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Xie H, Waschl N, Zeng S. Measuring family outcomes for young autistic children receiving interventions in China: The structure of the Family Outcomes Survey and predicting variables. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:2048-2062. [PMID: 36823989 DOI: 10.1177/13623613231152563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
LAY ABSTRACT Efforts to measure, document, and monitor family outcomes can be helpful to practitioners in developing and delivering effective and sustainable interventions. Researchers have developed the Family Outcomes Survey, Form A, for measuring the outcomes experienced by families of children in the early intervention/early childhood special education system. Little has been reported on how well the five outcomes on the Family Outcomes Survey, Form A describe the experiences and expectations of families of autistic children in China. We conducted a survey using the Family Outcomes Survey, Form A, Chinese version with 467 caregivers of young autistic children in China. First, the five-outcome structure of the Family Outcomes Survey, Form A seemed to be appropriate for measuring family outcomes of autistic children in China. We also found that the Chinese caregivers of autistic children seemed to give general lower ratings on all five outcomes on the Family Outcomes Survey, Form A as compared to caregivers of children in early intervention/early childhood special education in Western countries like the United States and Australia. Furthermore, caregivers' ratings on the five Family Outcomes Survey, Form A outcomes seemed to be related to their educational attainment, employment status, family income level, and how much time caregivers spent with their autistic child. This study supported the use of the Family Outcomes Survey, Form A, Chinese version with families of autistic children in China. We also discussed how the coronavirus disease 2019 pandemic could have impacted the family outcomes as reported by the Chinese caregivers.
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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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Saki F, Cheraghi M, Mohamadian H, Ghorbanyjavadpour F. Oral Health-Related Quality of Life Among Narcotic and Stimulant Users Referred to Maintenance Methadone Therapy Centers in Ahvaz City: Iran. Front Public Health 2022; 10:850550. [PMID: 35669740 PMCID: PMC9163318 DOI: 10.3389/fpubh.2022.850550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 04/11/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction We aimed to assess quality of life related to oral health in narcotic or stimulant users those were referred to maintenance methadone therapy (MMT) centers in Ahvaz City, Iran. Methods It was a cross-sectional study based on exploratory approach which has conducted on 187 narcotic and stimulant users in Ahvaz city; during 15th May till September 2020. Data was selected by available non-random sampling method. The data collection tools included the demographic variables and the standard OHIP-14 questionnaires. All tests were used as descriptive statistics, Kolmogorov-Smirnov tests, independent t-test, one-way analysis of variance. P-values of less than 0.05 was considered significant. Results The mean and standard deviation of the participants' age was 36.03 ± 8.98 years. The quality-of-life scores related to oral health were totally 34.89 ± 6.50 as well as 37.37 and 33.96 in narcotic and stimulant users, respectively. The total quality of life related to OHIP-14 did not have a significant relationship with variables of age, life companions, level of education, number of children, economic status, employment status, insurance status, underlying disease, toothbrush use status, last dentist visit, and number of missing teeth (P > 0.05). However, a significant difference was found between the quality of life related to oral health based on the type of substance used (narcotic or stimulant), so that the mean quality of life related to oral health was higher in narcotic than stimulant users (P < 0.05). Conclusion Quality of life related to OHIP-14 was more unfavorable in stimulant users than narcotic users. So, policy makers and authorities are required to focus their interventions and research programs to improve health-related quality of life in users, especially stimulant.
