Manejo conductual de pacientes pediátricos con trastorno por déficit de atención e hiperactividad en odontología: enfoques clínicos y pedagógicos
DOI:
https://doi.org/10.29105/innoacad.v2i3.95Palabras clave:
Trastorno por déficit de atención con hiperactividad, Odontopediatría, Educación en odontologíaResumen
El Trastorno por Déficit de Atención e Hiperactividad (TDAH) es uno de los trastornos del neurodesarrollo más frecuentes en la infancia y se caracteriza por inatención, impulsividad e hiperactividad, lo que puede dificultar la cooperación durante la atención odontológica. El objetivo del presente trabajo es analizar la evidencia científica reciente sobre estrategias de manejo conductual en odontopediatría para pacientes con TDAH. Se realizó una revisión narrativa mediante búsqueda en PubMed, Scopus y Google Scholar, priorizando estudios de los últimos cinco años relacionados con TDAH, manejo conductual y odontología. Las técnicas estructuradas, como comunicación guiada, refuerzo positivo y distracción, mejoran la cooperación y reducen la ansiedad. La aplicación de estrategias adaptadas al perfil neuroconductual del paciente con TDAH optimiza la atención odontológica y favorece experiencias clínicas positivas.
Descargas
Citas
Alamri, H. (2022). Oral care for children with special healthcare needs in dentistry: Literature review. Journal of Clinical Medicine, 11(19), 5557. https://doi.org/10.3390/jcm11195557
American Academy of Pediatric Dentistry [AAPD]. (2024). Behavior guidance for the pediatric dental patient. In The Reference Manual of Pediatric Dentistry (pp. 358–378). AAPD. https://www.aapd.org/globalassets/media/policies_guidelines/bp_behavguide.pdf
Armfield, J. (2006). Cognitive vulnerability model of the etiology of fear. Clinical Psychology Review, 26(6), 746–768. https://doi.org/10.1016/j.cpr.2006.03.007
Armfield J. (2010). Development and psychometric evaluation of the Index of Dental Anxiety and Fear (IDAF-4C+). Psychological Assessment, 22(2), 279–287. https://doi.org/10.1037/a0018678
Armfield, J., & Heaton, L. (2013). Management of fear and anxiety in the dental clinic: a review. Australian Dental Journal, 58(4), 390–531. https://doi.org/10.1111/adj.12118
Bagher, S., Felemban, O., Alandijani, A., Tashkandi, M., Bhadila, G., & Bagher, A. (2023). The effect of virtual reality distraction during dental treatment among anxious pediatric patients. Journal of Clinical Pediatric Dentistry, 47(4), 63–71. https://doi.org/10.22514/jocpd.2023.036
Bayón, G., Stiernhufvud, F., Ribas-Pérez, D., Biedma, M., & Mendoza, A. (2025). Parental anxiety disorders and dental treatment in children. Journal of Clinical Medicine, 14(6), 1869. https://doi.org/10.3390/jcm14061869
Bhowmick, S., Bajana, P., Patel, K., Sharma, K., Varshini, R., & Srija, K. (2025). Impact of tell-show-do and audiovisual distraction techniques on pediatric dental anxiety. Bioinformation, 21(7), 2221–2225. https://doi.org/10.6026/973206300212221
Bimstein, E., Wilson, J., Guelmann, M., & Primosch, R. (2008). Oral characteristics of children with attention-deficit hyperactivity disorder. Special Care in Dentistry, 28(3), 107–110. https://doi.org/10.1111/j.1754-4505.2008.00021.x
Boland, L., Graham, I. D., Légaré, F., Lewis, K., Jull, J., Shephard, A., Lawson, M., Davis, A., Yameogo, A., & Stacey, D. (2019). Barriers and facilitators of pediatric shared decision-making: Systematic review. Implementation Science, 14(7), Artículo 7. https://doi.org/10.1186/s13012-018-0851-5
Candan, M., Kutlu, E., & Yilmaz, I. (2023). Predictors of parental acceptance of behavior management techniques in pediatric dentistry: a preliminary study on Turkish population. Children, 10(10), 1592. https://doi.org/10.3390/children10101592
Carrillo-Díaz, M., Crego, A., Armfield, J., & Romero, M. (2012). Self-assessed oral health, cognitive vulnerability and dental anxiety in children: testing a mediational model. Community dentistry and oral epidemiology, 40(1), 8–16. https://doi.org/10.1111/j.1600-0528.2011.00646.x
