The impact of methylphenidate on oral health parameters, salivary flow rate, and quality of life in children with attention-deficit/hyperactivity disorder: a cross-sectional study.

OBJECTIVES

This study aimed to evaluate and compare the effects of methylphenidate on oral health, salivary flow rate, and quality of life in children with Attention-Deficit/Hyperactivity Disorder (ADHD), focusing on differences between short-release methylphenidate (SRM) and long-release methylphenidate (LRM) formulations.

MATERIALS AND METHODS

A total of 99 children participated in this cross-sectional study (ADHD: n = 49; divided into SRM (n = 27) and LRM (n = 22) subgroups based on medication type; control: n = 50). Dental caries was assessed using the DMFT/dft indices and the International Caries Detection and Assessment System (ICDAS), while oral hygiene was evaluated using the Plaque Index (PI), Gingival Index (GI), and Bleeding on Probing (BOP). Unstimulated salivary flow rates were measured. Salivary Streptococcus mutans and Lactobacillus levels were quantified using quantitative real-time polymerase chain reaction (qPCR). Quality of life was assessed with the Child Perceptions Questionnaire (CPQ) and KIDSCREEN-10. Logistic regression analyses examined associations between oral health outcomes, ADHD status, and medication type.

RESULTS

The ADHD group, especially SRM users, showed significantly higher DMFT scores, poorer oral hygiene, and reduced salivary flow rates compared to controls. Regression models further identified increased BOP and decreased salivary flow as predictors of ADHD and SRM use. qPCR confirmed higher Streptococcus mutans levels in SRM users. Quality of life was lower in ADHD children, particularly older SRM users.

CONCLUSIONS

Children with ADHD receiving methylphenidate exhibited poorer oral health and reduced quality of life, especially with SRM formulations.

CLINICAL RELEVANCE

Clinicians should be aware that children-particularly those receiving SRM-are more likely to present with reduced salivary flow, increased plaque accumulation, and gingival inflammation. Regular dental monitoring, reinforcement of oral hygiene practices, and dietary counseling should be integrated into the care plans of these patients.