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Affiliation(s)
- Fatemeh Saki
- Department of Community Oral Health, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maria Cheraghi
- Social Determinant of Health Research Center, Department of Community Oral Health, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hashem Mohamadian
- Department of Health Education and Promotion, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fataneh Ghorbanyjavadpour
- Department of Orthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Simon L, Choudhary A, Ticku S, Barrow J, Tobey M. Dental care utilization in Massachusetts before and after initiation of medication for opioid use disorder: A cross-sectional study of a state all-payer claims database. J Public Health Dent 2021; 82:461-467. [PMID: 34816438 DOI: 10.1111/jphd.12488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 11/02/2021] [Accepted: 11/10/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Individuals with opioid use disorder (OUD) are at higher risk of poor oral health. Medication for opioid use disorder (MOUD) has been shown to improve outcomes for patients with OUD, but it is unknown how initiation of MOUD affects access to oral health services. METHODS This was a retrospective analysis of all individuals in the Massachusetts All-Payer Claims Database prescribed oral buprenorphine-naloxone or injectable naltrexone from 2013 to 2016. We evaluated dental utilization in the year before and after beginning MOUD. A logistic regression predicting dental utilization was conducted. RESULTS Among the 54,791 individuals, rates of dental utilization were low both before and after MOUD (10.5% and 10% with a dental visit, respectively). Of those who did not have a dental visit in the year before starting MOUD, 95.1% did not have a dental visit in the year after. Rates of various procedure types were comparable before and after MOUD. In a logistic regression, a prior dental visit was associated with 9.82 times the odds (95% CI 9.14-10.55) of having a dental visit after starting MOUD; increasing age, being prescribed naltrexone, having a mood disorder or HIV, year of initiation or being on Medicaid were also associated with having a dental visit. Male patients and those with Medicare or private insurance were less likely to have a dental visit. CONCLUSIONS Initiating MOUD did not substantially result in increased dental access or substantial changes in dental procedures received. Patients receiving treatment for OUD may require additional support to access dental care.
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Affiliation(s)
- Lisa Simon
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Abhishek Choudhary
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shenam Ticku
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jane Barrow
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Matthew Tobey
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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Nekouei AH, Kakooei S, Najafipour H, Kakoei S. Oral Health Determinants among Opium Users in Kerman, Iran. ADDICTION & HEALTH 2021; 13:156-164. [PMID: 35140894 PMCID: PMC8730451 DOI: 10.22122/ahj.v13i3.307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/03/2021] [Indexed: 11/27/2022]
Abstract
Background Promoting oral health is a complicated issue among drug abusers and opium is the most frequent drug abused in Iran. This study aims to find the oral health determinants of opium users in Kerman, Iran. Methods This cross-sectional study was a part of the second phase of Kerman coronary artery disease risk factors study (KERCADRS, 2014-2018). In this survey, the data of 1140 opium users were analyzed. The information about using a toothbrush, dental floss, number of dental visits at last year, age of first use of opium, duration, and opium consumption frequency was recorded. The total number of decayed, missing, and filled teeth (DMFT) index and Community Periodontal Index (CPI) was recorded by an oral examination. Poisson and logistic regressions analyses were used for assessing the relationship among variables. Findings The mean age of participants was 52 ± 12 years. 74.4% were men and 24.6% were women. The average DMFT index was 15.7 ± 7.6 and the prevalence of a healthy CPI score was 18.5%. Educational level (P < 0.001), brushing (P < 0.001), flossing (P < 0.001), dental visit (P < 0.001), first age of using opium (P < 0.001), frequency of consumption (P < 0.001), and age (P < 0.001) were associated with DMFT index. Only using floss (P < 0.001), dental visit [odds ratio (OR) = 1.80, P = 0.030], frequency of consumption (OR = 2.92, P < 0.001), and age (P = 0.001) were associated with CPI score. Conclusion The frequency of opium consumption has the same effect on caries incidence as oral hygiene habits. Moreover, using dental floss has a more significant effect on the periodontal health of participants.
