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ORAL FINDINGS IN CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER AMONG A GROUP OF EGYPTIAN CHILDREN: A CROSS-SECTIONAL STUDY

Objectives: To assess the oral findings of children with ADHD when compared to normal healthy children. Materials and Methods: A sample of 78 children (age 4–12 years); 39 participants with ADHD and 39 participants without ADHD (control). Oral examination included the following parameters: caries, traumatic dental injuries (TDIs), malocclusions, dental wear, and enamel hypocalcification (EH). Additionally, oral hygiene and parafunctional oral habits were assessed by a questionnaire to parents/caregivers. Data were compared using Mann–Whitney U-tests and Chi-square tests. Results: Children with ADHD have significantly lower values of deft/DMFT and frequencies of tooth brushing but higher values of parafunctional oral habits (bruxism, nail and object biting, tongue thrusting) and dental wear. No significant differences were found between children, with and without ADHD, in dmft, DMFT, TDIs, prevalence of malocclusion or EH. Conclusion: Children with ADHD exhibited a poorer oral health behavior, higher risk for TDIs and malocclusion than non-ADHD children. Hence, there is a need for meticulous preventive dental care for them. Parents/caregivers need instructions for better supervision of oral hygiene to improve the poor oral health of children with or without ADHD. (2) Sara Gaber Hussein Galal, et al. E.D.J. Vol. 68, No. 1 Children with ADHD may present with additional medical issues, such as sleep disorders, encopresis, and enuresis, or it may be secondary to medical conditions, including traumatic brain injury, fetal alcohol exposure, lead intoxication, premature birth, epilepsy, and tic disorders Charles, (2010). Attention-deficit/hyperactivity disorder has been extensively studied in the medical literature including neurology, psychiatry and psychology, but up to our knowledge, few studies have been published from the dental perspective. Since ADHD is a common disability, it is likely that dental practitioners will come across children, adolescents and even adults with this disorder in their practices. Accordingly, it is essential for the clinician to be familiar with this condition, the strategies for its management and its different effects on oral and dental health. The symptoms of ADHD are generally treated through behavioral therapy, with or without pharmacological intervention. Medications of ADHD have been implicated in adverse oral effects, such as xerostomia and gingival enlargement, although evidence is scant. The current evidence is debatable regarding the severity and prevalence of dental caries, dental trauma, periodontal diseases, oral habits and tooth wear among patients with ADHD. Thus, the potential for increased risk of dental diseases in this population remains undetermined Chau et al. (2017b). In the Arab world, few studies have been published on ADHD and these studies present conflicting results. Accordingly, in the Arab society and Egypt, there are limited data regarding the oral health of children with ADHD. Moreover, up to our knowledge, no published data was found about the oral and dental characteristics of children with ADHD in Egypt. Only single unpublished study carried out by Moawad et al. (2011) about oral findings, behavior and dental management of children with ADHD was found. Owing to the sparsity of these data, this study was conducted to evaluate different oral findings of children with ADHD in comparison to normal children.