The pathophysiology, medical management and dental implications of adult attention-deficit/hyperactivity disorder.
BACKGROUND
Few published reports in the dental literature have focused on adult attention-deficit/hyperactivity disorder (ADHD) and its dental implications.


METHODS
The authors conducted a MEDLINE search for the period 2000 through 2005 using the terms "adult" and "attention-deficit" to define ADHD's pathology, medical treatment and dental implications.


RESULTS
ADHD is a developmental condition that affects slightly more than 4 percent of the adult U.S. population. Its symptoms include inattention, hyperactivity and impulsivity that can cause personal, social, occupational and leisure-time dysfunction. Medications used to treat the disorder include stimulants, selective noradrenergic uptake inhibitors and tricyclic antidepressants.


CONCLUSIONS
The oral health of people with ADHD may be compromised by inattention and impulsivity that impair home care regimens and can lead to cigarette addiction, which may cause oral cancer and damage the periodontium, and excessive ingestion of caffeinated sugar-laden soft drinks that promote dental caries. To safely care for this patient population, dentists must be familiar with the stimulant and nonstimulant medications used to treat adult ADHD, because these drugs can cause adverse orofacial and systemic reactions and interact adversely with dental therapeutic agents.
Friedlander
Arthur H
AH
Graduate Medical Education, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA. arthur.friedlander@med.va.gov
Yagiela
John A
JA
Mahler
Michael E
ME
Rubin
Robert
R
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use; D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D003729:Dental Care; D006801:Humans
D018759:Adrenergic Uptake Inhibitors; D000929:Antidepressive Agents, Tricyclic; D000697:Central Nervous System Stimulants