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Affiliation(s)
- Amir Hossein Nekouei
- Social Determinants on Oral Health Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Sina Kakooei
- Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Najafipour
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Shahla Kakoei
- Endodontology Research Center, Kerman University of Medical Sciences, Kerman, Iran,Correspondence to: Shahla Kakoei; Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman,
Iran;
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Carlsen SEL, Isaksen K, Fadnes LT, Lygren OJS, Åstrøm AN. Non-financial barriers in oral health care: a qualitative study of patients receiving opioid maintenance treatment and professionals' experiences. Subst Abuse Treat Prev Policy 2021; 16:44. [PMID: 34001202 PMCID: PMC8130131 DOI: 10.1186/s13011-021-00379-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with substance use disorders often have poor oral health, which can negatively impact their quality of life. Since 2005, patients receiving opioid maintenance treatment (OMT) in Norway have been eligible for free oral health care services offered through public oral health clinics. Despite a large need for oral health services amongst patients in OMT, figures suggest that the use of these services is low amongst this patient group. It has been unclear which barriers that contribute to this. This qualitative study explores the underlying barriers to the use of oral health care services amongst patients in OMT, from the perspective of the patients as well as dental health care workers (DHW). METHODS Through a combination of focus group interviews and individual interviews, data were collected from 63 participants; 30 patients in OMT and 33 DHW. Thematic analysis identified key themes for the use (or not) of oral health care services amongst patients in OMT. RESULTS Both individual and structural barriers prevent OMT patients from using the free oral health care services offered to them. These barriers include struggling to attend appointments, anxiety and fear of dentists, discrepancies between patients' expectations and the services offered and perceived stigma. OMT patients' lack of information regarding their rights and access to oral health services was also a barrier, as was DHWs' lack of knowledge and information of the OMT system and what they can offer patients. CONCLUSIONS OMT patients face several barriers in accessing and using oral health care services. However, through a number of relatively simple measures, it is possible that the use of oral health services amongst OMT patients can be increased.
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Affiliation(s)
| | - Katja Isaksen
- Oral Health Centre of Expertise in Western Norway, PO Box 7900, 5020, Bergen, Norway
| | - Lars Thore Fadnes
- Department of Addiction medicine, Haukeland University Hospital, PO Box 1400, 5021, Bergen, Norway
- Institute of Global health, University of Bergen, PO Box 7804, 5020, Bergen, Norway
| | - Ole Jørgen Scheie Lygren
- Department of Addiction medicine, Haukeland University Hospital, PO Box 1400, 5021, Bergen, Norway
| | - Anne Nordrehaug Åstrøm
- Department of clinical dentistry, University of Bergen, PO Box 7804, 5020, Bergen, Norway.
- Oral Health Centre of Expertise in Western Norway, PO Box 7900, 5020, Bergen, Norway.
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Maripuri S, Sadi H, Nevius A, Terenzi G, Mehta N, Dragan IF. Using Evidence-Based Dentistry in the Clinical Management of Methadone Maintenance Therapy Patients. J Evid Based Dent Pract 2020; 20:101399. [PMID: 32381408 DOI: 10.1016/j.jebdp.2020.101399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/23/2019] [Accepted: 01/17/2020] [Indexed: 10/25/2022]
Abstract
AIMS AND OBJECTIVES There is an increased interest to incorporate interprofessional educational models in the academic dental institutions to serve both student education and patient care. The aim of this report is to integrate evidence-based dentistry (EBD) with an interprofessional approach to treat methadone maintenance therapy (MMT) patients. Current example illustrates the case of a 26-year-old man receiving MMT who presented at Tufts University School of Dental Medicine with the chief complaint of "I want to fix my teeth." He presented with a collapsed vertical dimension of occlusion, extensive partial edentulism on both arches with bone loss, and a past history of drug abuse since the age of 16 years. MATERIALS AND METHODS The 5-step (ask, acquire, appraise, apply, assess) framework for the EBD process was used. First, the PICO (population, intervention, comparison, and outcome) question was asked, and then the literature was acquired and appraised. An expert librarian assisted in finding articles on the effects of methadone on the oral cavity and consequences that will affect dental treatment. The search was conducted on PubMed, using the following keywords: oral health, dentistry, dental health, and methadone. The search was performed from 1/1/2005 to 1/1/2018. After appraisal, the studies were applied in the clinical setting and treatment outcomes were assessed both subjectively and objectively. RESULTS The initial search identified there is sparse evidence on the topic. Only 34 articles were acquired. Based on the scientific evidence published, the interprofessional expertise of the clinical care team, and patient's perspective, 4 treatment plan options were proposed. The selected treatment plan was considered the best option considering an EBD person-centered approach. Progress of treatment, outcomes, and lessons learned were assessed. CONCLUSIONS This study demonstrates that incorporating EBD concepts and an interprofessional approach, MMT patients can be successfully treated. Future studies on this topic are recommended, specially considering the growth of the opioid epidemic in the past years and the need to treat the MMT patients and educate students.
