ADHD in School-age Children

Attention-deficit/hyperactivity disorder (ADHD) is estimated to affect 3% to 5% of school-age children, making it considered to be the most common neurobehavioral disorder among this group and with survey and epidemiologically derived data showing that 4 to 5% of college aged students and adults have ADHD (Wilens and Spencer para 3). This could also mean that the same population is at a higher risk of having poor oral hygiene and dietary habits. A strong correlation has been found between poor oral hygiene practices and bad dietary habits in children with ADD/ADHD because ADD/ADHD is associated with the tendency of eating sugary foods and poor impulse control. Therefore, to prevent dental and diet issues from developing in people with ADD/ADHD, it is important to educate them on how to keep their teeth healthy, help them with the impulsive behavior that leads to the consequences in the teeth, and bring awareness as to why kids with ADD/ADHD are more at risk for dental problems. Types and Symptoms of ADHD Firstly, Attention-deficit/hyperactivity disorder (ADHD) is an illness characterized by inattention, hyperactivity, and impulsivity, the most commonly diagnosed behavioral disorder in young people (NAMI 1).

Attention deficit/hyperactivity disorder (ADHD) is generally sorted into three different subtypes: Predominantly Inattentive Type, Predominantly Hyperactive-Impulsive Type, and ADHD Combined Type, which involves both hyperactive-impulsive and inattentive symptoms (Griffin, n.d., para 1). Symptoms for the Predominantly Inattentive Type include the need for constant movement, often fidget[ing], squirm[ing], and struggl[ing] to stay seated...act[ing] as if driven by a motor and often talk[ing] and/or run[ning] around excessively...interrupt[ing] others, blurt[ing] out answers, and struggl[ing] with self-control. (Williams, n.d., para 2). Symptoms for the Predominantly Hyperactive-Impulsive Type include mak[ing] careless mistakes because they have difficulty sustaining attention, following detailed instructions, and organizing tasks and activities[being]forgetful, [being] easily distracted by external stimuli, and often los[ing] things.(Williams, n.d., para 2). People who have the ADHD Combined Type exhibit six or more symptoms of inattention, and six or more symptoms of hyperactivity and impulsivity(Williams, n.d., para 2). The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) stipulates that all cases of attention deficit are diagnosed as ADHD...A child may be diagnosed with ADHD only if he or she exhibits at least six of nine symptoms...and if the symptoms have been noticeable for at least six months in two or more settings ” for example, at home and at school.

Furthermore, the symptoms must interfere with the child's functioning or development, and at least some of the symptoms must have been apparent before age 12. Older teens and adults may need to demonstrate just five of these symptoms in multiple settings.(Williams, n.d., para 1 ) ADD/ADHD has certain effects on the brains of children and on the lives of people. Attention-deficit disorder (ADD) and attention-deficit hyperactivity disorder (ADHD) both affect people's ability to stay focused on things like schoolwork, social interactions, and everyday activities like brushing teeth and getting dressed (Griffin 1). Some kids with ADHD act and speak without thinking because their brains works differently than those of kids who do not have it. The part of the brain that controls impulses develops more slowly than usual. That is why children with ADHD often seem less mature than their peers (Morin, n.d., para 1). ADHD Medication ADHD medication is effective in reducing symptoms of ADHD (also known as ADD) in most kids. However, it can sometimes cause side effects. This is true for both stimulant and non-stimulant medications. (The understood team, n.d, para 1) Side effects like an upset stomach or headaches often disappear after a child's body has a few days to get used to the medication. But other common side effects, like decreased appetite, might not go away after a few days.

