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Ganhewa M, Murthy V, Rajappa R, Raj R, Lawrence D, Cirillo N. Rampant caries: What it is and what it isn't. SPECIAL CARE IN DENTISTRY 2024; 44:1300-1302. [PMID: 38462548 DOI: 10.1111/scd.12986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/16/2024] [Accepted: 02/21/2024] [Indexed: 03/12/2024]
Affiliation(s)
- Mahen Ganhewa
- CoTreatAI, CoTreat Pty Ltd, Melbourne, VIC, Australia
| | | | | | - Ruchika Raj
- CoTreatAI, CoTreat Pty Ltd, Melbourne, VIC, Australia
| | | | - Nicola Cirillo
- CoTreatAI, CoTreat Pty Ltd, Melbourne, VIC, Australia
- Melbourne Dental School, The University of Melbourne, Carlton, VIC, Australia
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Abdelsalam S, Van Den Boom W, Higgs P, Dietze P, Erbas B. The association between depression and oral health related quality of life in people who inject drugs. Drug Alcohol Depend 2021; 229:109121. [PMID: 34688121 DOI: 10.1016/j.drugalcdep.2021.109121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/24/2021] [Accepted: 10/05/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Oral health related quality of life (OHRQoL) is known to be reduced in disadvantaged populations, including people who inject drugs. Mental health issues, such as depression are also commonly reported. In this study we examined the association between depression and OHRQoL. METHODS Cross-sectional analysis survey data was collected from the Melbourne Injecting Drug User Cohort Study (SuperMIX) of people who inject drugs (N = 982). Three measures derived from the Oral Health Impact Profile (OHIP-14) were used to assess OHRQoL: Prevalence (reporting one or more dental issue "Very often" or "Fairly often" in the previous year), Extent (number of items reported either "Very often" or "Fairly often") and Severity (summary score of all ordinal responses). Regression analyses assessed the association between depression, indexed as scoring above 10 on the Patient Health Questionnaire (PHQ-9), and OHIP-14 measures, adjusted for sociodemographic, drug use and dental service utilisation variables. RESULTS Overall, participants had low levels of OHRQoL, indexed through OHIP-14 scores (46% exhibiting prevalence, mean extent of 2.35 and mean severity of 12.72). Depression was associated with increases in all OHIP-14 measures, after adjustment for potential confounders. CONCLUSIONS We found a significant association between depression and poor OHRQoL in this sample of people who inject drugs. Further research using a longitudinal frame is needed to determine the direction of this relationship. Interventions to improve oral health of people who inject drugs are urgently needed, and these may benefit mental health outcomes for people who inject drugs.
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Affiliation(s)
- Shady Abdelsalam
- National Drug Research Institute, Curtin University, 85 Commercial Rd, Melbourne, Vic 3004, Australia; Burnet Institute, 85 Commercial Rd, Melbourne, Vic 3004, Australia; La Trobe University, Plenty Rd &, Kingsbury Dr, Bundoora, Vic 3086, Australia.
| | - Wijnand Van Den Boom
- Burnet Institute, 85 Commercial Rd, Melbourne, Vic 3004, Australia; National Institute for Public Health and The Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
| | - Peter Higgs
- Burnet Institute, 85 Commercial Rd, Melbourne, Vic 3004, Australia; La Trobe University, Plenty Rd &, Kingsbury Dr, Bundoora, Vic 3086, Australia.
| | - Paul Dietze
- National Drug Research Institute, Curtin University, 85 Commercial Rd, Melbourne, Vic 3004, Australia; Burnet Institute, 85 Commercial Rd, Melbourne, Vic 3004, Australia.
| | - Bircan Erbas
- La Trobe University, Plenty Rd &, Kingsbury Dr, Bundoora, Vic 3086, Australia; Faculty of Public Health, Universitas AirLangga, Surabaya 60115, Indonesia.
