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Alqarni H, Aldghim A, Alkahtani R, Alshahrani N, Altoman MS, Alfaifi MA, Helmi M, Alzaid AA. Crystal methamphetamine and its effects on mental and oral health: A narrative review. Saudi Dent J 2024; 36:665-673. [PMID: 38766295 PMCID: PMC11096620 DOI: 10.1016/j.sdentj.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 05/22/2024] Open
Abstract
The purpose of this comprehensive literature review is to present the available evidence on the effects of methamphetamine on mental and oral health, as well as provide an overview of the most widely used medical and dental care strategies in the management of meth mouth. For this purpose, PubMed and Google Scholar electronic databases were searched for relevant articles, yielding 115 search results, which were further scrutinized for their relevance, leaving 55 for a detailed review. The analysis of the gathered data indicates that a comprehensive patient-centered approach that takes into consideration the physical, mental, and social aspects is crucial for mitigating the detrimental effects of increasing methamphetamine use.
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Affiliation(s)
- Hatem Alqarni
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Adhwaa Aldghim
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Rose Alkahtani
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Nasser Alshahrani
- Dental Intern, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Majed S. Altoman
- Department of Prosthetic Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammed A. Alfaifi
- Department of Prosthetic Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammad Helmi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz A. Alzaid
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
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Abdelsalam S, Livingston M, Quinn B, Agius PA, Ward B, Jamieson L, Dietze P. Correlates of poor oral health related quality of life in a cohort of people who use methamphetamine in Australia. BMC Oral Health 2023; 23:479. [PMID: 37443024 PMCID: PMC10339651 DOI: 10.1186/s12903-023-03201-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVES Methamphetamine use impacts oral health, but little is known about its impacts on oral health related quality of life (OHRQoL). In this study we examined OHRQoL in a cohort of people who use methamphetamine and assessed associations with sociodemographic, behavioural, psychosocial and dental service utilisation correlates. A secondary aim was to examine the relationship between methamphetamine route of administration and OHRQoL, to test whether smoking the drug is associated with reduced OHRQoL. METHODS Cross-sectional analysis was performed, using data from VMAX, a cohort of people who use methamphetamine at least monthly in Victoria, Australia (n = 194). Utilising the oral health impact profile (OHIP-14), we assessed three OHRQoL outcomes: OHIP-14 prevalence, OHIP-14 extent and OHIP-14 severity. Regression analyses examined associations between independent variables and the three OHIP-14 outcome measures. RESULTS A significant segment of the cohort (35%) reported poor OHRQoL. Overall, no statistically significant association was detected between methamphetamine route of administration and the three OHIP-14 outcomes. Participants living in rural areas, with moderate-to-severe self-reported depression and with methamphetamine dependence had significantly worse OHRQoL levels, which persisted after adjusting for other covariates. CONCLUSION Overall, VMAX cohort participants reported reduced OHRQoL levels. Our findings highlight the need for upstream interventions to improve the OHRQoL of people who use methamphetamine, with specific focus on those living in rural locations. Further research on the links between OHRQoL and mental health among people who use methamphetamine is required.