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Affiliation(s)
- S Maripuri
- DMD Class of 2019, Tufts University School of Dental Medicine, Boston, MA, USA
| | - H Sadi
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, MA, USA
| | - A Nevius
- Tufts University Hirsh Health Sciences Library, Boston, MA, USA
| | - G Terenzi
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, MA, USA
| | - N Mehta
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, MA, USA
| | - I F Dragan
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA.
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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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Bowes C, Page G, Wassall R, Lloyd C. The need for further oral health research surrounding the provision of dental treatment for people with drug dependency. Br Dent J 2019; 227:58-60. [PMID: 31300786 DOI: 10.1038/s41415-019-0469-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of this article is to highlight the need for further research in providing dental care for people with drug dependency. The association between people who misuse substances and dental disease is widely known occurrence, yet there have been few studies conducted in the UK surrounding this issue due to the nature of the cohort. Further to this, there are a multitude of barriers to accessing/seeking dental care that exist for those with drug dependency. Going forward, there is a need for the development of a new service model where dental care is part of a multidisciplinary team working towards treating people with drug dependency in a holistic way.
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Affiliation(s)
- Charlotte Bowes
- Newcastle University, Restorative Dentistry, Dental Hospital, Newcastle, UK.
| | - Geoff Page
- University of York, Department of Social Policy and Social Work, York, UK
| | - Rebecca Wassall
- Newcastle University, School of Dental Sciences, Newcastle, UK
| | - Charlie Lloyd
- University of York, Social Policy and Criminal Justice, Director of Graduate School, York, UK
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10
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Mehmood A, Abduljabbar T, Al-Hamoudi N, Gholamiazizi E, Kellesarian SV, Vohra F, Javed F. Self-perceived oral symptoms and periodontal status among young intravenous heroin addicts: A cross-sectional case-control study. J Periodontol 2019. [PMID: 29520791 DOI: 10.1002/jper.17-0495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND It is hypothesized that (a) self-perceived oral symptoms (OSs) are worse in intravenous heroin addicts (IHA) than controls; and (b) clinical periodontal inflammatory parameters (plaque index [PI], bleeding on probing [BOP], PD and clinical attachment loss [AL]), number of missing teeth (MT), and radiographic marginal bone loss (MBL) are higher in IHA compared with controls. The aim was to compare the self-perceived OSs and periodontal parameters among young IHA and controls. METHODS Sociodemographic data, self-perceived OSs and duration and daily frequency of intravenous heroin use was gathered using a structured questionnaire. Full-mouth PI, BOP, PD, and clinical AL were measured, and number of MT were recorded. Mesial and distal MBL on all teeth was measured on digital radiographs. Odds ratios (OR) with 95% confidence intervals (CI) were computed for self-perceived OSs and periodontal parameters were assessed using the Mann Whitney U-test and logistic regression analysis. Sample-size was estimated, and level of significance was set at P < 0.05. RESULTS OR (95% CI) for self-perceived loose teeth (P < 0.001), pain in teeth (P < 0.001), dry mouth (P < 0.001), burning sensation in mouth (P < 0.001), bleeding gums (P < 0.001) and pain during chewing (P < 0.001) were significantly higher in the test than control group. Number of MT (P < 0.05), PI (P < 0.05), clinical AL (P < 0.05), and mesial (P < 0.05) and distal (P < 0.05) MBL were statistically significantly higher among individuals in the test group compared with the control group. CONCLUSION Self-perceived OSs and periodontal inflammatory parameters were worse in IHA than controls.
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Affiliation(s)
- Abid Mehmood
- Department of Dentistry, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Eng. Abdullah Bugshan research chair for Dental and Oral Rehabilitation, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nawwaf Al-Hamoudi
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Fahim Vohra
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Eng. Abdullah Bugshan research chair for Dental and Oral Rehabilitation, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fawad Javed
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY
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11
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Hughes FJ, Bartold PM. Periodontal complications of prescription and recreational drugs. Periodontol 2000 2019; 78:47-58. [PMID: 30198137 DOI: 10.1111/prd.12230] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Drug use for both therapeutic and recreational purposes is very widespread in most societies. The range of drugs used, the variations in response to these drugs and other health and behavioral confounders mean that drug use may be an important contributor to individualized periodontal diagnoses. In this narrative review, we review the main reported effects of drugs on the periodontal tissues and periodontal disease processes. Although some of the more common adverse drug reactions on periodontal tissues are well described, in many other cases the evidence for these drug effects is quite limited and based on small case series or isolated reports. Prescription drugs are responsible for a range of effects, including drug-induced gingival overgrowth and increased gingival bleeding, and influence periodontal inflammation and periodontal breakdown. The effects of recreational drugs on the periodontal tissues is less well researched, perhaps for the obvious reason that assembling large cohorts of recreational drug users presents particular challenges. Use of nearly all of these substances is associated with poorer periodontal and dental health, although there is almost certainly a large degree of behavioral confounding in these findings. Overall, further studies of adverse drug reactions on the periodontal tissues are required as this continues to be an important and increasing factor in periodontal health determination.