There may also be a range in how kids experience side effects, from mild to fairly significant. They can occur while the medication is working, or after it's worn off. Sometimes side effects go on for longer than a few days. Or kids may find them so uncomfortable that changes need to be made. In that case, the doctor might change the dosage or change from one type of medication to another. (The understood team, n.d, para 1) Oral Health Effects of ADHD Some actions or characteristics that people with ADHD are more prone to can lead to dental problems. For example, decreased attention span could lead to poor oral hygiene which creates a potential for increased caries and periodontal disease. For example impulsive behavior of a person with ADHD can cause them to eat many sugary foods and think of the consequences, then a short attention span can cause forgetting tasks such as brushing their teeth, which then leads to problems in teeth. People with ADHD are also more prone to Bruxism, which is a condition in which you grind, gnash or clench your teeth. If you have bruxism, you may unconsciously clench your teeth when you're awake (awake bruxism) or clench or grind them during sleep (sleep bruxism) (MAYO, n.d, para 1). This can cause the tooth to become worn down or damaged.

There are also other potential factors that cause dental issues such as: Higher risk for dental/oral trauma in people with ADHD due to increased rates of automobile accidents because of (inattention, impulsivity) Higher risk of periodontal disease and oral cancer due to higher rates of smoking found in people with ADHD. (University of Washington, n.d., para 2) Diet is another important factor that affects the overall oral health of a person including those who have ADHD. Research found that There's no evidence to support the idea that eliminating certain foods has a direct impact on ADHD symptoms. But there is a connection between food reactions and kids with ADHD. (Rosen, n.d.,para 9) Research found that Kids with ADHD are more likely to be sensitive or allergic to specific foods (Rosen, n.d.,para 10).

Which means when if they eat those foods, their reactions which may cause them to feel tired, itchy, nauseated or anxious and that can make it harder than usual for them to focus or control their emotions. (Rosen, n.d.,para 10). Cutting those foods would help the child feel better physically which could make their ADHD symptoms seem less severe. But it's not that eliminating foods actually lessens ADHD symptoms (Rosen, n.d., para 11). Reducing sugar consumption is a general rule that would benefit all children, especially children with ADHD. This is not because sugar causes them to be more hyperactive but because kids with ADHD are at increased risk of developing type 2 diabetes later in life. (Rosen, n.d., para 12). Avoiding sugary foods and sodas can help them stay at a healthy weight and reduce their risk. It's also wise for kids with ADHD to avoid caffeine. It may seem to increase their focus in the short term. But withdrawal from caffeine can make them particularly irritable. (Rosen, n.d., para 13). Reducing sugar in the diet will help a child with ADHD have healthier teeth and could reduce their risk of cavities due to sugary foods. Oral Hygiene in Islam Additionally, good oral hygiene is an important topic in Islam and has been mentioned and practiced by the Prophet Muhammed. Something mentioned often is the siwak, which is a branch from a specific plant that is used to clean and brush teeth. The Prophet was recorded in the hadith as having often used the siwak and urged his Muslim followers to do the same.

It was reported in one hadith that Abu Hurayrah (may Allaah be pleased with him) reported that the Prophet (peace and blessings of Allaah be upon him) said: Were it not for the fact that I did not want to make things too hard for my ummah, I would have commanded them to use the siwaak at every time of prayer. (Reported by al-Bukhaari, 2/299 and Muslim, 1/151) According to another report narrated by al-Bukhaari, he said: at every time of making wudoo'.( Anonymous, 2008, para 6). According to another hadith, 'Aa'ishah was asked what the Messenger of Allah (peace and blessings of Allaah be upon him) did when he first came home. She said, When he entered his house, the first thing he would do was to use the siwaak. (Reported by Muslim, 1/220) ( Anonymous, 2008, para 7). It was recorded in yet another hadith that Hudhayfah ibn al-Yamaan (may Allaah be pleased with him) reported that when the Prophet (peace and blessings of Allaah be upon him) got up during the night, he would clean his mouth thoroughly with the siwaak. (Reported by al-Bukhaari, 1/98 and Muslim, 1/220) ( Anonymous, 2008, para 7). It is clear from how many times Prophet Muhammad's use of the siwak was recorded and in many different situations and times of day, showing the emphasis put on good oral hygiene in Islam. The prophet encourage the use of the siwaak to clean teeth and spoke of the importance of cleanliness and hygiene, specifically oral hygiene, is for a Muslim.

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