Oral Health of Children and Adolescents with Attention Deficit Hyperactivity Disorder
Gilmar J Begnini, João A Brancher, Ana TB Guimarães, Melissa R de Araujo, Eduardo Pizzatto
Citation Information :
Begnini GJ, Brancher JA, Guimarães AT, de Araujo MR, Pizzatto E. Oral Health of Children and Adolescents with Attention Deficit Hyperactivity Disorder. Int J Clin Pediatr Dent 2019; 12 (6):543-547.
Aim: The aim of the study was to evaluate the oral health conditions of children and adolescents with attention deficit hyperactivity disorder (ADHD). Materials and methods: Two groups were selected: a test group comprising 51 individuals with ADHD and a control group with 50 individuals without ADHD, with ages ranging from 7 to 14 years. Through an intraoral clinical examination, the numbers of decayed, missing, and filled teeth (DMFT index), the visible plaque index (VPI), the gingival bleeding index (GBI), bruxism, and dental traumatism were verified. A questionnaire confirmed oral hygiene supervision. Results: In the test group, the average DMFT index was 3.41 while it was 2.52 in the control group (p = 0.405). The VPI in the test and control groups was 36.84% and 24.54%, respectively (p = 0.004). The GBI was 8.37% for the test group and 4.94% for the control group (p = 0.012). The DMFT index when supervised the oral hygiene by those responsible in comparison with the nonsupervision was 1.89 and 4.31, respectively, in the test group, and 1.71 and 2.94, respectively, in the control group. Conclusion: These data suggest that children and adolescents with ADHD present with worse oral health conditions and need greater attention from dental professionals and those responsible for their diet and oral hygiene. Clinical significance: Attention deficit hyperactivity disorder needs a special attention. This research brings this important issue focus on oral health.
American Psychiatric Association. Diagnostic and statistical manual of mental diseases (DSM-5). 5th ed., Washington, DC: American Psychiatric Publishing; 2013. pp. 59–66.
Pliszka S. AACAP work group on quality issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2007;46(7):894–921. DOI: 10.1097/chi.0b013e318054e724.
Sprich S, Biederman J, Crawford MH, et al. Adoptive and biological families of children and adolescents with ADHD. J Am Acad Child Adolesc Psychiatry 2000;39(11):1432–1437. DOI: 10.1097/00004583-200011000-00018.
Merikangas KR, He JP, Brody D, et al. Prevalence and treatment of mental disorders among us children in the 2001–2004 NHANES. Pediatrics 2010;125(1):75–81. DOI: 10.1542/peds.2008-2598.
American Academy of Pediatrics. Clinical practice guideline: diagnosis and evaluation of the child with attention-deficit/hyperactivity disorder. Pediatrics 2000;105(5):1158–1170. DOI: 10.1542/peds.105.5.1158.
American Journal of Medical Genetics. The ADHD molecular genetics network. Report from the third international meeting of the attention-deficit/hyperactivity disorder molecular genetics network. Am J Med Genet 2002;114(3):272–276. DOI: 10.1002/ajmg. 10039.
Department of Health and Human Services. Centers for Disease Control and Prevention. USA government. Attention-deficit/hyperactivity disorder (ADHD) 2013. Available at: http://www.cdc.gov/ncbddd/adhd/.
Swanson JM. School-based assessments and interventions for add students. Irvine, CA: K.C. Publishing; 1992.
World Health Organization. The ICD-10. International classification of mental and behavioral disorders: diagnostic criteria for research. Geneva, Switzerland; 1993.
Conners CK. Clinical use of rating scales in diagnosis and treatment of attention-deficit/hyperactivity disorder. Pediatr Clin North Am 1999;46(5):857–870. DOI: 10.1016/S0031-3955(05)70159-0.
Blomqvist M, Holmberg K, Fernell E, et al. Dental caries and oral health behavior in children with attention-deficit/hyperactivity disorder. Eur J Oral Sci 2007;115(3):186–191. DOI: 10.1111/j.1600-0722.2007.00451.x.
Blomqvist M, Ahadi S, Fernell E, et al. Dental caries in adolescents with attention-deficit/hyperactivity disorder: a population-based follow-up study. Eur J Oral Sci 2011;119(5):381–385. DOI: 10.1111/j.1600-0722.2011.00844.x.
Dhull KS, Dutta B, Devraj IM, et al. Knowledge attitude and practice of mothers towards infant oral healthcare. Int J Clin Pediatr Dent 2018;11(5):435–439. DOI: 10.5005/jp-journals-10005-1553.
Bimstein E, Wilson J, Guelmann M, et al. Oral characteristics of children with attention-deficit/hyperactivity disorder. Spec Care Dentist 2008;28(3):107–110. DOI: 10.1111/j.1754-4505.2008.00021.x.
Katz-Sagi H, Redlich M, Brinsky-Rapoport T. Increased dental trauma in children with attention-deficit/hyperactivity disorder treated with methylphenidate-a pilot study. J Clin Pediatr Dent 2010;34(4):287–289. DOI: 10.17796/jcpd.34.4.p6714ln2g658322u.