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Affiliation(s)
- Shady Abdelsalam
- National Drug Research Institute (NDRI), Faculty of Health Sciences, Curtin University, 85 Commercial Rd, Melbourne, VIC 3004 Australia
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC 3004 Australia
| | - Michael Livingston
- National Drug Research Institute (NDRI), Faculty of Health Sciences, Curtin University, 85 Commercial Rd, Melbourne, VIC 3004 Australia
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC 3004 Australia
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC 3086 Australia
| | - Brendan Quinn
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC 3004 Australia
- School of Public Health and Preventative Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004 Australia
| | - Paul A Agius
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC 3004 Australia
- School of Public Health and Preventative Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004 Australia
- Faculty of Health, Deakin University, Burwood, VIC 3125 Australia
| | - Bernadette Ward
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC 3004 Australia
- Monash University School of Rural Health, 26 Mercy St, Bendigo, VIC 3550 Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide Dental School, Adelaide, SA 5005 Australia
| | - Paul Dietze
- National Drug Research Institute (NDRI), Faculty of Health Sciences, Curtin University, 85 Commercial Rd, Melbourne, VIC 3004 Australia
- Disease Elimination Program, Burnet Institute, 85 Commercial Rd, Melbourne, VIC 3004 Australia
- School of Public Health and Preventative Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC 3004 Australia
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Poudel P, Kong A, Hocking S, Whitton G, Srinivas R, Borgnakke WS, George A. Oral health-care needs among clients receiving alcohol and other drugs treatment-A scoping review. Drug Alcohol Rev 2023; 42:346-366. [PMID: 36529982 PMCID: PMC10107646 DOI: 10.1111/dar.13583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 12/23/2022]
Abstract
ISSUES Poor oral health is a significant problem among people who access alcohol and other drugs (AOD) health services, yet little is known about their oral health-care needs and whether any interventions and guidelines are implemented within AOD treatment services. APPROACH A scoping review was conducted to identify scientific literature in three focus areas: oral health knowledge, attitudes and practices of clients and clinicians at AOD-related services; oral health guidelines for AOD clinicians; and interventions that describe clinicians promoting oral health among clients. KEY FINDINGS Thirty-two reports were identified. Twenty-three studies focused on the oral health knowledge, attitudes and practices of AOD clients, but none of the studies explored perspectives of clinicians. Seven clinical practice guidelines were identified but recommendations varied. Only two interventions in which an AOD clinician promoted oral health were identified. IMPLICATIONS Most reports provided insight into the perspectives of clients accessing AOD treatment services. Little evidence demonstrated that clinical practice guidelines were being implemented into practice, or that oral health promotion was part of the tasks of AOD clinicians. CONCLUSION This review identified oral health knowledge gaps and perceived poor attitudes that appeared to be reflected in certain oral health practices among clients. This finding indicates a need to educate clients about oral health while receiving AOD treatment. There was an absence of research about the needs for AOD clinicians to advocate for good oral health, and little evidence exists about effective interventions that could enhance integrating oral health care into AOD treatment services.
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Affiliation(s)
- Prakash Poudel
- eHealth New South Wales, Sydney, Australia
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Ariana Kong
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
| | | | - Gilbert Whitton
- Drug Health Services, South Western Sydney Local Health District, Sydney, Australia
| | - Ravi Srinivas
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
- Oral Health Services, South Western Sydney Local Health District, Sydney, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Wenche S Borgnakke
- Department of Periodontics and Oral Medicine, School of Dentistry, The University of Michigan, Ann Arbor, USA
| | - Ajesh George
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Translational Health Research Institute, Western Sydney University, Sydney, Australia
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Mizuno S, Ono S, Takano A, Yasunaga H, Iwase H. Dental characteristics associated with methamphetamine use: analysis using forensic autopsy data. BMC Oral Health 2022; 22:141. [PMID: 35473930 PMCID: PMC9044830 DOI: 10.1186/s12903-022-02182-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022] Open
Abstract
Background Little is known regarding the oral conditions in nonelderly methamphetamine users, such as the presence of dental caries and periodontitis. We aimed the oral conditions between methamphetamine users and non-users stratified by age groups. Methods In this cross-sectional study, computed tomography images were obtained from 3,338 decedents at two forensic medicine departments in Japan. Decedents aged > 20 or ≤ 64 years were included in the study and categorised into methamphetamine-detected (MA) and undetected (control) groups based on toxicological examinations. Decedents in the MA and control groups were matched for age and sex in a 1:4 ratio. The matched pairs were further categorised into young adults (20–44 years) and middle-aged adults (45–64 years). Oral characteristics, including the decayed, missing, and filled teeth (DMFT) index; periodontitis; distributional patterns of each tooth condition; and occlusal status, were compared between the MA and control groups for each age category. Among 3,338 decedents, 37 young and 55 middle-aged adults in the MA group were matched with 148 and 220 adults in the control group, respectively. Results In the young adult group, methamphetamine use was significantly associated with higher DMFT index (mean [standard deviation], 14.2 [7.6] vs 11.0 [6.1]; p = 0.007), smaller number of filled teeth (2.8 [2.9] vs 5.3 [4.0]; p = 0.001), higher proportion of periodontitis (39.0% vs 6.8%; p < 0.001), and lower proportion of occlusal support (54.1% vs 81.1%; p = 0.001). Young adult methamphetamine users tended to have untreated decayed canines and molars and missing molars. These findings were similar to those in middle-aged adults except the tendency to have missing maxillary incisors. Conclusions Nonelderly methamphetamine users had distinctive oral characteristics that may help screen for methamphetamine abuse through dental examinations. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02182-6.