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Affiliation(s)
| | - P Mark Bartold
- Periodontology, University of Adelaide, Adelaide, SA, Australia
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12
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Abstract
Heroin addiction is associated with poor oral health. Oral and dental care in heroin addiction might be complicated by altered mental status, negative attitude towards oral health, dental anxiety and fear, drug interaction, and associated medical co-morbidity. We present the oral findings and discuss the dental, behavioural, and anaesthetic management considerations in a 46-year-old man who had dental anxiety and had been an intravenous heroin user for the past 23 years.
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Shekarchizadeh H, Khami MR, Mohebbi SZ, Ekhtiari H, Virtanen JI. Oral health status and its determinants among opiate dependents: a cross-sectional study. BMC Oral Health 2019; 19:5. [PMID: 30616605 PMCID: PMC6323735 DOI: 10.1186/s12903-018-0691-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 12/10/2018] [Indexed: 01/03/2024] Open
Abstract
Background In addition to numerous general health problems, drug dependents manifest various oral health disorders. Our aim was to investigate the oral health status and its determinants among in-treatment opiate dependents. Methods As part of a comprehensive cross-sectional survey on opiate dependents admitted to methadone maintenance centers in Tehran, Iran, we conducted a clinical study in two centers from different socioeconomic areas. A trained dentist conducted face to face interviews and clinical oral examinations based on World Health Organization (WHO) criteria for Decayed, Missing, Filled Teeth (DMFT) index and Community Periodontal Index (CPI) on volunteer patients. Student’s t-test, Mann-Whitney U, Kruskal Wallis, and Chi2 tests, in addition to linear and logistic regression models served for statistical analysis (p < 0.05). Results A total of 217 patients (98% men), with a mean age of 43.6 years (SD 12.3) participated in the study. Opium was the main drug of abuse reported by 70% of the participants followed by crystalline heroin (22%). Of the participants, 24.4% were totally edentulous. The mean DMFT score of participants was 20.3 (SD 7.8). Missing teeth comprised the main part of the index followed by decayed and filled teeth. Older patients (p < 0.001) and the patients with a lower socioeconomic status (p = 0.01) had higher DMFT scores. None of the dentate patients had a healthy periodontium. Maximum CPI mostly consisted of shallow pockets (66%) followed by calculus in 15%, deep pockets in 11%, and bleeding in 8% of the participants. Older participants (p = 0.02) and those who started drug abuse at a younger age (p = 0.01) were more likely to develop periodontal pockets. Conclusions Opiate dependents had a poor oral health status in terms of the dentition status and periodontal health. Missing teeth comprised the main part of their dental caries history and none had a healthy periodontium. Oral health care should be integrated into the package of general health services available in treatment centers.
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Affiliation(s)
- Hajar Shekarchizadeh
- Department of Community Oral Health, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, University Blvd, Arqavanieh, Jey Street, P.O.Box: 81595-158, Isfahan, Iran.
