The "tell-show-do" technique is incredibly effective for teaching tooth brushing to patients with ADHD. This technique focuses attention on the procedures and stimulates cooperative behavior. Emphasis should be placed on providing only one instruction at a time and repeating important aspects. Stimulating educational materials are effective in reinforcing important concepts.11,19 Timers and mechanical brushes, especially those with quadrant pacers, are very effective in assisting the child in thorough brushing. When providing oral hygiene instruction, provide short, clear instructions directly to the patient with ADHD. In addition, convey only one instruction at a time.31
It is important to provide parents of ADHD children with a review of valuable information presented during the dental visit. In addition, parents should be encouraged to support homecare through non-food based reward systems (stickers, lesser amounts of money, privileges, etc). It should be noted that children with ADHD function at an age level that is about 30% reduced.6 This means that a 12 year old with ADHD may perform executive functions at a level comparable to that of an 8 year old. Thus, the children with ADHD need more support in many daily activities.6
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