Why Do People with ADHD Suffer From Dry Mouth?

Research has shown that children and adults with ADHD suffer from worse oral health symptoms than those without, including dry mouth. Why is this the case? On the surface, ADHD is a neurodevelopmental disorder, unrelated to oral health or hygiene. However, digging deeper, the behavior of people with ADHD affects the way they approach and implement oral hygiene practices. Fortunately, there are ways people with ADHD can help themselves maintain better oral health and alleviate dry mouth, and ways for dental professionals to help them. 

ADHD and Oral Health in Adults

CareQuest Institute’s annual State of Oral Health Equity in America survey focuses on adults’ attitudes, experiences, and behaviors related to oral health. The 2024 survey surveyed 9,000 adults across the country and showed that adults with ADHD are more likely to have poor oral health than those without. 

• 35.5% of study participants with ADHD rated their oral health as either fair or poor, compared to 24.9% of neurotypical respondents who gave the same rating. 
• 48.4% with ADHD were embarrassed about the state of their oral health, while only 29.6% of those without cited embarrassment. 
• 40.4% of participants with ADHD reported not visiting a dentist in the past year, as opposed to 31.9% of adults without ADHD who reported the same thing.
• 13% of participants with ADHD reported visiting an emergency clinic for dental care, whereas only 2.3% of neurotypical adults reported the same thing.
• 11.7% of participants with ADHD reported feeling discriminated against in a dental setting, as well as an increased level of dental anxiety, compared to 7% of adults without ADHD.

ADHD and Oral Health in Children

Several studies have shown that children with ADHD have worse oral health than those without. One study in Gran Canaria observed children between 6 and 16 years old, 53 with ADHD and 106 without. Those with ADHD were found to have significantly more dental caries and gingival bleeding than those without. 

Why Does ADHD Affect Oral Health?

Several factors play a role in the relationship between ADHD and oral health, both in children and adults. 

1. The nature of ADHD: ADHD is characterized by inattentive, hyperactive, and impulsive behavior, which has a direct impact on oral health.
   1. Children and adults who are easily distracted may not remember to brush and floss daily. 
   2. They may be hyper-intent upon other tasks, which takes away their focus from oral hygiene practices. 
   3. Impulsive behavior may cause them to make unhealthy food choices, such as increased sugar intake, which directly impacts oral health (especially when not brushing and flossing regularly). 
   4. People with ADHD suffer more from dental anxiety than those without, which can cause children to misbehave during dental checkups and adults to avoid checkups altogether. 
2. ADHD medications: ADHD medications, mainly stimulants like Adderall, Ritalin, and Concerta, cause dry mouth, a condition that directly impacts oral health. Dry mouth is when the salivary glands don’t produce enough saliva, a much-needed ingredient for good oral hygiene. Saliva washes away sugar and food particles, assists with the prevention of tooth decay, protects against harmful bacteria, and prevents infections. Saliva also aids in chewing, tasting, and digesting food. Therefore, when an adult or child doesn’t have enough saliva, it directly impacts their oral health and causes many unpleasant symptoms. 
3. Discrimination: People with ADHD report feeling discriminated against in oral healthcare settings, which may lead them to receive poor-quality treatment.
4. Poor oral health indicator for the future: Children who grow up with poor oral health are likely to continue on the same path toward adulthood. In fact, research shows that a high number of dental caries during early childhood is the single strongest predictor of caries in adolescence and adulthood.

Improving Oral Hygiene for People With ADHD

The first step in enhancing oral hygiene for people with ADHD is understanding the problem. People with ADHD must be aware of their unique challenges, and this awareness is often the key to treatment. 

• Those who are aware that they are easily distracted can set alarms for themselves, reminders, and enlist the help of others to stick with their tasks. 
• Those who have dental anxiety can seek professional help to help them deal with their fear. 
• Parents of children with ADHD can guide them in making better food choices, making sugary foods less readily available, and reminding them to brush their teeth and floss. 
• Children and adults who take ADHD medications that cause dry mouth can speak to their doctor or dentist and ask for prevention ideas and dry mouth treatments. There are many options, though it can take a few tries to arrive at a suitable, personalized treatment plan.
• Dental professionals can help their patients by being aware of their challenges and making them feel as comfortable as possible during their dental visits. Dentists should also suggest more frequent checkups so they can be on top of cavities and other oral health issues. 

Dry Mouth Treatment Options for People with ADHD

There are several dry mouth treatments available, some of which can be used simultaneously. In fact, research shows that a holistic approach to dry mouth is most effective. 

• Lifestyle habits: Drinking enough water is Healthy Living 101. It doesn’t only keep the mouth moist, but it’s good for the entire body. Other lifestyle habits that can reduce the discomfort of dry mouth include avoiding caffeine, nicotine, and alcohol, reducing sugar intake, and sleeping with a humidifier at night. 
• Saliva stimulants: Several prescription medications, including pilocarpine and cevimeline, stimulate the salivary glands to produce more saliva. Intra-oral electrostimulation is a non-pharmacological way of achieving the same result.
• Medication adjustment: People with ADHD who take medications that cause dry mouth can speak to their healthcare provider and try to adjust the medications/dosage to achieve a balance that doesn’t cause dry mouth (or that lessens its symptoms).
• Saliva substitutes: Gels, sprays, lozenges, and mouthwashes can act as saliva substitutes, providing artificial saliva that can temporarily reduce dry mouth discomfort. 

• Treatment of underlying conditions: People with ADHD who also have other conditions that cause dry mouth, such as Sjögren’s syndrome and diabetes, can treat the underlying condition to minimize dry mouth symptoms. 

FAQS

Do people with ADHD have bad oral hygiene habits?

People with ADHD don’t necessarily have bad habits, but it can be harder for them than for neurotypical people to stick with an oral health routine. 

Are children with poor oral health likely to have poor oral health as adults?

Yes,  research shows that a high number of dental caries during early childhood is the single strongest predictor of caries in adolescence and adulthood. Additionally, dental erosion (often linked to carbonated drinks and bulimia), is irreversible, so those who incur erosion as children will have it as adults. 

What can people with ADHD do to combat poor oral health?

Adults with ADHD can set daily reminders to brush and floss their teeth, schedule frequent dental checkups, check their medications with their doctors, and cut down on sugary foods and drinks.If they have dental anxiety, seeking professional help can help alleviate it. Parents of children with ADHD can help them do the same.

What are effective dry mouth treatments for people with ADHD?

People with ADHD who have dry mouth can choose any number of treatment options (under a doctor’s supervision). These include prescription or OTC medications, saliva substitutes, electrostimulation via the SaliPen, medication adjustment, and lifestyle changes. 

Is the SaliPen safe to use for dry mouth?

Yes, the SaliPen is FDA-approved and a safe, effective treatment for dry mouth. It can be purchased here.