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Affiliation(s)
- Satomi Mizuno
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Sachiko Ono
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Ayumi Takano
- Department of Mental Health and Psychiatric Nursing, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Hirotaro Iwase
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture, 260-8670, Japan
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Rossow I. Illicit drug use and oral health. Addiction 2021; 116:3235-3242. [PMID: 33247857 DOI: 10.1111/add.15360] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/16/2020] [Accepted: 11/24/2020] [Indexed: 12/18/2022]
Abstract
People with drug use disorders (PWDUD) have elevated prevalence of oral diseases, in particular dental caries (tooth decay), periodontal (gum) disease and xerostomia (dry mouth). When left untreated, these oral health conditions may progress and lead to tooth ache, abscesses and tooth loss, and in turn, to poor chewing functioning and digestion, dental aesthetic problems and reduced wellbeing. Illicit drug use may, per se, cause xerostomia, which in turn increases vulnerability for dental caries. However, the other main drivers of oral diseases and their progression-poor oral hygiene, frequent sugar intake and infrequent dental visits-can mainly be ascribed to the irregular lifestyle, poor economy and mental health problems that often accompany illicit drug use. Establishment of good oral health habits is essential in the dental care for PWDUD. Dental treatment is often comprehensive and challenging; because the patients may have extensive treatment needs but also difficulties adhering to preventive measures and dental appointments. An integrated care approach for PWDUD would likely benefit both their oral and general health.
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Affiliation(s)
- Ingeborg Rossow
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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Paisi M, Witton R, Plessas A. Is there an association between drug use and oral health conditions? Evid Based Dent 2021; 22:46-47. [PMID: 33772138 DOI: 10.1038/s41432-021-0158-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Data sources Databases searched included PsycINFO, PubMed, SciELO, Scopus and Web of Science.Study selection Cross-sectional, longitudinal and retrospective studies that compared caries, periodontal disease or tooth loss in people who use drugs as compared to those who do not. Studies that included psychiatric populations and alcohol or tobacco users were not included in the review. Qualitative studies, in vitro investigations, animal studies, reviews, case reports and series, letters to editor and conference abstracts were also excluded. The authors included only English studies published before 1 July 2019. Two independent reviewers screened the papers on title and abstract and then full text. In case of disagreements, these were discussed between the two reviewers and a third one was consulted if needed.Data extraction and synthesis Two reviewers extracted the data and contacted the primary authors for necessary clarifications, if needed. The unweighted kappa was applied to examine inter-examiner agreement. The Joanna Briggs Institute Critical Appraisal Checklist for observational studies was used to critically appraise the studies. The study selection results were presented through a flowchart. For the meta-analysis, the authors considered adjusted data. In some cases, crude estimates were used. Heterogeneity was estimated using the I2 statistic. The 'meta' package was used for the meta-analysis.Results Ten studies were included in the meta-analysis. Drug use was associated with higher risk of periodontal disease (OR 1.44; 95% CI 0.8-2.6) and higher DMFT index (OR 4.11; 95% CI 2.07-8.15).Conclusions The review showed high risk of periodontal disease and caries among people who use drugs. The authors concluded that this association may be explained by irregular tooth brushing and long history of drug use. It is important to develop programmes that aim to improve oral hygiene practices among people who use drugs.
