The Effects of Psychostimulants on Oral Health and Saliva in Children with Attention Deficit Hyperactivity Disorder: A Case-Control Study

Ertugrul C. C., KIRZIOĞLU Z., Aktepe E., Savas H. B.

NIGERIAN JOURNAL OF CLINICAL PRACTICE, vol.21, no.9, pp.1213-1220, 2018 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 21 Issue: 9
  • Publication Date: 2018
  • Doi Number: 10.4103/njcp.njcp_385_17
  • Journal Name: NIGERIAN JOURNAL OF CLINICAL PRACTICE
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.1213-1220
  • Keywords: Attention-deficit hyperactivity disorder, bruxism, dental erosion, dry mouth, psychostimulants, saliva biochemical components, salivary flow rate, BEHAVIOR MANAGEMENT PROBLEMS, DENTAL-CARIES, DEFICIT/HYPERACTIVITY DISORDER, OUTPATIENT CHILD, FLOW-RATE, ADOLESCENTS, ADHD, BRUXISM, METHYLPHENIDATE, DRUGS
  • Akdeniz University Affiliated: Yes

Abstract

Introduction: This study investigated the dental health problems and saliva characteristics of children under psychostimulant therapy for attention-deficit hyperactivity disorder (ADHD). Materials and Methods: One hundred and twenty children aged 7-12 years were divided into three groups. Groups 1-2 comprised children diagnosed with ADHD: those who had not yet started psychostimulant therapy (Group 1) and those already receiving long-term psychostimulant therapy (Group 2). Group 3 comprised healthy, nonmedicated children. Possible side effects of psychostimulants were investigated at the beginning of study in Group 2 and after 3 months drug use in Group 1. Bruxism and dental erosion prevalence, salivary Streptococcus mutans count, buffering capacity, and stimulated salivary flow rate (SSFR) were measured, and salivary a-amylase, calcium, total protein, and proline-rich acidic protein (PRAP) levels were quantified in the beginning of the study. Data were analyzed using the Kruskal-Wallis test. Results: The most frequently reported side effects of psychostimulants were decreased appetite, dry mouth, and increased fluid consumption. The prevalence of bruxism and dental erosion was higher in Groups 1 and 2 than in Group 3, but the differences were not significant (P > 0.05). In Group 2, subjective dry mouth feel was reported by 32.5% of patients and 17.5% had a very low SSFR. Salivary a-amylase, calcium, total protein, and PRAP levels were lower in Group 2 than the others, but the differences were not significant (P > 0.05). Conclusions: ADHD and psychostimulant therapy do not appear to be significantly related to decreasing SSFR or protective saliva components against dental caries. However, a systematic investigation of the long-term safety of psychostimulants is needed. The most effective method of maintaining dental health of children with ADHD is frequent appointments focusing on oral hygiene practices accompanied by dietary analyses.