Illegal drugs and periodontal conditions

Antifungal susceptibility profile of Candida species and uncommon yeasts from drug abusers with oral candidiasis

In Iran, there is limited information regarding the species distribution and antifungal susceptibility profiles of yeast isolates from drug addicts suffering from oral candidiasis (OC). In this study, 104 yeast isolates, including 98 Candida species and 6 uncommon yeasts, were collected from 71 drug abusers with OC. The susceptibility profiles of Candida spp. and uncommon yeasts to amphotericin B (AMB), itraconazole (ITC), nystatin (NYC), fluconazole (FLC), and caspofungin (CAS) were evaluated using the CLSI broth microdilution method. The prevalence of OC in the sampled population was found to be 29%. The susceptibility profile of Candida spp. revealed remarkable sensitivity, with 100% and 99% of isolates susceptible to NYC and AMB, respectively. However, concerning levels of resistance or non-wild-type minimum inhibitory concentrations (MICs) were observed, with 13.2% of Candida isolates showing resistance to FLC, 13.2% to ITC, and 16.3% to CAS. Notably, 35.2% of patients showed mixed yeast species, while 5.1% of Candida isolates exhibited multidrug resistance. The analysis of the uncommon yeast species showed that the overall frequencies of the highest MICs were observed for CAS. Furthermore, within the six non-Candida species identified, Hanseniaspora opuntiae and one isolate of Pichia kluyveri exhibited resistance to FLC and ITC, respectively, while all non-Candida species were susceptible to AMB and NYC. Additionally, one isolate of Pichia kluyveri exhibited simultaneously high MICs to two drugs ITC and CAS. Furthermore, the Hanseniaspora opuntiae isolate showed high MICs to CAS and FLC. The findings from the present study suggest that AMB and NYC can be suitable choices for empiric treatment of both common Candida species and uncommon yeast infections in substance abuse patients.

Severe Gingival Enlargement Associated With Methamphetamine Abuse: A Case Report

Gingival enlargement (GE) is characterized by the overgrowth of gingival tissues, often exacerbated by dental biofilm and certain medications or substances. This report presents a case of severe GE in a 61-year-old male with generalized stage 4, grade C periodontitis linked to methamphetamine use, which the patient disclosed occurred during a period of homelessness. The treatment involved antibiotic therapy, extractions, gingivectomy, gingivoplasty, and osteoplasty to facilitate future oral rehabilitation. After treatment, the patient reported no pain and improved eating habits, significantly enhancing his quality of life. This case highlights the critical relationship between GE, substance abuse, and advanced periodontal disease, underscoring the need for increased awareness and interdisciplinary approaches in managing such patients.

Systemic Factors Affecting Prognosis in Periodontics: Part II

This study gives an insight into certain systemic conditions and factors such as nutrition, age, hematological disorders, hypertension, smoking, obesity, and metabolic syndrome that have a notable effect on the periodontium. The review highlights the importance of taking these factors into consideration in periodontal therapy and their impact on the prognosis of periodontal therapies. The other systemic factors are discussed in detail elsewhere in the special issue.

The Effects of Recreational and Pharmaceutical Substance Use on Oral Microbiomes and Health

Oral health remains one of the most taken for granted parts of human body health, even though poor oral health has now been linked to various diseases, such as cancers, diabetes, autoimmune complications, neurological disorders, and cardiovascular disease, just to name a few. As we review in this paper, substance use or abuse, including alcohol, smoking, recreational drugs, and pharmaceutical drugs can have significant implications on oral health, which in turn can lead to more systemic diseases. In this paper, we show that oral microbiome dysbiosis and inflammatory cytokine pathways are two of the most significant mechanisms contributing to oral health complications from substance use. When substance use decreases beneficial oral species and increases periodontopathogenic strains, a subsequent cascade of oncogenic and inflammatory cytokines is triggered. In this review, we explore these mechanisms and others to determine the consequences of substance use on oral health. The findings are of significance clinically and in research fields as the substance-use-induced deterioration of oral health significantly reduces quality of life and daily functions. Overall, the studies in this review may provide valuable information for future personalized medicine and safer alternatives to legal and pharmaceutical substances. Furthermore, they can lead towards better rehabilitation or preventative initiatives and policies, as it is critical for healthcare and addiction aid specialists to have proper tools at their disposal.

Mucocutaneous Manifestations of Recreational Drug Use

Recreational drug use is increasingly common in the dermatology patient population and is often associated with both general and specific mucocutaneous manifestations. Signs of substance use disorder may include changes to general appearance, skin, and mucosal findings associated with particular routes of drug administration (injection, insufflation, or inhalation) or findings specific to a particular drug. In this review article, we provide an overview of the mucocutaneous manifestations of illicit drug use including cocaine, methamphetamine, heroin, hallucinogens, marijuana, and common adulterants to facilitate the identification and improved care of these patients with the goal being to connect this patient population with appropriate resources for treatment.

Towards nanotube-based sensors for discrimination of drug molecules

The proper detection of drug molecules is key for applications that have an impact in several fields, ranging from medical treatments to industrial applications. In case of illegal drugs, their correct and fast detection has important implications that affect different parts of society such as security or public health. Here we present a method based on nanoscale sensors made of carbon nanotubes modified with dopants that can detect three types of drug molecules: mephedrone, methamphetamine and heroin. We show that each molecule produces a distinctive feature in the density of states that can be used to detect it and distinguish it from other types of molecules. In particular, we show that for semiconducting nanotubes the inclusion of molecules reduces the gap around the Fermi energy and produces peaks in the density of states below the Fermi energy at positions that are different for each molecule. These results prove that it is possible to design nanoscale sensors based on carbon nanotubes tailored with dopants, in such a way that they might be able to discriminate between different types of compounds and, especially, drug molecules whose proper recognition has important consequences in different fields.

Risk factors for periodontitis & peri-implantitis

Risk is part of all health professions and generally indicates the chance of getting some form of illness. For dental practitioners this includes periodontitis or peri-implantitis, the focus of this issue. Many risk factors are involved in the development of disease and most likely interact or overlap. Most patients will probably have multiple risk factors, some of which will be the same for both periodontitis and peri-implantitis. The most recent classification of periodontal disease recognises the importance of risk factors and contemporary dental practice requires that clinicians be aware of and manage them. Broadly speaking risk factors can be patient, environment or practitioner related. Patient risk factors would include socio-economic status, smoking, substance use disorders, diabetes, diet and dietary supplements, mental health disorders, old age, poor home dental care or understanding of the need for good home care and use of medications. Environmental modification of the host response through gene function is an emerging risk factor. Lastly, practitioner-related factors in implant dentistry are now known to affect risk. These would include the use of digital technology, but patient related factors such implant location and the body's reaction to an implant itself add to the risk of developing disease. This edition of Periodontology provides an uptodate review of many of these risk factors and their impact summarising current knowledge.