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3
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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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Hegazi F, Alhazmi H, Abdullah A, Alamer N, Nelson J, Aldosari M, Tillman N, Bahdila D, Odani S, Agaku I, Vardavas C. Prevalence of oral conditions among methamphetamine users: NHANES 2009-2014. J Public Health Dent 2020; 81:21-28. [PMID: 32812220 DOI: 10.1111/jphd.12389] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/08/2020] [Accepted: 07/02/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Methamphetamine (MA) is a widely used illicit drug and a nationwide public health concern. Although dental complications are consistently reported among MA users, yet limited nationally representative studies on the associations between MA use and oral health currently exist. METHODS Using the National Health and Nutrition Examination Survey 2009-2014, we analyzed 8,762 respondents aged 30-64 years who had completed a periodontal examination. MA use was self-reported; periodontitis, untreated caries, and missing teeth were assessed by calibrated dentists. Descriptive statistics as well as multivariable regression analyses were performed. Data were weighted to yield representative estimates of the US adult population. RESULTS Overall 7.8 percent of US adults aged ≥30 years had ever used MA. Ever-use prevalence was higher among males, whites, and individuals below the federal poverty level. Established MA users had a higher prevalence of untreated dental caries (36.6 percent), any periodontitis (54.8 percent), and severe periodontitis (12.2 percent) than those who had never used MA. The prevalence of any periodontitis was higher among current MA users (PR: 1.31; 95% CI: 1.05-1.62) than those who never used MA. Prevalence of untreated dental caries was higher among current MA users (PR: 1.53; 95% CI: 1.10-2.13) and established users (PR: 1.21; 95% CI: 1.02-1.48) than never users. Taking MA orally and/or through injection was associated with higher odds of severe periodontitis than orally only (AOR: 3.72; CI: 1.79-7.75). CONCLUSIONS MA users had a higher prevalence of periodontitis and dental caries. Continued research assessing the relationship between MA use and oral health can inform clinical interventions and management of dental diseases in MA users.
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Affiliation(s)
- Fahad Hegazi
- Preventive Dental Sciences, Imam Abdulrahman Bin Faisal University, College of Dentistry, Dammam, Saudi Arabia
| | - Hesham Alhazmi
- Preventive Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abeer Abdullah
- Preventive Dental Science, King Abdulaziz University, Riyadh, Saudi Arabia
| | - Nora Alamer
- Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Jevae Nelson
- Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA
| | - Muath Aldosari
- Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA
| | - Nailah Tillman
- Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA
| | - Dania Bahdila
- Preventive Dental Science, King Abdulaziz University, Riyadh, Saudi Arabia
| | - Satomi Odani
- University of Crete School of Medicine, Crete, Greece
| | - Israel Agaku
- Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA
| | - Constantine Vardavas
- Oral Health Policy and Epidemiology, Harvard 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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Cossa F, Piastra A, Sarrion-Pérez MG, Bagán L. Oral manifestations in drug users: A review. J Clin Exp Dent 2020; 12:e193-e200. [PMID: 32071702 PMCID: PMC7018485 DOI: 10.4317/jced.55928] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 01/08/2020] [Indexed: 01/13/2023] Open
Abstract
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.
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Affiliation(s)
- Federico Cossa
- Student of the master of Implantology at the Universidad Europea de Valencia. Graduated in Dentistry at the Universidad Europea de Valencia
| | - Alessia Piastra
- Student of the master of Endodontics at the University of Valencia. Graduated in Dentistry at the Universidad Europea de Valencia
| | - Mª Gracia Sarrion-Pérez
- PhD, Associate Professor. Faculty of Health Sciences. Department of Dentistry. European University of Valencia. Spain
| | - Leticia Bagán
- PhD, Titular professor. Faculty of Health Sciences. Department of Dentistry. European University of Valencia. Spain
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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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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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Haber PS, Elsayed M, Espinoza D, Lintzeris N, Veillard AS, Hallinan R. Constipation and other common symptoms reported by women and men in methadone and buprenorphine maintenance treatment. Drug Alcohol Depend 2017; 181:132-139. [PMID: 29054032 DOI: 10.1016/j.drugalcdep.2017.09.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 09/19/2017] [Accepted: 09/23/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Opioid substitution treatment (OST) is often continued long-term and, therefore, opioid-associated symptoms are of interest. Symptoms associated with methadone maintenance treatment (MMT) in men are well described, but there are fewer reports concerning symptoms associated with buprenorphine maintenance treatment (BMT) and very few reports among women. METHOD Recipients of BMT (n=113) and MMT (n=184), non-opioid users (n=105) and opioid users not receiving OST (n=87) completed the Patient Assessment of Constipation (PAC-SYM) and a general symptom checklist. Multivariate analysis included other potential moderators of opioid-associated symptoms. FINDINGS Opioid users reported a higher frequency and severity of symptoms than non-opioid users. Constipation, dry mouth, decreased appetite, sweating and fatigue were highly prevalent in the previous 30days (51-80%). Nausea, itchy skin, trouble urinating, menstrual problems, lightheadedness, blurred vision, heart racing were also common (30-50%). Non-OST opioid users had significantly higher frequency and severity than OST recipients of nausea, vomiting, diarrhoea, decreased appetite, sweating and itchy skin. Sweating was significantly more common in MMT than BMT. Constipation scores were higher in women, otherwise most sex differences were small. Higher PAC-SYM scores were associated with vomiting (OR=1.04) and sweating (OR=1.06). Cannabis use was associated with vomiting (OR=2.19). Constipation (OR=1.07), insomnia (OR=2.5) and depression (OR=2.82) were associated with fatigue. CONCLUSION Men and women receiving OST report similarly high rates of somatic symptoms, though less than opioid users not receiving OST. There were few differences between BMT and MMT. Buprenorphine might be preferred where sweating is problematic. Several modifiable factors were identified.
