Medically reviewed by Globally, Attention-Deficit/Hyperactivity Disorder (ADHD) is estimated to affect approximately 5% of children and 2.5% to 4% of adults, according to multiple large-scale studies and the World Health Organization (WHO). Attention-Deficit/Hyperactivity Disorder (ADHD) affects an estimated 8.4% of children and 2.5% of adults in the United States, according to the American Psychiatric Association.
While the cognitive and behavioural aspects of ADHD are well known, its effects on physical health, particularly oral health, are often overlooked. For many adults with ADHD, maintaining daily routines such as brushing, flossing, and scheduling dental appointments can be a significant challenge.
Understanding the Link Between ADHD and Oral Health
ADHD stands for Attention-Deficit/Hyperactivity Disorder. It’s a neurodevelopmental condition characterized by symptoms of inattention, hyperactivity, and impulsivity that can impact daily functioning across personal, academic, and professional settings.
ADHD is characterized by symptoms such as inattention, hyperactivity, impulsivity, and executive dysfunction. These core symptoms can interfere with the ability to maintain consistent oral hygiene routines, leading to a higher risk of dental issues.
Executive Dysfunction and Daily Oral Routines
Executive dysfunction, a common feature of ADHD, impairs one’s ability to plan, organize, and follow through with tasks. Maintaining oral hygiene requires performing a sequence of actions, consistently brushing, flossing, and rinsing, often twice a day. Adults with ADHD may struggle with initiating these tasks or forget them altogether.
A 2023 Article, “Executive function and oral health behaviours in adults with ADHD,” Authors: Bennett, T. D., Moffitt, T. E., & Caspi, A.
This study founds that executive dysfunction in adults with ADHD negatively affects routine health behaviours like flossing and brushing. Specific components of executive functioning, such as planning and emotion regulation, were linked to oral health Behavior frequency. It supports the link between ADHD-related executive dysfunction and inconsistent oral hygiene, reinforcing that the root cause is neurological rather than behavioural.
Medications For ADHD
When to Take ADHD Stimulant Medications
Important: Taking stimulants late in the day may interfere with sleep.
| Medication | Best Time to Take | Duration of Effect |
| Adderall (mixed amphetamine salts) | Morning, with or without food | IR: ~4–6 hrs XR: ~10–12 hrs |
| Ritalin (methylphenidate) | Morning; may require second dose for IR | IR: ~3–4 hrs LA: ~6–8 hrs |
| Vyvanse (lisdexamfetamine) | Once daily in the morning | ~10–14 hrs (long-acting) |
Benefits of Stimulant Medications
Stimulants are considered first-line treatment for adult ADHD because they help with:
- Improved focus and attention
- Reduced impulsivity and hyperactivity
- Better time management and task completion
- Improved executive functioning
- Enhanced academic or workplace performance
Clinical studies show up to 70-80% of adults with ADHD respond positively to stimulant medications when dosed correctly.
Side Effects of ADHD Medication
Physical Side Effects
- Dry mouth (linked to increased risk of dental caries)
- Loss of appetite
- Insomnia
- Headaches
- Increased heart rate or blood pressure
Mental/Emotional Side Effects
- Anxiety or restlessness
- Mood swings
- Irritability
- Rebound symptoms (worsening of ADHD when the medication wears off)
Why This Matters for Oral Health?
For adults with ADHD:
- Dry mouth (xerostomia) reduces saliva, increasing cavity risk.
- Appetite suppression may lead to fewer meals but more frequent sugary snacking.
- Insomnia and anxiety can disrupt daily routines, including oral hygiene habits.
One of the lesser-discussed side effects of these medications is xerostomia, or dry mouth. Saliva plays a critical role in neutralizing acids and washing away food particles. When saliva production decreases, it increases the risk of cavities and gum disease.
A 2022 Article “Salivary flow and dental caries in patients using ADHD medication” Authors: Hidas, A., Noy, A., Birman, N., Shapira, J., Matot, I., Steinberg, D., & Moskovitz, M.
This study demonstrated that stimulant medications used for ADHD (e.g., methylphenidate) reduce saliva flow, which in turn increases the risk of dental caries in both children and adults.
This provides a biological explanation of how ADHD treatment contributes to oral health deterioration, emphasizing the need for targeted dental care for medicated individuals.
Recommendations
- Take medications early in the day.
- Drink plenty of water and use saliva substitutes if experiencing dry mouth.
- Use sugar-free gum or lozenges to stimulate saliva.
- Communicate with your doctor about any side effects.
