Dental management and behavioral considerations in pediatric patients with attention-deficit/hyperactivity disorder: A narrative review

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental condition that affected children’s behavior, learning, and oral health. This narrative review aimed to synthesize current evidence on diagnostic considerations, comorbidities, behavioral manifestations, and dental management strategies in pediatric patients with ADHD. A structured electronic search was performed in PubMed/MEDLINE, Lilacs, BBO, and SciELO databases for English-language publications from 1971 to 2022. Of 145 records initially identified, 54 met the inclusion criteria. All studies were critically appraised by two independent reviewers to assess methodological rigor and relevance to pediatric dental practice. Children with ADHD were consistently reported to have an elevated risk of dental caries, traumatic dental injuries, and bruxism, largely attributable to behavioral challenges, poor oral hygiene practices, and side effects of stimulant medications. ADHD was also frequently associated with comorbid psychiatric and functional impairments that further complicated dental management. Effective care should be facilitated by short, well-timed appointments, simplified instructions, use of positive reinforcement, and coordination with caregivers and healthcare providers. A comprehensive understanding of the behavioral, medical, and pharmacological dimensions of ADHD is indispensable for pediatric dental practitioners. Individualized, multidisciplinary approaches are essential to optimize oral health outcomes and overall quality of life in children with ADHD.