Is there a relationship between hyperactivity/inattention symptoms and poor oral health? Results from the GINIplus and LISAplus study
Is there a relationship between hyperactivity/inattention symptoms and poor oral health? Results from the GINIplus and LISAplus study
复制标题
DOI：
10.1007/s00784-012-0829-7
复制
发表时间：
2013-06-01
影响因子：
3.4
通讯作者：
Kuehnisch, Jan
中科院分区：
文献类型：
--
作者：
Kohlboeck, Gabriele;Heitmueller, Daniela;Kuehnisch, Jan
一些临床观察报告称，与没有注意缺陷多动障碍（ADHD）的儿童相比，患有ADHD的儿童的口腔健康状况较差。然而，证据并不确凿。我们在一项基于人群的研究中评估了多动/注意力不集中与口腔健康之间的关系。作为正在进行的出生队列研究的一部分，德国婴儿营养干预+（GINIplus）和生活方式相关因素对免疫系统的影响以及儿童过敏症的发展（LISAplus），来自慕尼黑（德国）的1，126名10岁（+/- 10.2）的儿童被包括在本分析中。在牙科检查期间，记录口腔卫生、非龋蚀和龋蚀病变、牙外伤和恒牙列（MIH/1）中的釉质矿化不足（EH）。磨牙-切牙-低矿化的儿童被细分为至少一个第一恒磨牙（MIH/1A）和至少一个第一恒磨牙和恒切牙（MIH/1B）的EH。儿童多动/注意力不集中症状的数据通过父母报告的力量和困难问卷收集。Logistic回归和零膨胀Poisson回归分析显示，多动/注意力不集中与非龋蚀呈正相关（ORadj = 1.51，CI 95%= 1.08-2.11）。校正父母背景后，多动/注意力不集中症状与MIH/1A有相关性，但差异无统计学意义（ORadj = 1.59，CI 95%= 1.00-2.53），多动/注意力不集中症状临界值和异常值儿童的非龋洞性龋损发生率较高。学龄期儿童注意力不集中/多动的程度越高，患MIH/1A的风险越高。对注意力不集中/多动的儿童，特别是来自低社会背景的儿童，进行适当的牙齿预防护理，对于最佳的龋病预防至关重要。
A few clinical observations reported that children with attention deficit hyperactivity disorder (ADHD) have poor oral health compared to children without ADHD. However, evidence is not conclusive. We assess the association between hyperactivity/inattention and oral health in a population-based study.As part of the ongoing birth cohort studies German Infant Nutritional Intervention-plus (GINIplus) and Influences of lifestyle-related factors on the immune system and the development of allergies in childhood-plus (LISAplus), 1,126 children at age 10 years (+/- 10.2) from Munich (Germany) were included in the present analysis. During the dental examination, oral hygiene, non-cavitated and cavitated caries lesions, dental trauma, and enamel hypomineralization (EH) in the permanent dentition (MIH/1) were recorded. Children with a Molar-Incisor-Hypomineralization were subcategorized into those with EH on at least one first permanent molar (MIH/1A), and on at least one first permanent molar and permanent incisor (MIH/1B). Data on children's hyperactivity/inattention symptoms were collected by parent-reported Strength and Difficulties Questionnaire. Logistic regressions and zero-inflated Poisson regression models were applied adjusted for gender, parental education, parental income, and methylphenidate or atomoxetine medication.Logistic regressions showed that non-cavitated caries lesions were positively related with the presence of hyperactivity/inattention (ORadj = 1.51,CI95% = 1.08-2.11). When adjusted for parental background, an association showed between hyperactivity/inattention symptoms and MIH/1A but did not reach statistical significance (ORadj = 1.59,CI95% = 1.00-2.53).Children with borderline and abnormal values of hyperactivity/inattention symptoms showed more non-cavitated caries lesions. Severe levels of hyperactivity/inattention may contribute to a higher risk for MIH/1A in school age.Adequate dental preventive care for children with hyperactivity/inattention, especially from a low social background, is of importance for optimal caries prevention.