The prevalence of malocclusion is higher in schoolchildren with signs of hyperactivity

Abstract

Attention deficit-hyperactivity disorder is a behavioral disorder characterized by a lack of focus, impulsive behavior, and or excessive activity. This research aimed to evaluate the association between signs of attention deficit-hyperactivity disorder and malocclusion in schoolchildren. A cross-sectional study was conducted with a representative sample of 633 children aged 7-12years. The children were clinically examined for malocclusion using the Dental Aesthetic Index. The predominant breathing pattern was also determined. Parents answered a questionnaire addressing socioeconomic characteristics and the presence of nonnutritive sucking habits. The Swanson, Nolan, and Pelham Scale-IV was filled out by both parents and teachers to compare behavioral patterns. The children were submitted to a neuropsychological evaluation using the Raven's Colored Progressive Matrix Test. Data analysis involved the chi-square test and Poisson regression analysis. The prevalence of malocclusion was 42% higher among children with signs of hyperactivity reported by both parents and teachers (prevalence ratio [PR], 1.42; 95% confidence interval [CI], 1.11-1.81; P=0.004). In the final Poisson regression model, the prevalence of malocclusion was lower among schoolchildren aged 11 and 12years (PR, 0.62; 95% CI. 0.52-0.73; P<0.001) and higher among those who used a pacifier for at least 4years (PR, 1.25; 95% CI, 1.02-1.54; P=0.029) as well as those classified as mouth breathers (PR, 1.28; 95% CI, 1.09-1.51; P=0.003). The prevalence of malocclusion was higher among children with signs of hyperactivity independently of age, pacifier use, and mouth breathing.