Children with
ADHD may present with behavioral management problems in the dental setting due to increased anxiety and fear. These children also have a higher risk of suffering from traumatic dental and orofacial injuries.
Common risk factors
- Poor oral hygiene and increased risk of cavities due to difficulty performing routine activities such as brushing teeth and increased consumption of sugary foods.
- Medications used to manage ADHD can lead to changes in diet and appetite which can increase the risk of cavities.
- Medications used to manage ADHD may also have side effects such as dry mouth which increases risk of cavities.
Dental Management and Prevention
Prevention is essential in managing the dental health of the child with ADHD. Scheduling the child for early professional dental examinations as well as following a more frequent dental recall schedule is recommended.
Parents and caregivers should support children at home in maintaining daily activities such as tooth brushing and with healthy dietary habits.
Try these Tips
- Use colorful or highly stimulating educational material.
- Create an atmosphere of confidence with a gentle but firm approach.
- Repeat simplified instructions numerous times.
- Use a tooth brushing chart at home to keep track of the tooth brushing schedule.
- Place emphasis on the brushing of teeth rather than the brushing technique.
- You may use positive reinforcement/rewards for better results.
- The use of tell-show-do method has been shown to be very effective.
Preparing the ADHD Child for a Dentist Appointment
Discuss medications currently being taken with the child's dentist. It may be helpful to either change the dose or the timing of the medication to optimize the action of the medicine at the time of the dental visit, as some medications used to treat ADHD may interact with drugs used in dentistry.
Morning appointments have been shown to be more successful. You might also find that spacing the treatment into multiple short visits will be better, rather than a few long visits. In some cases inhalation sedation may be useful, ask the dentist about sedation options.
Stephie Castera, DMD, MS - Nicklaus Children's Pediatric Dentistry Residency Program
References
Cameron, Angus C., and Richard P. Widmer. Handbook of Pediatric Dentistry. 4th ed. Mosby Elsevier, 2014.
Centers for Disease Control and Prevention. Available at: “https://www.cdc.gov/ncbddd/adhd/facts.html”
Chandra, P.; Anandakrishna, L.; Ray, P. Caries Experience and Oral Hygiene Status of Children Suffering from Attention Deficit Hyperactivity Disorder. J Clin Pediatr Dent, 34 (1): 25-30, 2009.
Friedlander, A.H.; Yagiela, JA; Paterno, VI; Mahler, ME. The pathophysiology, Medical Management, and Dental Implications of Children and Young Adults Having Attention-Deficit Hyperactivity Disorder. CDA Journal, 31(9): 2003.
Grooms, M.T.; Keels, MA; Roberts, MW; McIver, FT. Caries Experience Associated with Attention-Deficit/Hyperactivity Disorder. J Clin Pediatr Dent, 30(1): 3-8, 2005.
National Institute of Mental Health. Available at “https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml#part_145449”.