Dental Caries in Children with Attention Deficit/Hyperactivity Disorder: A Meta-Analysis

Abstract

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

Early Childhood Caries and Its Association With Behavior in Preschool Children

“…In a study utilizing the International Caries Detection and Assessment System (ICDAS), it was revealed that children affected by ADHD had an elevated risk of developing dental caries in both their primary and permanent dentition [ 29 ]. A recent meta-analysis further supported these findings, indicating that children with ADHD were more susceptible to dental caries development compared to their healthy peers [ 30 ]. Similar outcomes were observed in the current study.…”

Attention‐deficit hyperactivity disorder and psychostimulant use in patients seeking dental care—Associations with common orofacial pain complaints

“…There is evidence that these conditions can negatively affect oral health. Children with ADHD have higher prevalence of caries, 9 hyposalivation, 10 higher plaque index, 10 and gingival bleeding index 11 . The scope of practice of dentistry has been expanding in the recent years and orofacial pain has been recognised by the American Dental Association (ADA) as a new dental specialty 12 .…”

Associated Factors of Dental Caries among Intellectually Disabled Persons in Specialized Centers of Ouagadougou

“…Studies from diverse geographical regions have contributed to a growing body of evidence indicating that intellectually disabled individuals are at an elevated risk for dental caries due to a complex interplay of factors [1] [2].…”