Cermak, S., Stein, L., Williams, M., Dawson, M., Lane, C., & Polido, J. C. (2015). Sensory Adapted Dental Environments to Enhance Oral Care for Children with Autism Spectrum Disorders: A Randomized Controlled Pilot Study. Journal of autism and developmental disorders, 45(9), 2876–2888. https://doi.org/10.1007/s10803-015-2450-5
Chatti, M., Chebbi, N., & Baaziz, A. (2025). Attention-deficit hyperactivity disorder and oral health in children and adolescents: A systematic review. European Archives of Paediatric Dentistry. https://doi.org/10.1007/s40368-025-01096-5
Chau, Y., Lai, K., McGrath, C., & Yiu, C. (2017). Oral health of children with attention deficit hyperactivity disorder. European journal of oral sciences, 125(1), 49–54. https://doi.org/10.1111/eos.12323
Chau, Y., Peng, S., McGrath, C., & Yiu, C. (2020). Oral health of children with ADHD: Systematic review and meta-analysis. Journal of Attention Disorders, 24(7), 947–962. https://doi.org/10.1177/1087054717743331
Coté, C., & Wilson, S. (2019). Guidelines for monitoring pediatric patients before, during and after sedation. Pediatrics, 143(6), e20191000. https://doi.org/10.1542/peds.2019-1000
Custódio, N., Cademartori, M., Azevedo, M., Mendes, M., Schardozim, L., Costa, L., & Goettems, M. (2021). Efficacy of audiovisual distraction using eyeglasses during dental care: a randomized clinical trial. Brazilian oral research, 35, e26. https://doi.org/10.1590/1807-3107bor-2021.vol35.0026
Daley, D., & Birchwood, J. (2010). ADHD and academic performance. Child: Care, Health and Development, 36(4), 455–464. https://doi.org/10.1111/j.1365-2214.2009.01046.x
De Oliveira, R., Khalid, H., Zhang, Z., Chakraborty, S., Benzano, D., Kruger, J., & McKernan, S. (2025). Visit characteristics associated with pediatric dental appointment no-shows in an academic dental setting. International Journal of Dentistry, 2025 (1), 2114933. https://doi.org/10.1155/ijod/2114933
Elicherla, N., Saikiran, K., Anchala, K., Elicherla, S., & Nuvvula, S. (2024). Evaluation of the effectiveness of tell-show-do and ask-tell-ask in the management of dental fear and anxiety: A randomized trial. Journal of Dental Anesthesia and Pain Medicine, 24(1), 57–65. https://doi.org/10.17245/jdapm.2024.24.1.57
Feigal, R. (2001). Guiding and managing the child dental patient. Journal of Dental Education, 65(12), 1369–1377. https://pubmed.ncbi.nlm.nih.gov/11780655/
Ferreira, A., Rabelo-Costa, D., Barbosa, I., Baraúna, M., Cople, L., Martins, S., & Baccin, C. (2023). The relationship between temperament and dental fear and anxiety: a systematic review. Evidence-based dentistry, 24(1), 42. https://doi.org/10.1038/s41432-023-00852-0
Flippin, M., Reszka, S., & Watson, L. (2010). Effectiveness of the picture exchange communication system in autism spectrum disorders: a meta-analysis. American Journal of Speech-Language Pathology, 19(2), 178–195. https://doi.org/10.1044/1058-0360(2010/09-0022)
Fox, C., & Newton, J. (2006). A controlled trial of the impact of exposure to positive images of dentistry on anticipatory dental fear in children. Community Dentistry and Oral Epidemiology, 34(6), 455–459. https://doi.org/10.1111/j.1600-0528.2006.00303.x
Gemp, S., Ziebolz, D., Haak, R., Mauche, N., Prase, M., Dogan-Sander, E., Görges, F., Strauß, M., & Schmalz, G. (2023). Oral health-related quality of life in adult patients with depression or ADHD. Journal of Clinical Medicine, 12(22), 7192. https://doi.org/10.3390/jcm12227192
Gisour, E., Beigi, M., Jahanimoghadam, F., & Nekouei, A. (2025). Determinants of pediatric dental anxiety after dental treatment under general anesthesia. Scientific Reports, 15, 10006. https://www.nature.com/articles/s41598-025-94979-y
Goleman, J. (2014). Cultural factors affecting behavior guidance and family compliance. Pediatric Dentistry, 36(2), 121–127. https://pubmed.ncbi.nlm.nih.gov/24717749/