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Affiliation(s)
- Martha Paisi
- Peninsula Dental School, University of Plymouth, Plymouth, UK; Peninsula Dental Social Enterprise, University of Plymouth, Plymouth, UK.
| | - Robert Witton
- Peninsula Dental School, University of Plymouth, Plymouth, UK; Peninsula Dental Social Enterprise, University of Plymouth, Plymouth, UK
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Hovden ES, Ansteinsson VE, Klepaker IV, Widström E, Skudutyte-Rysstad R. Dental care for drug users in Norway: dental professionals' attitudes to treatment and experiences with interprofessional collaboration. BMC Oral Health 2020; 20:299. [PMID: 33129288 PMCID: PMC7603759 DOI: 10.1186/s12903-020-01240-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 08/31/2020] [Indexed: 11/16/2022] Open
Abstract
Background The present study aimed to assess dental professionals’ attitudes and experiences related to the dental treatment of drug users and to interprofessional collaboration with the rehabilitation institutions (RIs). Methods The study population comprised 141 dentists and dental hygienists (response rate 73%) working in the Public Dental Service (PDS) in three counties in Norway. All of the participants completed an electronically distributed questionnaire on existing practices and experiences regarding dental treatment for drug users and interprofessional collaboration with RIs. The Norwegian Centre for Research Data (NSD) approved the study. Results Thirty-five percent of the dentists and 10% of the dental hygienists had treated five or more drug users per month (p < 0.05). The majority of dentists and dental hygienists used more time for examination and treatment of drug users compared to other patient groups. Over 70% of dental clinicians considered drug users as demanding patients due to fear, missing appointments, and poor compliance with oral hygiene advice. Multivariable logistic regression analyses showed that attitudes and experiences with dental treatment of drug users were significantly associated with background characteristics of professionals. The overall perception was that drug users often had higher expectations of dental treatment than what could be defined as necessary care and provided by the PDS. One-third of dental professionals reported that they were satisfied with the collaboration they had with RIs. Most of the respondents agreed that personnel from RIs could positively influence interprofessional collaboration by having sufficient knowledge of drug users statutory rights to free of charge dental treatment, as well as by close follow-up and motivation of patients before dental treatment. Conclusions Dental professionals perceived the management of drug users as demanding due to dental fear, difficulties in coping with appointments, poor compliance to preventive measures, and disagreement between dental treatment defined as necessary and drug users’ expectations. Attitudes and experiences related to dental treatment of drug users were significantly associated with background characteristics of clinicians. Organizational barriers regarding leadership, accessibility, and collaborative routines, as well as lack of interprofessional communication, suggest current models of health care delivery to drug users need reviewing.
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Affiliation(s)
- Ewa S Hovden
- Oral Health Centre of Expertise in Eastern Norway (OHCE), Oslo, Norway.
| | | | | | - Eeva Widström
- Institute of Clinical Dentistry, Arctic University of Norway, Oslo, Norway
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Yazdanian M, Armoon B, Noroozi A, Mohammadi R, Bayat AH, Ahounbar E, Higgs P, Nasab HS, Bayani A, Hemmat M. Dental caries and periodontal disease among people who use drugs: a systematic review and meta-analysis. BMC Oral Health 2020; 20:44. [PMID: 32041585 PMCID: PMC7011515 DOI: 10.1186/s12903-020-1010-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 01/15/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The aim of our study was to perform a systematic review of the literature and meta-analysis in order to investigate relationship between drug use and oral health. METHODS We searched for studies in English published before July 1, 2019 on PsycINFO, PubMed, SciELO, Scopus, and Web of Science. We assessed the relationship between drug use (methamphetamines, heroin; opiates; crack, cocaine and cannabis as dependent variables) and reported tooth loss, periodontal disease, or decayed, missing, and filled teeth index as an independent variable. The data were analyzed using Stata 12.0 software. RESULTS We initially identified 1836 potential articles (with 1100 duplicates) and screened the remaining 736 titles and abstracts, comprising 54 studies. In the next step, we evaluated the full-texts; 44 studies were excluded, accordingly. In total, we included 10 publications in the meta-analysis. Drug type was associated with periodontal disease (OR 1.44; 95% CI 0.8-2.6) and pooled estimates showed that type of drug used increased the odds of the number of decayed, missed and filled teeth (DMFT) (OR 4.11; 95% CI 2.07-8.15) respectively. CONCLUSIONS The analytical challenges of segregating the impact of individual drug types on oral health diseases mean that investigations on the direct relationship between oral health status and drug use are limited. Developing programs to improve potential confounding with various substances and addressing the dental health needs of people who use drugs is vital if we are to improve their overall quality of life.
