Morphine and severe dryness of the lips

Evaluation of the effect of diacetyl morphine on salivary factors and their changes after methadone therapy

OBJECTIVES

Psychoactive drugs are responsible for pathological changes in the mouth including dental caries, which most troublesome. The aim of the present study was to evaluate the effect of heroin on several salivary factors which are involved in the oral health and their changes after methadone maintenance therapy (MMT).

MATERIALS AND METHODS

Forty patients with heroin abuse history, who referred to Imam Reza Hospital for MMT were included. Saliva sampling was carried out two times; at the first visit (time 1) and repeated 1 month after MMT (time 2). The saliva was analyzed immediately to evaluate the total volume, Ph, CPR, the Uric acid concentration, nitric oxide and antioxidant capacity.

RESULTS

The mean values for saliva volume, pH, CRP, Uric acid, antioxidant and nitric oxide were 0.38 ± 0.14, 7.63 ± 1.22, 5.2 ± 2.3, 1.47 ± 0.8, 0.80 ± 0.23, and 0.26 ± 0.03, respectively at first visit and 0.34 ± 0.22, 7.37 ± 1.01, 6.1 ± 2.6, 2.18 ± 0.9, 0.74 ± 0.3 and 0.29 ± 0.08 after 1 month of MMT. These values are below the normal ranges; however, there was no significant difference between two times in term of saliva volume, pH and saliva component (p > 0.05).

CONCLUSION

Heroin addiction changed the effective salivary factors and therefore could negatively contribute to oral health. These factors were not return to the normal range after 1 month of MMT. Physicians should be informed about focusing on oral health in patients under MMT.

Impact of opioid use on dentistry

The oral consequences of opioid drug use are commonly attributed to personal neglect of general health and financial constraint. These factors are compounded by the increasingly recognized range of physical effects exerted by opioid drugs. The dental management of opioid drug dependents is further complicated by a variety of infections and behavioural modifications commonly associated with opioid use. Adequate strategies for the oral care of opioid users need to take cognisance of the broad medical issues for these people along with an appropriate personal approach.