注意力缺陷与多动障碍儿童的口腔疾病研究 进展

Research Progress of Oral Diseases in ADHD Children

摘要: 注意力缺陷与多动障碍(ADHD，简称多动症)是儿童期高发的慢性神经发育障碍，以与年龄不匹配的注意力不足、多动冲动为核心表现，常伴随认知、情绪及社交能力异常，需药物、行为干预等综合措施改善远期预后。与健康儿童相比，ADHD儿童口腔健康状况更严峻，疾病更复杂、进展更快，且诊疗配合度差，增加了临床治疗难度。ADHD儿童常见龋齿、牙周病、牙外伤等口腔疾病，其中龋齿发生率显著偏高，与患儿不良口腔习惯密切相关——注意力不集中导致无法规范刷牙，且常挑食、频繁进食甜食，加重口腔菌群紊乱，加速龋齿进展。同时，多动冲动的特点不仅增加口腔外伤风险，也使其在诊疗中难以配合医生，易出现哭闹、挣扎，影响治疗效果甚至导致治疗中断。此外，ADHD儿童常与焦虑、对立违抗等精神行为问题共病，进一步降低其口腔健康意识和自我管理能力，形成恶性循环。掌握其行为特点与口腔疾病规律，是制定个体化诊疗方案的关键。近年来，多媒体引导、分时段诊疗、多学科协作等新型干预模式逐步应用，为改善其口腔健康提供新路径。本文就ADHD儿童口腔疾病特征、危险因素及防治进展进行综述，为临床实践提供参考。

Abstract: Attention Deficit Hyperactivity Disorder (ADHD), commonly known as hyperactivity disorder, is a prevalent chronic neurodevelopmental disorder in childhood. It is characterized by age-inappropriate inattention, hyperactivity and impulsivity as core manifestations, often accompanied by abnormalities in cognitive, emotional and social abilities. Comprehensive interventions including medication and behavioral intervention are required to improve long-term prognosis. Compared with healthy children, children with ADHD present poorer oral health conditions, more complex oral diseases with faster progression, as well as poor cooperation during diagnosis and treatment, which increases the difficulty of clinical management. Children with ADHD are susceptible to common oral diseases such as dental caries, periodontal diseases and dental trauma. Among these, the incidence of dental caries is markedly higher, which is closely associated with their unhealthy oral habits. Inattention makes them unable to brush their teeth in a standardized manner; moreover, they are often picky eaters and frequently consume sweets, aggravating the disturbance of oral flora and accelerating the progression of dental caries. Meanwhile, the traits of hyperactivity and impulsivity not only raise the risk of oral trauma, but also make it difficult for them to cooperate with dentists during treatment. They tend to cry and struggle, undermining therapeutic effects and even leading to treatment interruption. In addition, children with ADHD often have comorbid mental and behavioral problems such as anxiety and oppositional defiant disorder, which further reduce their awareness of oral health and self-management ability, thus forming a vicious cycle. Understanding their behavioral characteristics and the pathogenesis pattern of oral diseases is the key to developing individualized diagnosis and treatment protocols. In recent years, novel intervention models such as multimedia guidance, time-phased diagnosis and treatment, and multidisciplinary collaboration have been gradually applied, providing new approaches to improve their oral health. This article reviews the characteristics, risk factors and research progress in the prevention and treatment of oral diseases in children with ADHD, so as to provide references for clinical practice.