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Affiliation(s)
- Mohsen Yazdanian
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Bahram Armoon
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Alireza Noroozi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Rasool Mohammadi
- Department of Public Health,, Loresatn University of Medical Sciences, Khoram Abad, Iran
| | - Amir-Hosein Bayat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Elahe Ahounbar
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Peter Higgs
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Hormoz Sanaei Nasab
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Azadeh Bayani
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Hemmat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
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Cuberos M, Chatah EM, Baquerizo HZ, Weinstein G. Dental management of patients with substance use disorder. CLINICAL DENTISTRY REVIEWED 2020; 4:14. [PMCID: PMC7294521 DOI: 10.1007/s41894-020-00078-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/14/2020] [Indexed: 09/19/2023]
Abstract
Substance use disorder (SUD) is a relapsing brain disorder characterized by compulsion and chronicity. SUD has detrimental effects on oral health. Drugs and alcohol negatively impact oral health by inducing a myriad of orofacial conditions including xerostomia, dental caries, periodontal disease, bruxism, pre-cancer and cancer, to name a few. Limited recommendations are available for dental professionals on how best to manage patients afflicted with SUD. The aim of this article is to review the oral health consequences of alcohol and commonly abused drugs to provide guidelines for the public health community and dental professionals. The United Nations estimates that a quarter billion people, representing five per cent of the global adult population, used drugs at least once in 2015. Developing public health interventions that include the participation of dental professionals and access to dental services for persons afflicted with SUD could play a critical role in improving their quality of life, their recovery, and their reintroduction into society.
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Affiliation(s)
- Mara Cuberos
- University of Connecticut School of Dental Medicine, Farmington, CT USA
| | - Elias M. Chatah
- University of Connecticut School of Dental Medicine, Farmington, CT USA
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Mukherjee A, Dye BA, Clague J, Belin TR, Shetty V. Methamphetamine use and oral health-related quality of life. Qual Life Res 2018; 27:3179-3190. [PMID: 30076578 DOI: 10.1007/s11136-018-1957-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE Methamphetamine (MA) is associated with adverse health effects, including the rampant tooth decay condition called "Meth Mouth." However, the impact of MA use on oral health-related quality of life (OHRQOL) is unknown. This study assessed the relationship between MA use and self-reported OHRQOL. METHODS This cross-sectional study uses information from 545 MA-using participants recruited from Los Angeles County, California. Dental examinations were performed by three calibrated dentists using National Health and Nutrition Examination Survey (NHANES) protocols. Data on socio-demographic, behavioral, and drug-use history were recorded using questionnaires. Participants were categorized as 'light' or 'moderate/heavy' users based on reported frequency of MA use in the past 30 days. Route of MA administration was categorized as 'smoking' or 'other.' Self-reported OHRQOL was based on the Oral Health Impact Profile scale. RESULTS Majority of the participants were male (80.9%). Median age was 45.0 years (IQR-13.0). Median number of days of MA use was 10.0 (IQR-12.0). Smoking was the preferred route of MA use (70.2%). Root caries in ≥ 3 teeth were reported in 78% of MA users. More than half of the participants reported having painful aching in mouth, avoidance of particular food items, feeling embarrassed, and discomfort while eating in the last 12 months. In unadjusted logistic models, moderate/heavy MA users were more likely to report an affected sense of taste [OR = 1.58, 95% CI (1.10-2.27)] and avoidance of particular foods [OR = 1.45, 95% CI (1.02-2.01)] than light users. Among individuals preferring other MA administration routes, moderate/heavy MA users were 3.09 times as likely to report an affected sense of taste than light users [OR = 3.09, 95% CI (1.52-6.27)]. CONCLUSION Oral health and OHRQOL appear to be worse among Methamphetamine users than in the US general population.