| | - Mohammad R Khami
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Postal code 1417614411, Iran.,Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Postal code 1439955934, Iran
| | - Simin Z Mohebbi
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Postal code 1417614411, Iran.,Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Postal code 1439955934, Iran
| | - Hamed Ekhtiari
- Neurocognitive Laboratory, Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Postal code 1336616357, Iran
| | - Jorma I Virtanen
- Department of Clinical Dentistry, University of Bergen, N-5020, Bergen, Norway.,Medical Research Center, Oulu University Hospital, FI-90029, Oulu, Finland
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14
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Baghaie H, Kisely S, Forbes M, Sawyer E, Siskind DJ. A systematic review and meta-analysis of the association between poor oral health and substance abuse. Addiction 2017; 112:765-779. [PMID: 28299855 DOI: 10.1111/add.13754] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 11/08/2016] [Accepted: 01/02/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Substance use disorders are associated commonly with comorbid physical illness. There are fewer data on dental disease in these conditions, in spite of high rates of dry mouth (xerostomia), as well as the associated indirect or life-style effects such as poverty and lack of access to care. We compared the oral health of people with substance use disorders (SUDs) with non-using controls. METHOD This was a systematic search for studies from the last 35 years of the oral health of people reporting SUDs. We used MEDLINE, PsycInfo, OVID, Google Scholar, EMBASE and article bibliographies. Results were compared with the general population. Oral health was assessed in terms of dental caries and periodontal disease using the following standardized measures: the mean number of decayed, missing and filled teeth (DMFT) or surfaces (DMFS) and probing pocket depth. Non-carious tooth loss was assessed clinically. RESULTS We identified 28 studies that had sufficient data for a meta-analysis, comprising 4086 SU patients and 28 031 controls. People with SUD had significantly higher mean scores for DMFT [mean difference = 5.15, 95% confidence interval (CI) = 2.61-7.69 and DMFS (mean difference = 17.83, 95% CI = 6.85-28.8]. They had more decayed teeth but fewer restorations, indicating reduced access to dental care. Patients with SUD also exhibited greater tooth loss, non-carious tooth loss and destructive periodontal disease compared to controls. CONCLUSION Patients with substance use disorders have greater and more severe dental caries and periodontal disease than the general population, but are less likely to have received dental care.
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Affiliation(s)
- Hooman Baghaie
- School of Dentistry, The University of Queensland, Herston, QLD, Australia
| | - Steve Kisely
- School of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.,Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
| | - Malcolm Forbes
- School of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.,School of Medicine, The University of Melbourne, Melbourne, VIC, Australia
| | - Emily Sawyer
- James Cook University, Townsville, QLD, Australia
| | - Dan J Siskind
- School of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.,Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
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15
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Cury PR, Oliveira MGA, Dos Santos JN. Periodontal status in crack and cocaine addicted men: a cross-sectional study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2017; 24:3423-3429. [PMID: 27866365 DOI: 10.1007/s11356-016-7918-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 10/16/2016] [Indexed: 06/06/2023]
Abstract
This cross-sectional study evaluated the association between crack/cocaine addiction and periodontal disease in men. Periodontal examination (probing depth, clinical attachment level, bleeding on probing, and plaque index) and interviews were performed in 160 patients (≥18 years) from the Federal University of Bahia. Crack and cocaine dependence was defined according to the medical records and interviews of each patient; all drug addicted volunteers used both crack and cocaine. T test, Chi-square test, and logistic regression were used to assess the associations between destructive periodontal disease and crack/cocaine dependence (p ≤ 0.05). Probing depth was significantly greater in crack/cocaine addicted individuals (2.84 ± 0.76 mm) compared with non-addicted individuals (2.55 ± 0.73 mm, p = 0.04). After adjusting for covariates, periodontitis was not significantly associated with crack/cocaine addiction (OR = 2.31, 95 % CI = 0.82-6.46, p = 0.11), which was only associated with age ≥35 years (OR = 4.16, 95 % CI = 1.65-10.50, p = 0.003) and higher dental plaque index (OR = 6.46, 95 % CI = 1.95-21.42, p = 0.002). In conclusion, although probing depth was greater in crack/cocaine addicted individuals, destructive periodontal disease was not associated with crack and cocaine addiction in the present population. Destructive periodontal disease was associated with age and dental plaque. Further studies in a larger sample size are required to confirm the results.