- Visit your dentist regularly for preventive care.
Common Oral Health Problems in Adults with ADHD
Increased Risk of Cavities and Gum Disease
Due to inconsistent oral hygiene practices and the side effects of medications, adults with ADHD are more prone to developing dental problems such as cavities, gingivitis, and periodontitis.
An article in 2024, “Oral Health Challenges in Patients with ADHD,” Authors: Internal clinical team at 1Smile Dental.
Highlights the day to day struggles of ADHD patients in maintaining oral hygiene due to impulsivity, forgetfulness, and sugar cravings, contributing to increased dental decay and gum issues.
Dental Anxiety and Avoidance of Care
Dental anxiety is prevalent among adults with ADHD and often leads to the avoidance of regular dental care.
A 2013 study, “Dental Anxiety and ADHD: A common comorbidity”. Authors: Blomqvist, M., Holmberg, K., Fernell, E., Ek, U., & Dahllöf, G.
This study found a significant overlap between ADHD and high dental anxiety. ADHD patients often avoid dental visits, which leads to more advanced dental disease due to delayed treatment. This reinforces the argument that untreated dental issues in adults with ADHD are not merely due to neglect but are also influenced by coexisting anxiety and sensory sensitivities.
Sensory Challenges and ADHD
Many individuals with ADHD also experience sensory processing issues. The feel of dental instruments, the sound of drills, or even the taste of toothpaste can be overstimulating. These sensory challenges can make dental visits particularly uncomfortable, increasing the likelihood of appointment avoidance. Understanding and accommodating these sensory needs is crucial for improving access to dental care.
Strategies for Improving Oral Health in Adults with ADHD
Building Consistent Oral Hygiene Habits
For adults with ADHD, standard oral hygiene advice may not be enough. Instead, adopting ADHD-friendly strategies can be more effective:
- Habit Stacking: Pair brushing teeth with routine activities such as showering or morning coffee.
- Visual Cues: Use sticky notes or place your toothbrush near frequently used items as a visual reminder.
- Timers and Alarms: Set digital reminders or use electric toothbrushes with built-in timers to encourage thorough brushing.
- Gamification: Use mobile apps like Habitica or Brusheez that make brushing and flossing feel like a rewarding task.
Utilizing ADHD-Friendly Tools
- Electric Toothbrushes: These can make brushing more efficient and engaging.
- Water Flossers: Easier to use for those who struggle with manual dexterity or forgetfulness.
- Flavored Floss and Toothpaste: Helps reduce sensory aversion.
- Oral Hygiene Apps: Apps like CareClinic can track routines and medication, offering visual feedback and reminders.
Seeking ADHD-Inclusive Dental Care
Finding a dental provider who understands the unique needs of neurodivergent individuals can significantly improve oral health outcomes. Here’s what to look for:
- Open Communication: Be upfront with your dental team about your ADHD and any sensory issues or anxieties you have.
- Flexible Scheduling: Choose appointments during your most alert times of day.
- Extended Appointments: Allowing extra time can reduce pressure and accommodate breaks.
- Calm Environment: Noise-canceling headphones, dimmed lights, and a quieter room can ease sensory discomfort.
How Dentists Can Support ADHD Patients?
Dental professionals can play a pivotal role in improving care for adults with ADHD by:
- Offering multiple appointment reminders via text, email, or phone.
- Using visual aids and checklists to explain procedures.
- Practicing non-judgmental, patient-centered communication.
- Providing take-home materials tailored for ADHD patients, such as step-by-step hygiene instructions.
Limitations
- Most studies on ADHD and oral health focus on children. There is a relative lack of large-scale, peer-reviewed research focusing exclusively on adults with ADHD, which limits the strength of adult-specific conclusions.
- Many studies rely on self-reported data about hygiene habits, diet, or anxiety, which can introduce bias or inaccuracies, especially in populations with executive dysfunction.
- We suggest ADHD-informed dental care strategies, there is currently no standardized dental protocol tailored specifically for adults with ADHD, meaning care quality can vary widely by provider.
Conclusion
Oral health challenges in adults with ADHD are a complex but manageable issue. The combination of executive dysfunction, side effects from medication, and sensory sensitivities creates unique barriers that require thoughtful, tailored solutions. With the right strategies from habit-building techniques to ADHD informed dental care adults with ADHD can achieve and maintain healthy smiles.
As awareness grows, patients and dental professionals must work together to create more inclusive and effective oral health practices. Recognizing that these challenges are neurological not behavioral is the first step toward compassion-driven care.