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Affiliation(s)
- Amrita Mukherjee
- NIH, National Institute of Dental and Craniofacial Research, 31 Center Drive Suite 5B55, Bethesda, MD, 20892-2190, USA
| | - Bruce A Dye
- NIH, National Institute of Dental and Craniofacial Research, 31 Center Drive Suite 5B55, Bethesda, MD, 20892-2190, USA. .,NIDCR Dental Public Health Residency Program, NIH/NIDCR, 31 Center Drive Suite 5B55, Bethesda, MD, 20892-2190, USA.
| | - Jason Clague
- UCLA, School of Dentistry, 10833 Le Conte Ave, Office 23-009CHS, Box 951668, Los Angeles, CA, 90095-1668, USA.,Department of Biostatistics, UCLA, Fielding School of Public Health, 650 Charles E. Young Dr. South, Room 51-267, Los Angeles, CA, 90095-1772, USA
| | - Thomas R Belin
- Department of Biostatistics, UCLA, Fielding School of Public Health, 650 Charles E. Young Dr. South, Room 51-267, Los Angeles, CA, 90095-1772, USA
| | - Vivek Shetty
- UCLA, School of Dentistry, 10833 Le Conte Ave, Office 23-009CHS, Box 951668, Los Angeles, CA, 90095-1668, USA
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12
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Ye T, Sun D, Dong G, Xu G, Wang L, Du J, Ren P, Yu S. The effect of methamphetamine abuse on dental caries and periodontal diseases in an Eastern China city. BMC Oral Health 2018; 18:8. [PMID: 29321070 PMCID: PMC5763656 DOI: 10.1186/s12903-017-0463-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 12/17/2017] [Indexed: 01/20/2023] Open
Abstract
Background Dental diseases are among the most frequently reported health problems in drug abusers. However, few studies have been conducted on oral health of methamphetamine (meth) abusers in China. The aim of the present study was to investigate the caries and periodontal health profile of former meth abusers in Eastern China. Methods A cross-sectional study was conducted on 162 former meth abusers in the male Zhoushan Compulsory Detoxification Center. A standardized questionnaire, which collected information about age, drug-use duration / pattern, oral hygiene habit and systemic diseases, was administered. Then, a dental examination was performed to investigate the severity of dental caries and periodontal diseases. In evaluating dental caries, the prevalence of dental caries, the scores of decayed teeth (DT), missing teeth (MT), filled teeth (FT), and decayed, missing, filled teeth (DMFT) were recorded. In evaluating periodontal diseases, community periodontal index (CPI), and the prevalence of gingival bleeding, dental calculus, periodontal pocket and loose teeth, were recorded. Additionally, the non-parametric test was adopted to analyze the potential risk factors via SPSS. Results All the participants abused meth by inhalation. The mean scores of DT, MT, FT and DMFT in the former meth users were 2.72 ± 2.78, 3.07 ± 3.94, 0.33 ± 1.03 and 6.13 ± 5.20 respectively. The prevalence of gingival bleeding, dental calculus, periodontal pocket and loose teeth was 97.53%, 95.68%, 51.23% and 9.26% respectively. The DT, DMFT and CPI scores in those who had abused meth for longer than 4 years were significantly higher than those who abused for less than 4 years (P = 0.039, 0.045, P < 0.001, respectively). The DT score in those who brushed their teeth more than twice a day were significantly lower than those who brushed less (P = 0.018). Conclusions The status of caries and periodontal diseases among former male meth users in Eastern China was poor. Prolonged drug abuse and lower frequency of tooth brushing may be the risk factors of their poor status of caries and periodontal diseases. Electronic supplementary material The online version of this article (10.1186/s12903-017-0463-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tao Ye
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Dongliang Sun
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Guangying Dong
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Guangjie Xu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.,Department of Stomatology, Chinese PLA 413 Hospital, Zhoushan, Zhejiang, 316000, People's Republic of China
| | - Ligang Wang
- Department of Stomatology, Chinese PLA 413 Hospital, Zhoushan, Zhejiang, 316000, People's Republic of China
| | - Jinjin Du
- Department of Stomatology, Chinese PLA 413 Hospital, Zhoushan, Zhejiang, 316000, People's Republic of China
| | - Pengcheng Ren
- Tangdu Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
| | - Shibin Yu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
