The oral health of heroin drug users: case study in Bosnia and Herzegovina

Dental caries and periodontal disease among people who use drugs: a systematic review and meta-analysis

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.

Oral manifestations in drug users: A review

Background

In the dental environment there is not much talk about the oral manifestations resulting from the use of drugs, because in general the issue of drugs is a very difficult subject to deal with. Therefore, the objective of this work is to understand what are the most obvious manifestations in the oral cavity and as the dentist can detect them.

Material and Methods

In order to carry out this bibliographical review, a scientific article search was made by consulting the PubMed database. The abstracts were read to recruit only what was consistent with the chosen topic.

Results

The 23 sources of information affirmed the relationship between a bad state of general health, and more in the specific, bad state of oral cavity.

Conclusions

The most relevant manifestations were: decay, loss of teeth and precancerous lesions. These manifestations were present in most of the cases studied. All this is a consequence of the drug and the lifestyle acquired by the drug users studied.

Key words:Drug, caries, meth mouth, periodontitis, xerostomia.

Route of Drug Abuse and its Impact on Oral Health-Related Quality of Life among Drug Addicts

Background

Various studies have tested quality of life (QOL) among drug addicts, however very few have reported any association between oral health-related quality of life (OHRQOL) and mode of drug administration among drug addicts. Hence, the present study was conducted aiming to evaluate the impact of mode of administration of drugs on OHRQOL among drug addicts.

Methods

Data was collected using respondent-driven sampling (RDS) method among 313 male drug addicts in Sri Ganganagar, Rajasthan, India, using self-administered questionnaires on oral hygiene aids and drug addiction history. OHRQOL was recorded using Oral Health Impact Profile (OHIP-14) questionnaire. The chi-square test, t-test, and Kruskal-Wallis test were used for statistical analysis.

Findings

In this study, 56.2% of the drug addicts reported practicing oral hygiene aids. The main drugs abused were heroin, cocaine, and amphetamines as 51.4%, 35.1%, and 13.4%, respectively. Most of the drug addicts were employed (82.4%) and studied up to primary education (46.3%). The highest mean values of community periodontal index (CPI) and decayed, missing, filled surface (DMFS) were found among the cocaine addicts and amphetamine abusers with rates of 3.11 ± 0.98 and 6.69 ± 8.52, respectively. Poor OHRQOL was observed among addicts who consumed drugs in inhalation since a long time irrespective of the type of the drug, but among them heroin addicted subjects had the poorest OHRQOL.

Conclusion

OHRQOL was poor among the drug addicts in comparison to general population. Preventive strategies on oral health and other health promotion programs for this vulnerable group can be unified.

The effect of methamphetamine abuse on dental caries and periodontal diseases in an Eastern China city

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.

Perfil sociodemográfico e condição bucal de usuários de drogas em dois municípios do Estado do Paraná, Brasil

<title>Resumo</title><sec><title>Introdução</title><p>A pesquisa das condições bucais de usuários de drogas é importante para ser conhecida esta população, cujo crescimento é ascendente no Brasil, a fim de que metas preventivas e atendimento adequado sejam traçados.</p></sec><sec><title>Objetivo</title><p>Identificar o perfil sociodemográfico e a condição bucal desta população, em dois municípios paranaenses.</p></sec><sec><title>Material e método</title><p>Foram coletados, por meio de questionário e de exame físico, dados de 100 indivíduos. Foram obtidos os seguintes valores: índice CPOD, profundidade de sondagem (PS), nível de inserção clínica (NIC), índice gengival (IG), índice de placa (IP) e sangramento à sondagem (SS). Após análise descritiva inicial, empregaram-se os testes t de Student e ANOVA <italic>one-way</italic>.</p></sec><sec><title>Resultado</title><p>A média da idade foi 29,12 anos. As maiores frequências foram: gênero masculino (95,5%), solteiros (69,0%), baixa escolaridade (41%) e maior consumo de drogas lícitas – tabaco (90,9%) e álcool (84,5%) –, seguidas de <italic>crack</italic> (80,9%) e maconha (77,3%). A média do CPOD foi 15,21 (DP=5,84) e quanto maior o tempo de dependência, maior este índice (p<0,05). A média da PS foi 3,55 e do NIC, 3,59. O SS ocorreu em 82,7% dos casos e a inflamação moderada, em 79,5%. Placa detectável e moderado acúmulo de placa foram identificados em 39,5% e 35,3%, respectivamente.</p></sec><sec><title>Conclusão</title><p>Predominaram indivíduos do gênero masculino, jovens, solteiros, com baixa escolaridade e consumidores de drogas lícitas e ilícitas, com condição bucal ruim. Sugere-se mais atenção dos profissionais da área odontológica e dos elaboradores de políticas públicas, com vistas a esta população.</p></sec>