practicing biting and chewing skills.
  • give them sensory stimulation activities prior to meals to "wake up" their mouths

  • use oral massagers, vibration, and textured materials/objects for stimulation

  • use a combination of relaxing input (deep pressure, firm touch) and stimulating input (light, quick strokes)

  • choose foods with increased texture, flavor, and temperatures to provide more stimulation

  • encourage the child to take different sized bites and have them "feel" the food in their mouth (if old enough have them close their eyes and play guessing games with the food)

  • wash and wipe the child's face often during eating with different textured materials (i.e., baby washcloth, napkin, regular washcloth, paper towel with texture to it)

  • use the following order for stimulation; start on face with cheeks, jaw, lips, then teeth/gums, inside cheeks, then tip, middle, and sides of tongue, then the roof of the mouth


  • Above all, remember that children with oral sensitivities, whether hypo- or hyper- sensitive, will need specific treatment and oral stimulation activities by a knowledgeable therapist. Make sure you consult one if you are concerned about any signs of oral difficulties / oral sensitivities with your child.

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