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Affiliation(s)
- Patricia Ramos Cury
- Department of Periodontics, School of Dentistry, Federal University of Bahia, Av. Araújo Pinho, 62. Canela, Salvador, Bahia, 40110-150, Brazil.
| | - Maria Graças Alonso Oliveira
- Department of Oral Pathology, School of Dentistry, Federal University of Bahia, Av. Araújo Pinho, 62. Canela, Salvador, Bahia, 40110-150, Brazil
| | - Jean Nunes Dos Santos
- Department of Oral Pathology, School of Dentistry, Federal University of Bahia, Av. Araújo Pinho, 62. Canela, Salvador, Bahia, 40110-150, Brazil
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16
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Antoniazzi RP, Zanatta FB, Rösing CK, Feldens CA. Association Among Periodontitis and the Use of Crack Cocaine and Other Illicit Drugs. J Periodontol 2016; 87:1396-1405. [DOI: 10.1902/jop.2016.150732] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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17
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Pourhashemi SJ, Ghane M, Shekarchizadeh H, Jafari A. Oral health determinants among female addicts in Iran. Contemp Clin Dent 2015; 6:375-80. [PMID: 26321838 PMCID: PMC4549990 DOI: 10.4103/0976-237x.161893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
CONTEXT Addiction results in a range of health problems especially in the oral cavity. AIMS This study assessed the oral health status among women with a history of drug abuse in Tehran, Iran. SETTINGS AND DESIGN A cross-sectional study was conducted through structured interviews and clinical examinations of women at three rehabilitation centers in Tehran. MATERIALS AND METHODS Data on background characteristics, addiction history, knowledge, attitudes and behaviors, and oral health indices were collected. STATISTICAL ANALYSIS USED We used MANOVA test and multiple logistic regression models to analyze the data. RESULTS We assessed 95 participants aged 37.88 ± 10.65 years. The most commonly reported drugs used prior to treatment were opiates (77.2%). The mean knowledge and attitude score among the patients was 80.83 ± 12.89 (37.5-100). Less than half of the dentate women reported tooth brushing as "rarely or never" (44.2%). Most of them (81.8%) had never used dental floss and 76.1% were daily smokers. The mean score of dental caries index (decayed, missed and filled teeth) of the participants was 20.2 ± 7.18 and 17 subjects were edentulous (17.9%). Factors such as age, drug type, duration of addiction, time of last dental visit, and frequency of brushing were associated with oral health status among these women. CONCLUSIONS Women with a history of drug abuse in our study suffered from poor oral health. Although they had an acceptable level of knowledge and attitude toward oral health, their oral health, and hygiene was poor. These results call for more attention in designing and implementing oral health programs for addicts.
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Affiliation(s)
- S Jalal Pourhashemi
- Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Ghane
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hajar Shekarchizadeh
- Department of Community Oral Health, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
| | - Ahmad Jafari
- Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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18
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Medina-Solís CE, Pontigo-Loyola AP, Pérez-Campos E, Hernández-Cruz P, Avila-Burgos L, Mendoza-Rodríguez M, Maupomé G. Edentulism and other variables associated with self-reported health status in Mexican adults. Med Sci Monit 2014; 20:843-52. [PMID: 24852266 PMCID: PMC4043565 DOI: 10.12659/msm.890100] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 12/27/2013] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND To determine if edentulism, controlling for other known factors, is associated with subjective self-report health status (SRH) in Mexican adults. MATERIAL AND METHODS We examined the SRH of 13 966 individuals 35 years and older, using data from the National Survey of Performance Assessment, a cross-sectional study that is part of the technical collaboration between the Ministry of Health of Mexico and the World Health Organization, which used the survey instrument and sampling strategies developed by WHO for the World Health Survey. Sociodemographic, socioeconomic, medical, and behavioral variables were collected using questionnaires. Self-reported health was our dependent variable. Data on edentulism were available from 20 of the 32 Mexican states. A polynomial logistic regression model adjusted for complex sampling was generated. RESULTS In the SRH, 58.2% reported their health status as very good/good, 33.8% said they had a moderate health status, and 8.0% reported that their health was bad/very bad. The association between edentulism and SRH was modified by age and was significant only for bad/very bad SRH. Higher odds of reporting moderate health or poor/very poor health were found in women, people with lower socio-economic status and with physical disabilities, those who were not physically active, or those who were underweight or obese, those who had any chronic disease, and those who used alcohol. CONCLUSIONS The association of edentulism with a self-report of a poor health status (poor/very poor) was higher in young people than in adults. The results suggest socioeconomic inequalities in SRH. Inequality was further confirmed among people who had a general health condition or a disability. Dentists and health care professionals need to recognize the effect of edentulism on quality of life among elders people.
