Abstract
Background
This systematic review and meta-analysis aimed to answer the following question: Are children and adolescents with attention deficit hyperactivity disorder (ADHD) more likely to have gingival or periodontal disease-related outcomes than their non-ADHD peers?
Methods
Searches were conducted in the following databases: Embase, Scopus, Web of Science, and PubMed. Google Scholar and OpenGrey were also verified. Observational studies were included in which children and adolescents with ADHD were compared with their healthy peers in terms of gingival and/or periodontal endpoints. Bias appraisal was performed using the Joann Briggs tool for case–control and cross-sectional studies. Meta-analysis was performed using R language. Results are reported as mean difference (MD) and odds ratio (OR). Statistical analyses were performed in RStudio.
Results
A total of 149 records were identified in the searches. Seven studies were included. The meta-analysis showed that children and adolescents with ADHD had a higher mean gingival bleeding index (percentage) than their non-ADHD peers (MD = 11.25; CI = 0.08–22.41; I2 = 73%). There was no difference between groups for plaque index (MD = 4.87; CI = − 2.56 to 12.30; I2 = 63%) and gingivitis (OR = 1.42; CI = 0.22–9.21; I2 = 76%). Regarding the assessment of risk of bias, the major issue found in the articles was the absence of analyses for the control of confounding factors.
Conclusion
Children and adolescents with ADHD had more gingival bleeding than their non-ADHD peers, but no difference regarding plaque or gingivitis was detected between groups.
Clinical registration
CRD42021258404.
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Acknowledgements
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001, Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (305493/2018-3, 435644/2018-1, 404710/2018-2, 310797/2019-5), and Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG). Lucas Guimarães Abreu and Ricardo Alves Mesquita are research fellows at CNPq. José Alcides Almeida de Arruda is a recipient of a scholarship from CAPES. Mrs. E. Greene provided English editing of the manuscript.
Funding
Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (305493/2018-3, 435644/2018-1, 310797/2019-5).
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Conceptualization: VZD and LGA; methodology: LGA; formal analysis and investigation: VZD, AAA, RAM and LGA; writing—original draft preparation: VZD and JAAdA; writing—review and editing: VZD, JAAdA, RAM and LGA; supervision: LGA.
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Additional information is available and can be consulted in the Supplementary Files. The full list of references assessed in this systematic review and meta-analysis is provided in Supplementary File 12. (PDF 1641 KB)
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Drumond, V.Z., Andrade, A.A., de Arruda, J.A.A. et al. Periodontal outcomes of children and adolescents with attention deficit hyperactivity disorder: a systematic review and meta-analysis. Eur Arch Paediatr Dent 23, 537–546 (2022). https://doi.org/10.1007/s40368-022-00732-8
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DOI: https://doi.org/10.1007/s40368-022-00732-8