Gupta, R., Randell, K., & Dowd, M. (2021). Addressing parental adverse childhood experiences in the pediatric setting. Advances in Pediatrics, 68, 71–88. https://doi.org/10.1016/j.yapd.2021.05.003
Isong, I., Rao, S., Holifield, C., Iannuzzi, D., Hanson, E., Ware, J., & Nelson, L. (2014). Addressing dental fear in children with autism spectrum disorders: a randomized controlled pilot study using electronic screen media. Clinical Pediatrics, 53(3), 230–237. https://doi.org/10.1177/0009922813517169
Javadinejad, S., Farajzadegan, Z., & Madahain, M. (2011). Iranian version of a face version of the Modified Child Dental Anxiety Scale: Transcultural adaptation and reliability analysis. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences, 16(7), 872–877. https://pubmed.ncbi.nlm.nih.gov/22279453/
Kohli, N., Hugar, S., Soneta, S., Saxena, N., Kadam, K., & Gokhale, N. (2022). Psychological behavior management techniques to alleviate dental fear and anxiety in children: Systematic review and meta-analysis. Dental Research Journal, 19, 47. https://pubmed.ncbi.nlm.nih.gov/35915712/
Kumar, R., Sindgi, R., Nirmal, D., Lakshmi, P., Kumar, P., Dubey, A., & Reddy, S.(2024). Effectiveness of behavior management techniques in pediatric dentistry. Journal of Pharmacy and Bioallied Sciences, 16(Suppl 3), S2434–S2436. https://doi.org/10.4103/jpbs.jpbs_262_24
Li, J. (2018). Children’s reward and punishment sensitivity moderates parenting behaviors in child ADHD symptoms. Journal of Abnormal Child Psychology, 46(8), 1585–1598. https://doi.org/10.1007/s10802-018-0421-y
Long, N. (2014). Stress and economic hardship: Impact on children and parents. Pediatric Dentistry, 36(2), 109–114. https://pubmed.ncbi.nlm.nih.gov/24717747/
Moura, M., Firmino, R., Neves, É., Paiva, S., Ferreira, F., & Granville-Garcia, A. (2022). Family cohesion and attention deficit exert an influence on visits to the dentist. Community Dentistry and Oral Epidemiology, 50(3), 164–170. https://doi.org/10.1111/cdoe.12647
Navit, S., Johri, N., Khan, S., Singh, R., Chadha, D., Navit, P., Sharma, A., & Bahuguna, R. (2015). Effectiveness and Comparison of Various Audio Distraction Aids in Management of Anxious Dental Paediatric Patients. Journal of clinical and diagnostic research: JCDR, 9(12), ZC05–ZC9. https://doi.org/10.7860/JCDR/2015/15564.6910
Oliver, K., & Manton, D. (2015). Contemporary behavior management techniques in pediatric dentistry. Journal of Dentistry for Children, 82(1), 22–28. https://pubmed.ncbi.nlm.nih.gov/25909839/
Passos, M., Massignan, C., Bolan, M., Butini, L., Aydinoz, S., Dick, B., & De Luca, G. (2021). Does the presence of parents in the dental operatory room influence children's behaviour, anxiety and fear during their dental treatment? A systematic review. International journal of paediatric dentistry, 31(3), 318–336. https://doi.org/10.1111/ipd.12762
Pisano, M., Bramanti, A., De Benedetto, G., Carreras-Presas, C., & Di Spirito, F. (2024). The use of audiovisual distraction tools in the dental setting of pediatric subjects with special healthcare needs: a review and proposal of a multi-session model for behavioral management. Children, 11(9), 1077. https://doi.org/10.3390/children11091077
Polanczyk, G., Willcutt, E., Salum, G., Kieling, C., & Rohde, L. (2014). ADHD prevalence estimates across three decades. International Journal of Epidemiology, 43(2), 434–442. https://doi.org/10.1093/ije/dyt261
Rathore, A., Kalra, N., Tyagi, R., Khatri, A., Srivastava, S., & Khandelwal, D. (2024). Eye movement desensitization and reprocessing therapy in children. Journal of Dental Anesthesia and Pain Medicine, 24(5), 329–340. https://doi.org/10.17245/jdapm.2024.24.5.329
Reddy, E., Kiranmayi, M., Mudusu, S., Raju, S., Jannapureddy, R., & Kumar, A. (2022). Oral health status in children with ADHD. International Journal of Clinical Pediatric Dentistry, 15(4), 438–441. https://doi.org/10.5005/jp-journals-10005-2420
