Analysis of Oral Health among ADHD-Affected and Non-ADHD Children in Gran Canaria

A study in Gran Canaria assessed the oral health of 53 children diagnosed with attention deficit hyperactivity disorder (ADHD) and 106 without ADHD, aged 6 to 16 years. Clinical data on dental caries, conservative treatments, and periodontal health were recorded. The main objective of this study was to investigate the prevalence of dental caries in children with ADHD and how their habits and behaviors contribute to their oral health status. The results showed that children with ADHD had a significant increase in dental caries, conservative treatments, and gingival bleeding. A connection with diet was found, though it did not have a negative impact. No increase in periodontal index was observed, and no significant relationship with diet, family factors, or breastfeeding was found. The evidence suggests that children with ADHD should undergo frequent dental check-ups to monitor oral health and receive education on the importance of the quality and frequency of tooth brushing. These findings highlight the need to address oral health in children with ADHD and the necessity for adequate dental care in this group.

Dental caries in children with attention deficit/hyperactivity disorder: a meta-analysis

OBJECTIVES

To evaluate whether children with attention deficit/hyperactivity disorder (ADHD) are more affected by dental caries than children without ADHD by means of a systematic review and meta-analysis.

DESIGN

Electronic searches was performed in four databases (PubMed, Embase, Scopus, and Web of Science) in July 2021. Grey literature search in OpenGrey, a search in Google Scholar, and searches in the reference list of included articles were also conducted. The eligibility criteria were observational studies in which children with ADHD were compared with children without ADHD with respect to the dental caries. Study selection, data extraction, and risk of bias assessment, applying the Joanna Briggs tool were performed by two reviewers independently. Meta-analysis and assessment of heterogeneity among studies were conducted with the meta-package of RStudio using the R programming language (R Core Team, Vienna, Austria). Results of meta-analysis were provided in mean difference (MD), odds ratio (OR), and confidence intervals (CI). For assessment of heterogeneity, Baujat plot and influence analysis plot were obtained.

RESULTS

Thirteen studies were included and 10 were incorporated into meta-analyses. The meta-analysis showed that children with ADHD had a higher decayed, missing, and filled teeth (DMFT) index than their peers without ADHD (I²=42%; MD=0.75 [0.38-1.13]). For decayed, missing, and filled surfaces (DMFS) (I²=0; MD=0.39 [-0.02-0.80]) and decayed surfaces (DS/ds) (I²=0%; MD=0.35 [-0.63-1.33]), no difference between groups was observed. In addition, children with ADHD had higher odds of having dental caries than their healthy peers (OR = 3.31 [1.25, 8.73]; I² = 0%). After assessment of heterogeneity among studies, sensitivity analysis was conducted for DMFT. One study was removed and the significant difference between groups remained. Children with ADHD had a significantly higher DMFT index than their peers without ADHD (MD = 0.98 [CI = 0.75, 1.20]; I² = 0%) Risk of bias ranged from low to high.

CONCLUSION

The main shortcoming of the included studies is the high risk of bias regarding the strategies to deal with confounding factors. Within its limitations, this systematic review and meta-analysis demonstrated that children with ADHD were more likely to develop dental caries than their healthy counterparts.

FUNDING

No funding Registration: CRD42021238923.

Attention-deficit/hyperactivity disorder and oral health literacy exert an influence on the occurrence of dental caries in early adolescence