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13
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Pabst A, Castillo-Duque JC, Mayer A, Klinghuber M, Werkmeister R. Meth Mouth-A Growing Epidemic in Dentistry? Dent J (Basel) 2017; 5:dj5040029. [PMID: 29563435 PMCID: PMC5806971 DOI: 10.3390/dj5040029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 09/09/2017] [Accepted: 09/19/2017] [Indexed: 01/29/2023] Open
Abstract
In the past two decades, the synthetic style and fashion drug “crystal meth” (“crystal”, “meth”), chemically representing the crystalline form of the methamphetamine hydrochloride, has become more and more popular in the United States, in Eastern Europe, and just recently in Central and Western Europe. “Meth” is cheap, easy to synthesize and to market, and has an extremely high potential for abuse and dependence. As a strong sympathomimetic, “meth” has the potency to switch off hunger, fatigue and, pain while simultaneously increasing physical and mental performance. The most relevant side effects are heart and circulatory complaints, severe psychotic attacks, personality changes, and progressive neurodegeneration. Another effect is “meth mouth”, defined as serious tooth and oral health damage after long-standing “meth” abuse; this condition may become increasingly relevant in dentistry and oral- and maxillofacial surgery. There might be an association between general methamphetamine abuse and the development of osteonecrosis, similar to the medication-related osteonecrosis of the jaws (MRONJ). Several case reports concerning “meth” patients after tooth extractions or oral surgery have presented clinical pictures similar to MRONJ. This overview summarizes the most relevant aspect concerning “crystal meth” abuse and “meth mouth”.
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Affiliation(s)
- Andreas Pabst
- Department of Oral- and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstrasse 170, 56072 Koblenz, Germany.
| | - Juan Carlos Castillo-Duque
- Department of Oral- and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstrasse 170, 56072 Koblenz, Germany.
| | - Axel Mayer
- Department of Oral- and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstrasse 170, 56072 Koblenz, Germany.
| | - Marcus Klinghuber
- Department of Oral- and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstrasse 170, 56072 Koblenz, Germany.
| | - Richard Werkmeister
- Department of Oral- and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstrasse 170, 56072 Koblenz, Germany.
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14
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Abstract
OBJECTIVE Chronic methamphetamine (MA) users experience many dental problems, a condition characterized as "meth mouth." These devastating effects on dentition is the main reason why many seek professional help. Here, we discuss the effects of MA on oral health and advocate for improved collaboration between dentists and mental health providers. We also introduce a dental evaluation tool with the goal of improving the quality of care for this often-marginalized patient population. METHODS A Medline literature search (1985-2016) was conducted with keywords "meth mouth," "methamphetamine AND oral health"; "methamphetamine AND dental"; "methamphetamine AND dentist." Results were supplemented by references gleaned from recent reviews, credible online sources, and citations of search returns. RESULTS MA predisposes users to tooth decay. They are also more likely to have missing dentition with a linear relationship correlating the number of years of use. A constellation of dental symptoms resulting from chronic MA use has been described in literature: gingival inflammation, excessive tooth wear, decreased salivary output, and severe dental caries. With continued use, mucosal lesions may appear on the lips and the gingival tissue may recede. MA can trigger bruxism, resulting in severe wear patterns and even cracked teeth. CONCLUSIONS Users of MA have many unmet medical and mental health needs. An interdisciplinary approach between dentists and mental health providers can improve outcomes. The dental evaluation tool described here can improve the bidirectional collaboration between mental health and dentistry. Dental professionals are in a unique position to identify users and can facilitate referral to substance abuse treatment. Likewise, mental health providers can identify, assess severity, and prompt users for medical and dental attention.
