Oral Health Fact Sheet for Medical Professionals Treating Children with Attention Deficit Hyperactivity Disorder
Attention deficit hyperactivity disorder is a behavior disorder with developmentally inappropriate inattention, impulsivity, and hyperactivity. (ICD 9 code 314.01)
Oral Manifestations and Considerations
Oral
- Decreased attention span→ poor oral hygiene →potential for increased caries
- Bruxism
- High risk for dental/oral trauma
Other Potential Disorders/Concerns
- Oppositional defiant
- Obsessive-compulsive
- Anxiety
- Conduct
- Tic
- Mood (anxiety, depression, bipolar)
Oral Side Effects of Commonly Prescribed Medications
Medication
- Prescribed based on symptoms for their intended purpose or used off label for associated conditions.
- Some children will go on medication “holidays” during times when they are not in school. Ask if a child has taken medication, and avoid treatment during periods when child is off normal meds.
| SYMPTOM | MEDICATION | SIDE EFFECTS |
|---|---|---|
| Generalized | Stimulants (Ritalin,Adderall) Atomoxetine (Strattera) |
Xerostomia, dysgeusia, bruxism Xerostomia |
| Repetitive Behaviors | Antidepressants (Wellbutrin,Tofranil) | Xerostomia, dysgeusia, stomatitis, gingivitis, glossitis, sialadenitis, bruxism, dysphagia, discolored tongue, and oral edema |
| Hyperactivity | Antihypertensive (Clonidine, Tenex) | Xerostomia, sialadenitis, dysphagia, dysgeusia |
Parent/Caregiver Support and Guidance
- Discourage consumption of cariogenic foods and beverages.
- Prescribe sugar-free medications if available.
- Recommend preventive measures such as topical fluoride and sealants.
- Advise the use of fluoridated toothpaste twice daily and support the family in following dental care instructions
- Instruct caregiver on appropriate protocol following dental trauma (locate/preserve missing tooth and put in cold milk; seek immediate professional care).
- Recommend rinsing the mouth with water after each dose, especially after taking medications that cause xerostomia.
- Review safety issues appropriate to the age of the child, such as mouth guards to prevent oral-facial trauma.
- Refer to dentist any oral developmental abnormalities.
References
- Bimstein, E., Wilson, J., Guelmann, M., Primosch, R. (2008) Oral characteristics of children with attention-deficit hyperactivity disorder. Special Care Dentistry, 28(3): 107-110
- Blomqvist, M., Holmberg, K., Fernell, E., Ek, U., Dahllof, G. (2006) Oral health, dental anxiety, and behavior management problems in children with attention deficit hyperactivity disorder. European Journal of Oral Sciences, 114(5): 385-390.
Additional Resources
- NIH Institute for Attention Deficit Hyperactivity Disorder
- Special Care: an Oral Health Professionals Guide to Serving Young Children with Special Health Care Needs
- Bright Futures Oral Health Pocket Guide
- American Academy of Pediatric Dentistry: 2011–2012 Definitions, Oral Health Policies and Clinical Guidelines
- MCH Resource Center
- ASTDD – Special Needs
- Block Oral Disease, MA
- Free of charge CDE courses: MCH Oral Health CDE (4 CDE hours) NIDCR CDE (2 CDE hours)
Permission is given to reproduce this fact sheet. Oral Health Fact Sheets for Patients with Special Needs © 2011 by University of Washington and Washington State Oral Health Program.
Fact sheets developed by the University of Washington DECOD (Dental Education in the Care of Persons with Disabilities) Program through funding provided to the Washington State Department of Health Oral Health Program by HRSA grant #H47MC08598).
For persons with disabilities, this document is available on request in other formats. To submit a request, please call 1-800-525-0127 (TTY/TDD 1-800-833-6388).