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Affiliation(s)
- Carlo Eduardo Medina-Solís
- Academic Area of Dentistry of Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca, Hidalgo, Mexico
- Research Centre in Medical and Biological Sciences, School of Medicine and Surgery, Autonomous University “Benito Juarez” of Oaxaca, Oaxaca, Mexico
| | | | - Eduardo Pérez-Campos
- Research Centre in Medical and Biological Sciences, School of Medicine and Surgery, Autonomous University “Benito Juarez” of Oaxaca, Oaxaca, Mexico
- Biochemistry Unit ITO-UNAM, Oaxaca, Mexico
| | - Pedro Hernández-Cruz
- Research Centre in Medical and Biological Sciences, School of Medicine and Surgery, Autonomous University “Benito Juarez” of Oaxaca, Oaxaca, Mexico
- Biochemistry Unit ITO-UNAM, Oaxaca, Mexico
| | - Leticia Avila-Burgos
- Health Systems Research Centre, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Martha Mendoza-Rodríguez
- Academic Area of Dentistry of Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca, Hidalgo, Mexico
| | - Gerardo Maupomé
- Indiana University/Purdue University at Indianapolis, School of Dentistry, Indianapolis, IN, U.S.A
- The Regenstrief Institute, Inc. Indianapolis, Indiana, IN, U.S.A
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19
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SHEKARCHIZADEH H, KHAMI MR, MOHEBBI SZ, EKHTIARI H, VIRTANEN JI. Oral Health of Drug Abusers: A Review of Health Effects and Care. IRANIAN JOURNAL OF PUBLIC HEALTH 2013; 42:929-40. [PMID: 26060654 PMCID: PMC4453891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 07/10/2013] [Indexed: 11/24/2022]
Abstract
Oral health problems, among the most prevalent comorbidities related to addiction, require more attention by both clinicians and policy-makers. Our aims were to review oral complications associated with drugs, oral health care in addiction rehabilitation, health services available, and barriers against oral health promotion among addicts. Drug abuse is associated with serious oral health problems including generalized dental caries, periodontal diseases, mucosal dysplasia, xerostomia, bruxism, tooth wear, and tooth loss. Oral health care has positive effects in recovery from drug abuse: patients' need for pain control, destigmatization, and HIV transmission. Health care systems worldwide deliver services for addicts, but most lack oral health care programs. Barriers against oral health promotion among addicts include difficulty in accessing addicts as a target population, lack of appropriate settings and of valid assessment protocols for conducting oral health studies, and poor collaboration between dental and general health care sectors serving addicts. These interfere with an accurate picture of the situation. Moreover, lack of appropriate policies to improve access to dental services, lack of comprehensive knowledge of and interest among dental professionals in treating addicts, and low demand for non-emergency dental care affect provision of effective interventions. Management of drug addiction as a multi-organ disease requires a multidisciplinary approach. Health care programs usually lack oral health care elements. Published evidence on oral complications related to addiction emphasizes that regardless of these barriers, oral health care at various levels including education, prevention, and treatment should be integrated into general care services for addicts.
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Affiliation(s)
- Hajar SHEKARCHIZADEH
- 1. Research Center for Caries Prevention, Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,2. Dept. of Oral Public Health, University of Helsinki, Helsinki, Finland
| | - Mohammad R. KHAMI
- 2. Dept. of Oral Public Health, University of Helsinki, Helsinki, Finland,3. Dental Research Center, Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,* Corresponding Author:
| | - Simin Z. MOHEBBI
- 1. Research Center for Caries Prevention, Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,2. Dept. of Oral Public Health, University of Helsinki, Helsinki, Finland
| | - Hamed EKHTIARI
- 4. Translational Neuroscience Program, Institute for Cognitive Science Studies, Iran,5. Neurocognitive Laboratory, Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Jorma I. VIRTANEN
- 6. Dept. of Community Dentistry, University of Oulu, Oulu, Finland,7. Dept. of Public Health, University of Helsinki, Helsinki, Finland
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