German Research Center for Environmental Health, Institute of Epidemiology I, Helmholtz Zentrum Muenchen, Ingolstaedter Landstrasse 1, Neuherberg, Germany.
Clin Oral Investig. 2013 Jun;17(5):1329-38. doi: 10.1007/s00784-012-0829-7. Epub 2012 Aug 29.
A few clinical observations reported that children with attention deficit hyperactivity disorder (ADHD) have poor oral health compared to children without ADHD. However, evidence is not conclusive. We assess the association between hyperactivity/inattention and oral health in a population-based study.
As part of the ongoing birth cohort studies German Infant Nutritional Intervention-plus (GINIplus) and Influences of lifestyle-related factors on the immune system and the development of allergies in childhood-plus (LISAplus), 1,126 children at age 10 years (±10.2) from Munich (Germany) were included in the present analysis. During the dental examination, oral hygiene, non-cavitated and cavitated caries lesions, dental trauma, and enamel hypomineralization (EH) in the permanent dentition (MIH/1) were recorded. Children with a Molar-Incisor-Hypomineralization were subcategorized into those with EH on at least one first permanent molar (MIH/1A), and on at least one first permanent molar and permanent incisor (MIH/1B). Data on children's hyperactivity/inattention symptoms were collected by parent-reported Strength and Difficulties Questionnaire. Logistic regressions and zero-inflated Poisson regression models were applied adjusted for gender, parental education, parental income, and methylphenidate or atomoxetine medication.
Logistic regressions showed that non-cavitated caries lesions were positively related with the presence of hyperactivity/inattention (ORadj = 1.51,CI95% = 1.08-2.11). When adjusted for parental background, an association showed between hyperactivity/inattention symptoms and MIH/1A but did not reach statistical significance (ORadj = 1.59,CI95% = 1.00-2.53).
Children with borderline and abnormal values of hyperactivity/inattention symptoms showed more non-cavitated caries lesions. Severe levels of hyperactivity/inattention may contribute to a higher risk for MIH/1A in school age.
Adequate dental preventive care for children with hyperactivity/inattention, especially from a low social background, is of importance for optimal caries prevention.
一些临床观察报告显示，与无注意力缺陷多动障碍（ADHD）的儿童相比，患有 ADHD 的儿童口腔健康状况较差。然而，证据并不确凿。我们在一项基于人群的研究中评估了多动/注意力不集中与口腔健康之间的关系。
作为正在进行的德国婴儿营养干预加（GINIplus）和生活方式相关因素对儿童免疫系统和过敏发展的影响加（LISAplus）的一部分，共有 1126 名 10 岁（±10.2）的儿童来自慕尼黑（德国）被纳入本分析。在牙科检查期间，记录了口腔卫生、未龋和龋病、牙外伤和恒牙萌出的釉质发育不全（MIH/1）。患有恒磨牙-切牙-釉质发育不全的儿童分为至少有一颗第一恒磨牙（MIH/1A）和至少有一颗第一恒磨牙和恒切牙（MIH/1B）的釉质发育不全。通过家长报告的《长处和困难问卷》收集有关儿童多动/注意力不集中症状的数据。应用逻辑回归和零膨胀泊松回归模型进行调整，包括性别、父母教育、父母收入和哌甲酯或托莫西汀药物。
逻辑回归显示，未龋病与多动/注意力不集中的存在呈正相关（ORadj=1.51，95%CI=1.08-2.11）。当调整父母背景时，多动/注意力不集中症状与 MIH/1A 之间存在关联，但未达到统计学意义（ORadj=1.59，95%CI=1.00-2.53）。
有边缘和异常多动/注意力不集中症状的儿童有更多的未龋病。严重的多动/注意力不集中可能会增加学龄期 MIH/1A 的风险。
对于患有多动/注意力不集中的儿童，特别是来自社会背景较低的儿童，提供适当的口腔预防保健对于最佳龋齿预防非常重要。