Little is known regarding the influence of psychosocial factors on dental caries at early adolescence. The study aimed to investigate associations between family environment, attention-deficit/hyperactivity disorder (ADHD) and oral health literacy (OHL) with dental caries experience in early adolescence. A cross-sectional study was conducted with a representative sample of 448 12-year-old adolescents at public and private schools in North-eastern Brazil. Parents/guardians and teachers answered the Brazilian version of the inattention and hyperactivity/impulsivity subscales (SNAP- IV) for the evaluation of ADHD and a sociodemographic questionnaire. An OHL instrument (BREALD-30) and the Family Adaptability and Cohesion Scales (FACES III) were administered to the adolescents. Caries experience (DMFT) was the dependent variable. Data analysis involved Poisson regression with robust variance (α = 5%). Adolescents with more symptoms of ADHD (teachers' reports) (RR: 1.73; 95% CI: 1.31-2.28), those with lower OHL (RR: 1.59; 95% CI: 1.01-2.51), those with a lower family income (RR: 1.38; 95% CI: 1.03-1.83), and those from families with a greater number of residents in the home (RR: 1.18; 95% CI: 1.06-1.31) had greater caries experience. Family adaptability and cohesion were not associated with caries experience. Dental caries experience in early adolescence was influenced by symptoms of ADHD, OHL, and sociodemographic factors.

Family cohesion and attention deficit exert an influence on visits to the dentist in early adolescence

OBJECTIVES

To determine whether family environment, signs of attention deficit/hyperactivity disorder (ADHD) and oral health literacy (OHL) are associated with visits to the dentist in adolescents.

METHODS

A school-based cross-sectional study was conducted with a representative sample of 448 12-year-old adolescents enrolled at schools in the city of Cajazeiras, Brazil. The adolescents answered a validated questionnaire addressing family cohesion and adaptability (FACES III), an OHL measure (Brazilian Rapid Estimate of Adult Literacy in Dentistry [BREALD-30]) and a questionnaire addressing the history of visits to the dentist and previous toothache experience. The parents answered a questionnaire addressing sociodemographic characteristics. Parents and teachers answered the inattention and hyperactivity/impulsivity subscales of the Swanson, Nolan & Pelham (SNAP-IV) questionnaire for the detection of signs of ADHD. Multiple Poisson regression with robust variance was used for data analysis (α = 5%).

RESULTS

The prevalence of having visited a dentist some time in life was higher among adolescents with enmeshed (PR = 1.08; 95% CI: 1.01-1.15) and connected (PR = 1.06; 95% CI: 1.01-1.13) families and those with attention deficit according to parents' reports (PR = 1.09; 95% CI: 1.04-1.14). A family income higher than the Brazilian minimum wage (PR = 1.06; 95% CI: 1.01-1.12) and toothache in the previous six months (PR = 1.05; 95% CI: 1.01-1.11) were also associated with the outcome.

CONCLUSION

Family cohesion and attention deficit according to parental reports influenced visits to the dentist among adolescents. In contrast, OHL was not associated with the outcome.

Oral health of children and adolescents with or without attention deficit hyperactivity disorder (ADHD) living in residential care in rural Rhineland-Palatinate, Germany

Background

Attention deficit hyperactivity disorder (ADHD) is defined as childhood neurobehavioural disorder. Due to short attention span, oral hygiene and dental treatment of such individuals can be challenging. Aim of this study was to evaluate the oral health of children and adolescents with and without ADHD living in residential care in rural Rhineland-Palatinate, Germany.

Methods

Included in the study were 79 participants (male/female:58/21, age 9–15 years) living in residential care: 34 participants with ADHD and 45 participants without ADHD (control). Oral examination included the following parameters decayed, missing, filled teeth in the primary dentition (dmft), decayed, missing, filled surfaces/teeth in the secondary dentition (DMFS/DMFT), approximal plaque index (API), bruxism and orthodontic treatment. Additionally, oral hygiene, last dental visit and treatment performed, and dietary habits were assessed by questionnaire.

Results

There were no significant differences in dmft, API, bruxism and oral hygiene habits between groups. However, participants with ADHD tended to have higher DMFS/DMFT values than the control group. Ongoing orthodontic treatment was found more often in the control group. The ADHD group tended to consume acidic/sugary beverages and sweet snacks more often than the controls. Different treatments (control visit/prophylaxis, dental therapy, orthodontic treatment) were performed at the last dental visit in the two groups.

Conclusions

Within the limitations of this study, oral health was similar in children and adolescents with or without ADHD from the same residential care setting. Parents/guardians need instructions for better supervision of oral hygiene and dietary habits to improve the poor oral health of children with or without ADHD.