Thikkurissy S, McTigue DJ, Coury DL. Children presenting with dental trauma are more hyperactive than controls as measured by the ADHD rating scale IV. Pediatr Dent 2012;34(1):28–31.
Pulgarón ER. Childhood obesity: a review of increased risk for physical and psychological comorbidities. Clin Ther 2013;35(1): A18–A32. DOI: 10.1016/j.clinthera.2012.12.014.
Chau YCY, Lai KYC, McGrath CPJ, et al. Oral health of children with attention deficit hyperactivity disorder. Eur J Oral Sci 2017;125(1): 49–54. DOI: 10.1111/eos.12323.
Aminabadi NA, Najafpour E, Erfanparast L, et al. Oral health status, dental anxiety, and behavior management problems in children with oppositional defiant disorder. Eur J Oral Sci 2016 Feb;124(1): 45–51. DOI: 10.1111/eos.12236.
Sujlana A, Dang R. Dental care for children with attention-deficit/hyperactivity disorder. J Dent Child (Chic) 2013;80(2):67–70.
Hidas A, Birman N, Noy AF, et al. Salivary bacteria and oral health status in medicated and non-medicated children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Clin Oral Investig 2013;17(8):1863–1867. DOI: 10.1007/s00784-012-0876-0.
Grooms MT, Keels MA, Roberts MW, et al. Caries experience associated with attention-deficit/hyperactivity disorder. J Clin Pediatr Dent 2005;30(1):3–7. DOI: 10.17796/jcpd.30.1.d3n7k5147r3ru571.
Chandra P, Anandakrishna L, Ray P. Caries experience and oral hygiene status of children suffering from attention-deficit/hyperactivity disorder. J Clin Pediatr Dent 2009;34(1):25–29. DOI: 10.17796/jcpd.34.1.n170271832662v44.
Blomqvist M, Holmberg K, Fernell E, et al. Oral health, dental anxiety, and behavior management problems in children with attention-deficit/hyperactivity disorder. Eur J Oral Sci 2006;114(5):385–390. DOI: 10.1111/j.1600-0722.2006.00393.x.
Sinha S, Praveen P, Rani SP, et al. Pedodontic considerations in a child with attention deficit hyperactivity disorder: literature review and a case report. Int J Clin Pediatr Dent 2018;11(3):254–259. DOI: 10.5005/jp-journals-10005-1522.
Sabuncuoglu O, Taser H, Berkem M. Relationship between traumatic dental injuries and attention-deficit/hyperactivity disorder in children and adolescents: proposal of an explanatory model. Dent traumatol 2005;21(5):249–253. DOI: 10.1111/j.1600-9657.2005.00317.x.
Sabuncuoglu O. Traumatic dental injuries and attention-deficit/hyperactivity disorder: is there a link? Dent Traumatol 2007;23(3):137–142. DOI: 10.1111/j.1600-9657.2005.00431.x.
Ghanizadeh A. ADHD, bruxism and psychiatric disorders: does bruxism increase the chance of a comorbid psychiatric disorder in children with ADHD and their parents? Sleep Breath 2008;12(4): 375–380. DOI: 10.1007/s11325-008-0183-9.
Paredes SO, Almeida DB, Fernandes JMFA, et al. Behavioral and social factors related to dental caries in 3 to 13 year-old children from João Pessoa, Paraíba, Brazil. Rev Odonto Ciênc 2009;24(3):231–235.
Moimaz SAS, Martins RJ, Forte FDS, et al. Oral hygiene practices, parents' education level and dental caries pattern in 0 to 5 years-old children. Braz J Oral Sci 2005;4(14):778–782.
Mendhekar DN, Andrade C. Bruxism arising during monotherapy with methylphenidate. J Child Adolesc Psychopharmacol 2008;18(5): 537–538. DOI: 10.1089/cap.2008.18503.
Sivri RÇ, Bilgiç A. Methylphenidate-induced awake bruxism: a case report. Clin Neuropharmacol 2015;38(2):60–61. DOI: 10.1097/WNF.0000000000000068.
Bavle A, Vishwaraj S. Methylphenidate-induced obsessive compulsive sisorder in attention deficit hyperactivity disorder. J Med Sci 2016;2(1):21–22.
Martens MA, Seyfer DL, Andridge RR, et al. Caregiver survey of pharmacotherapy to treat attention-deficit/hyperactivity disorder in individuals with williams syndrome. Res Dev Disabil 2013;34(5):1700–1709. DOI: 10.1016/j.ridd.2013. 02.015.
Kohlboeck G, Heitmueller D, Neumann C, et al. Is there a relationship between hyperactivity/inattention symptoms and poor oral health? Results from the GINIplus and LISAplus study. Clin Oral Investig 2013;17(5):1329–1338. DOI: 10.1007/s00784-012-0829-7.
Chau YCY, Peng SM, McGrath CPJ, et al. Oral health of children with attention deficit hyperactivity disorder: systematic review and meta-analysis. J Atten Disord 2017;1087054717743331. DOI: 10.1177/1087054717743331.