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Year : 2018  |  Volume : 21  |  Issue : 9  |  Page : 1213-1220

The effects of psychostimulants on oral health and saliva in children with attention deficit hyperactivity disorder: A case-control study

1 Department of Pediatric Dentistry, School of Dentistry, Pamukkale University, Denizli, Turkey
2 Department of Pediatric Dentistry, School of Dentistry, Süleyman Demirel University, Isparta, Turkey
3 Department of Child and Adolescent Psychiatry, School of Medicine, Süleyman Demirel University, Isparta, Turkey
4 Department of Medical Biochemistry, School of Medicine, Alanya Alaaddin Keykubat University, Antalya, Turkey

Correspondence Address:
Dr. C C Ertugrul
Department of Paediatric Dentistry, Pamukkale University, Faculty of Dentistry, Denizli
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/njcp.njcp_385_17

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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 α-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 α-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.

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