Roberts, J., Curzon, M., Koch, G., & Martens, L. (2010). Behaviour management techniques in paediatric dentistry. European Archives of Paediatric Dentistry, 11(4), 166–174. https://doi.org/10.1007/bf03262738
Salam, T., Ummer, M., Alowairdhi, A., Alsubait, A., Aljuhani, S., Alzahrani, A., & Alqahtani, A. (2023). Management of ADHD children for dental procedures. Cureus, 15(4), e36989. https://doi.org/10.7759/cureus.36989
Sarnat, H., Arad, P., Hanauer, D., & Shohami, E. (2001). Communication strategies in pediatric dental treatment. Pediatric Dentistry, 23(4), 337–342. https://pubmed.ncbi.nlm.nih.gov/11572493/
Seens, H., Modarresi, S., MacDermid, J., Walton, D., & Grewal, R. (2021). Prevalence of bone fractures among children and adolescents with attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. BMC Pediatrics, 21, 354. https://doi.org/10.1186/s12887-021-02821-x
Shapiro, M., Melmed, R. N., Sgan-Cohen, H. D., Eli, I., & Parush, S. (2007). Behavioural and physiological effect of dental environment sensory adaptation on children's dental anxiety. European journal of oral sciences, 115(6), 479–483. https://doi.org/10.1111/j.1600-0722.2007.00490.x
Shim, Y., Kim, A., Jeon, E., & An, S. (2015). Dental fear and anxiety and dental pain in children and adolescents; a systematic review. Journal of Dental Anesthesia and Pain Medicine, 15(2), 53–61. https://doi.org/10.17245/jdapm.2015.15.2.53
Sinha, S., Praveen, P., Prathibha Rani, S., & Anantharaj, A. (2018). Pedodontic considerations in a child with attention deficit hyperactivity disorder: literature review and a case report. International Journal of Clinical Pediatric Dentistry, 11(3), 254–259. https://doi.org/10.5005/jp-journals-10005-1522
Stein, L., Polido, J., Mailloux, Z., Coleman, G., & Cermak, S. (2012). Oral care and sensory sensitivities in autism. Special Care in Dentistry, 31(3), 102–110. https://doi.org/10.1111/j.1754-4505.2011.00187.x
Van Gemert, M., & Bildt, M. (2017). Dental treatment of fearful children. Nederlands Tijdschrift voor Tandheelkunde, 124(4), 215–221. https://doi.org/10.5177/ntvt.2017.04.16214
Waschbusch, D., Cao, V., Shroff, D., Bansal, P., & Willoughby, M. (2024). Measuring children’s sensitivity to reward and punishment sensitivity: an initial psychometric evaluation of the contingency response rating scale. Assessment, 32(4), 561–576. https://doi.org/10.1177/10731911241256536
Yon, M., Chen, K., Gao, S., Duangthip, D., Lo, E., & Chu, C. (2020). Dental fear and anxiety of kindergarten children in Hong Kong: a cross-sectional study. International Journal of Environmental Research and Public Health, 17(8), 2827. https://doi.org/10.3390/ijerph17082827
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2026 Dra.Zenaida García , Dra.Perla Bueno, Dra.Idalia Rodríguez , Dr.Luis Angel

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
Los autores y autoras conservan los derechos de autor y otorgan a InnovAcademia el derecho de la primera publicación de sus trabajos, los cuales se publican bajo la licencia Creative Commons Atribución-NoComercial-CompartirIgual 4.0 Internacional (CC BY-NC-SA 4.0), por lo cual el usuario es libre de usar, compartir y adaptar el contenido de la revista siempre que se otorgue el crédito, no se use para fines comerciales, y se comparta cualquier material derivado bajo la misma licencia CC.
Política de Autoarchivo
Los autores y autoras pueden establecer acuerdos adicionales de licencia no exclusiva para la distribución de la versión publicada de su artículo o ensayo (por ejemplo, depositarlo en un repositorio institucional o incluirlo en un libro), siempre y cuando se mencione que la publicación original se realizó en esta revista.
Se permite y se alienta a los autores a publicar su trabajo en línea (por ejemplo, en repositorios institucionales o en su sitio web) antes y durante el proceso de envío, ya que puede conducir a intercambios productivos, así como a una citación más temprana y mayor del trabajo publicado (consulte El efecto del acceso abierto).