Family cohesion and attention deficit exert an influence on visits to the dentist in early adolescence

Abstract

Objectives: To determine whether family environment, signs of attention deficit/hyperactivity disorder (ADHD) and oral health literacy (OHL) are associated with visits to the dentist in adolescents. Methods: A school-based cross-sectional study was conducted with a representative sample of 448 12-year-old adolescents enrolled at schools in the city of Cajazeiras, Brazil. The adolescents answered a validated questionnaire addressing family cohesion and adaptability (FACES III), an OHL measure (Brazilian Rapid Estimate of Adult Literacy in Dentistry [BREALD-30]) and a questionnaire addressing the history of visits to the dentist and previous toothache experience. The parents answered a questionnaire addressing sociodemographic characteristics. Parents and teachers answered the inattention and hyperactivity/impulsivity subscales of the Swanson, Nolan & Pelham (SNAP-IV) questionnaire for the detection of signs of ADHD.Multiple Poisson regression with robust variance was used for data analysis (α = 5%). Results:The prevalence of having visited a dentist some time in life was higher among adolescents with enmeshed (PR = 1.08; 95% CI: 1.01-1.15) and connected (PR = 1.06; 95% CI: 1.01-1.13) families and those with attention deficit according to parents' reports (PR = 1.09; 95% CI: 1.04-1.14). A family income higher than the Brazilian minimum wage (PR = 1.06; 95% CI: 1.01-1.12) and toothache in the previous six months (PR = 1.05; 95% CI: 1.01-1.11) were also associated with the outcome. Conclusion:Family cohesion and attention deficit according to parental reports influenced visits to the dentist among adolescents. In contrast, OHL was not associated with the outcome.

Analysis of Oral Health among ADHD-Affected and Non-ADHD Children in Gran Canaria

“…Additionally, an increase in the DMFM index is associated with the presence of ADHD, a higher number of dental visits, and the absence of a parent. These findings partially align with previous studies that did not find family cohesion factors to be associated with oral health [10,11] but differs in the relationship between dental visits and oral health. The interaction between these factors and ADHD indicates a complex model where oral health is influenced not only by neurological conditions but also by socio-economic and familial environments, underscoring the necessity of a holistic approach in their dental care.…”

“…These findings are consistent with previous studies indicating a higher propensity for dental problems in this population [28][29][30]. However, unlike previous studies, our analysis incorporated a broader range of variables, such as sociodemographic aspects, family cohesion, and dental visits, whose importance has been highlighted in the recent literature [10,11]. This advancement is particularly important, as it addresses a critical gap in the literature, providing specific insights into the Gran Canaria population and enhancing our contextual understanding of the ADHD-oral health relationship across varied geographic and cultural settings.…”

“…ADHD is characterized by a lack of concentration and inappropriate levels of hyperactivity and impulsivity [9][10][11] and is one of the most common childhood conditions, typically diagnosed at school age [12]. This condition significantly impacts family stress, academic performance, and self-esteem [13].…”