Does Ritalin/Adderall cause teeth grinding?

This is a question that gets frequently asked by my patients.  Attention deficit Hyperactivity disorder (ADHD) is the most common neuropsychiatric disorder diagnosed in children but more and more adults are also being diagnosed with this condition. Patients with this diagnosis also tend to have other comorbid disorders such as anxiety and obsessive compulsive disorder. Ritalin (Methylphenidate) and Adderall (Dextroamphetamine) are medications that have gained clinical traction for their effectiveness in the management of ADHD.

Based on systematic clinical observations, patients with ADHD tend to have higher co-occurrence of oral habits such as nail-biting, teeth clenching, a phenomenon also known with anxiety disorders. So, these patients on Ritalin or Adderall may already have a higher tendency for oral habits of teeth clenching or teeth grinding.

With respect to Ritalin and Adderall, teeth-grinding is not listed as one of the significant side effects by the manufacturers. The side effect listed is "involuntary muscle contraction" which can be only vaguely correlated for jaw clenching/ or teeth grinding. Indeed scientific research is also lacking in evidence for direct correlation.  However, plenty of anecdotal evidence exists, as well as published case reports suggesting that Ritalin especially can contribute to increased teeth grinding.

So what can we conclude?

• If you are diagnosed with ADHD by your physician, and are on either Ritalin or Adderall, inform your dentist about the new medication so that your dentist can observe for teeth wear pattern.
•  If you already know you grind your teeth, and you are beginning a new medication, obtain a night time mouthguard for teeth grinding through your dentist/facial pain specialist who can monitor your oral health and behavior for you.
• If you have ongoing TMJ disorder and you are beginning to take Ritalin or Adderall, inform your specialist on the new diagnosis and treatment plan, as increased bruxism can also potentially aggravate your TMJ disorder related symptoms.

Listing some references on this topic:

- Behavioral and orofacial characteristics of children with attention-deficit hyperactivity disorder during a dental visit, J Clinc Ped Dent (2006), vol. 30 iss. 3, pg. 183.

- Adverse response to methylphenidate in combination with valproic acid, J child & Adolesc Psychopharmacol (2000), vol. 10, iss. 1, pg.39.