Attention deficit/hyperactivity disorder medication and dental caries in children

Few studies have been conducted to investigate the effects, if any, of specific medication used to manage the symptoms of attention deficit/hyperactivity disorder (ADHD) as a risk factor for dental caries. A reported side-effect of the medication is a reduction in saliva. Healthy saliva has been shown to play many important functions in the prevention of dental caries. The focus of this review is to determine if any evidence exists to confirm that stimulant medication used to treat the symptoms of ADHD in children increases the risk of dental caries by virtue of its effect on the reduction of salivary flow.

A MEDLINE search was conducted for relevant studies. Search terms used were dental caries, attention deficit/hyperactivity disorder, ADHD, pharmacologic treatment of ADHD, stimulant medication, xerostomia, dry-mouth and saliva flow. Publication dates ranged from 2002 to 2012.

Although dental caries prevalence has been found to be higher in children with ADHD, decreased salivary flow as a side-effect of pharmacological treatment does not appear to be responsible.

Dental caries is a multi-factorial disease process. The most effective method of reducing dental caries in ADHD children is more frequent recare visits focusing on home plaque removal practices along with dietary counseling to reduce the consumption of cariogenic foods and drinks. This can only be accomplished with inclusion of the parent/guardian in the process.