Association between attention deficit hyperactivity disorder and bruxism: a systematic review.

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental condition characterized by symptoms of inattention, disorganization, and/or hyperactivity-impulsivity. Bruxism, defined as repetitive masticatory muscle activity involving clenching or grinding of the teeth and/or forceful mandibular movements, has been associated with several physiological and psychosocial factors. Considering the neurobehavioral profile of individuals with ADHD, a possible association between ADHD and bruxism has been hypothesized.

AIMS: To determine whether an association exists between ADHD and bruxism.

METHODS

A comprehensive literature search was conducted across five electronic databases and two gray literature sources. Observational studies comparing individuals with ADHD to non-ADHD controls, with data on the presence of bruxism, were included. Independent authors conducted study selection and data extraction. Risk of bias was assessed using the JBI critical appraisal tools. A pairwise meta-analysis was performed using RevMan Web. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model.

Results

Sixteen studies with 16,348 participants were included. The pooled OR indicated that individuals with ADHD were two times more likely to present bruxism compared to controls (OR 2.16; 95% CI 1.72-2.71; p < 0.00001, I2 51%). Subgroup analyses by age group showed a consistent association across children, adolescents, and adults. Moderate heterogeneity and potential small-study bias (with little impact on the pooled results after sensitivity analysis) were observed.

CONCLUSIONS

Current evidence supports a possible association between ADHD and bruxism.