Attention-deficit hyperactivity disorder (ADHD) is one of the most common mental health problems in children. Children with ADHD exhibit reduced attention span, impaired impulse control, and difficulties with activity modulation compared with their peers. These symptoms emerge early in life and often persist into adulthood. The behavioural issues, cognitive deficits, and short attention span pose a significant challenge during the treatment.
Neurological abnormalities have been implicated in the pathophysiology of ADHD.
The management of such children becomes more difficult when they are undiagnosed. Their behaviour is perceived as spoiled, disobedient, overly anxious or lacking discipline. This can lead to ineffective management of the cases as incorrect behaviour management techniques may be used by the dentists.
Impulsivity can lead to sudden movements during procedures, which may result in injuries. Children may also struggle to comply with instructions given during treatment. They may attempt to get up from the chair mid-treatment.
The dentist needs to be vigilant to notice hyperactivity and inattentiveness in the child during the procedure. The signs that can be taken into account are
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Behaviour disproportionate to developmental age
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Persistent difficulty across multiple visits
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Extreme distractibility
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Impulsive movements despite clear instructions
The parents should be asked neutral questions like
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Does your child find it difficult to focus on tasks at home?
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Are there any issues mentioned by the teachers?
In such cases, the dentist must approach the parents with sensitivity and professionalism and guide the parents for appropriate evaluation.
Once the signs are noticed , following strategies can be used for management of such cases
- Give morning appointments (child is less fatigued and more attentive).
- Keep appointments short and well-structured.
- Avoid long waiting times.
- Explain procedures in simple language.
- Use visual aids or models.
ADHD is a chronic neurodevelopmental disorder that frequently persists into adulthood. If left unmanaged, ADHD can negatively affect academic achievement, employment, relationships, and overall quality of life. Early identification and appropriate management are therefore important to reduce long-term functional impairment and improve overall outcomes.