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15
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Pan N, Cai L, Xu C, Guan H, Jin Y. Oral health knowledge, behaviors and parental practices among rural-urban migrant children in Guangzhou: a follow-up study. BMC Oral Health 2017; 17:97. [PMID: 28592239 PMCID: PMC5461744 DOI: 10.1186/s12903-017-0385-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 05/25/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the growing number of rural-urban migrant children in China, follow-up observation on the oral health of migrant children is still scarce. This study described the changes of oral health knowledge, behaviors and parental practices in migrant children over a period of one year. Possible factors affecting changes were also investigated. METHODS The study used purposive sampling to select five private schools of migrant children in Guangzhou. A total of 1900 students in Grades 3 and 4 were recruited. A self-administered questionnaire was used in November 2011 to understand their basic situations, including oral health knowledge, behaviors and parental practices. A final survey was conducted in April 2013 to detect any changes. RESULTS The mean accuracy of oral health knowledge was 53.17% and 59.42% in 2011 and 2013, respectively (p < 0.001). For migrant children, the total score of oral hygiene, dietary habits and parental practices increased at the follow-up evaluation (p < 0.05). Children with less oral health knowledge were more likely to achieve significantly positive changes in score of knowledge (p < 0.001) in the final survey. Migrant children who had worse performance on oral hygiene (beta estimate = 0.68, p < 0.001), dietary habits (beta estimate = 0.58, p < 0.001) and good parental practices in the baseline survey were more likely to obtain beneficial changes. No significant associations between demographic characteristics and changes of oral health knowledge and behaviors (p > 0.05) were observed. CONCLUSION Oral health knowledge, behaviors and parental practices among migrant children significantly improved at the follow-up assessment. However, the overall situation was still poor. Positive and effective health education and prevention programs tailored to rural-urban migrant children with varying levels of oral health knowledge, behaviors and parental practices will be needed.
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Affiliation(s)
- Ning Pan
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Road 2, Guangzhou, Guangdong, 510080, China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Road 2, Guangzhou, Guangdong, 510080, China
| | - Caijuan Xu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Road 2, Guangzhou, Guangdong, 510080, China
| | - Han Guan
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Road 2, Guangzhou, Guangdong, 510080, China
| | - Yu Jin
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Road 2, Guangzhou, Guangdong, 510080, China.
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16
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Shetty V, Harrell L, Clague J, Murphy DA, Dye BA, Belin TR. Methamphetamine Users Have Increased Dental Disease: A Propensity Score Analysis. J Dent Res 2016; 95:814-21. [PMID: 26994107 PMCID: PMC4914865 DOI: 10.1177/0022034516640478] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Methamphetamine (MA) users are assumed to have a high burden of tooth decay. Less clear is how the distribution and severity of dental caries in MA users differ from the general population. Using a covariate-balancing propensity score strategy, we investigated the differential effects of MA use on dental caries by comparing the patterns of decayed, missing, and filled teeth in a community sample of 571 MA users with a subset of 2,755 demographically similar control individuals selected from a National Health and Nutrition Examination Survey (NHANES) cohort. Recruited over a 2-y period with a stratified sampling protocol, the MA users underwent comprehensive dental examinations by 3 trained and calibrated dentists using NHANES protocols. Propensity scores were estimated with logistic regression based on background characteristics, and a subset of closely matched subjects was stratified into quintiles for comparisons. MA users were twice as likely to have untreated caries (odds ratio [OR] = 2.08; 95% confidence interval [95% CI]: 1.55 to 2.78) and 4 times more likely to have caries experience (OR = 4.06; 95% CI: 2.24 to 7.34) than the control group of NHANES participants. Additionally, MA users were twice as likely to have 2 more decayed, missing, or filled teeth (OR = 2.08; 95% CI: 1.29 to 2.79) than the NHANES participants. The differential involvement of the teeth surfaces in MA users was quite distinctive, with carious surface involvement being highest for the maxillary central incisors, followed by maxillary posterior premolars and molars. Users injecting MA had significantly higher rates of tooth decay compared with noninjectors (P = 0.04). Although MA users experienced decayed and missing dental surfaces more frequently than NHANES participants, NHANES participants had more restored surfaces, especially on molars. The high rates and distinctive patterns of dental caries observed could be used 1) to alert dentists to covert MA use in their patients and 2) as the basis for comprehensive management strategies.
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Affiliation(s)
- V Shetty
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA
| | - L Harrell
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - J Clague
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - D A Murphy
- Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, CA, USA
| | - B A Dye
- National Institutes of Health, National Institute of Dental and Craniofacial Research, Bethesda, MD, USA
| | - T R Belin
- Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, CA, USA
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