ADHD May Be a Risk Factor for Periodontitis

Attention-deficit hyperactivity disorder (ADHD) is an independent risk factor periodontitis, according to research findings published in the Journal of Attention Disorders.

Periodontitis leads to tooth loss and may contribute to systemic inflammation. Although some evidence has supported a link between adolescents with ADHD and poor oral hygiene, few studies have investigated the association between ADHD and periodontitis.

To assess the risk for periodontitis among adolescents with ADHD, researchers sourced data from the Taiwan National Health Insurance Research Database (NHIRD), which consists of health care data from up to 99.7% of the entire Taiwanese population. Adolescents between 12 and 19 years of age with psychiatrist-diagnosed ADHD and no prior history of periodontitis were compared with matched control participants without ADHD. The primary outcome of interest was diagnosis of periodontitis by a dentist.

Overall, 16,211 adolescents with ADHD were compared with 162,110 age- and sex-matched control participants. The incidence of periodontitis was significantly higher among adolescents with ADHD (15%) relative to the control cohort (7.9%). Furthermore, those with ADHD developed periodontitis earlier than control participants (16.4 vs 21.5 years, respectively; P <.001).

Regression models adjusted for potential confounders (including smoking, diabetes, and depression) demonstrated similar results, as risk for periodontitis was higher among both boys (hazard ratio [HR], 2.29; 95% CI, 2.16-2.43) and girls (HR, 2.11; 95% CI, 1.90-2.34) with ADHD compared with control participants.

The researchers identified an increased risk of developing periodontitis among all 3 ADHD presentation subtypes:

• Combined presentation (HR, 2.69; 95% CI, 2.52-2.89);
• Predominantly inattentive presentation (HR, 2.23; 95% CI, 2.05-2.42); and,
• Predominantly hyperactive presentation (HR, 2.07; 95% CI, 1.90-2.26).

The researchers observed no significant associations between exposure to ADHD medications and the risk for periodontitis among adolescents with ADHD. However, the researchers observed a beneficial effect of short-term atomoxetine use on periodontitis risk (HR, 0.42; 95% CI, 035-0.70), although only 2% of the sample took atomoxetine.

“If ADHD was to be demonstrated as a risk factor of periodontitis and ADHD medications may be a potential preventative approach against the periodontitis risk, it would have broad public health significance given the prevalence of ADHD,” the researchers concluded.

Study limitations include the use of registry-based data, such as errors in the reporting of periodontitis and/or ADHD, and limited generalizability beyond Taiwanese individuals.

This article originally appeared on Psychiatry Advisor