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Affiliation(s)
- Paul S Haber
- Drug Health Services, Sydney Local Heath District, Australia; Sydney Medical School, Camperdown, 2006 NSW, Australia.
| | - Mahmoud Elsayed
- Liverpool Hospital, South Western Sydney Local Heath District, Liverpool, 2170 NSW, Australia
| | - David Espinoza
- NHMRC Clinical Trials Centre, The University of Sydney, Australia
| | - Nicholas Lintzeris
- Sydney Medical School, Camperdown, 2006 NSW, Australia; The Langton Centre, South Eastern Sydney Local Health District, Australia
| | | | - Richard Hallinan
- Sydney Medical School, Camperdown, 2006 NSW, Australia; The Byrne Surgery, Redfern, NSW, Australia
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10
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Antoniazzi RP, Zanatta FB, Ardenghi TM, Feldens CA. The use of crack and other illicit drugs impacts oral health-related quality of life in Brazilians. Oral Dis 2017; 24:482-488. [DOI: 10.1111/odi.12786] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 09/14/2017] [Accepted: 09/15/2017] [Indexed: 11/29/2022]
Affiliation(s)
- RP Antoniazzi
- School of Dentistry; Master's Degree in Health and Life Sciences; Centro Universitário Franciscano; Santa Maria Brazil
| | - FB Zanatta
- Stomatology Department; School of Dentistry; Universidade Federal de Santa Maria (UFSM); Santa Maria Brazil
| | - TM Ardenghi
- Stomatology Department; School of Dentistry; Universidade Federal de Santa Maria (UFSM); Santa Maria Brazil
| | - CA Feldens
- Post-graduate Program in Dentistry; Universidade Luterana do Brasil (ULBRA); Canoas Brazil
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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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Clague J, Belin TR, Shetty V. Mechanisms underlying methamphetamine-related dental disease. J Am Dent Assoc 2017; 148:377-386. [PMID: 28457476 DOI: 10.1016/j.adaj.2017.02.054] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/10/2017] [Accepted: 02/24/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND The authors clarified the causal mechanisms underlying the high prevalence of dental disease encountered in people who habitually use methamphetamine (meth). METHODS Using a stratified sampling approach, the authors conducted comprehensive oral examinations and psychosocial assessments for 571 study participants who used meth. Three calibrated dentists, who used National Health and Nutrition Examination Survey (NHANES) protocols, characterized the study participants' dental disease. The authors also collected data related to study participants' history of meth use and other attributes linked to dental disease. RESULTS Study participants who used meth manifested higher rates of xerostomia and caries experience compared with NHANES control participants. Participants who used meth had a higher level of daily consumption of sugary beverages compared with NHANES control participants. Smoking meth did not increase caries experience over other modes of intake. Dental hygiene was a significant determinant of dental health outcomes. CONCLUSIONS Mode of intake and frequency of meth use have a minimal impact on dental health outcomes. Behaviors, such as sugary beverage consumption and poor oral hygiene, better explain dental health outcomes. PRACTICAL IMPLICATIONS Having a better understanding of the causal mechanisms of "meth mouth" sets the stage for clinicians to provide more personalized interventions and management of dental disease in people who use meth.
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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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Curto A. Managing drug addicts. Br Dent J 2016; 221:100-1. [DOI: 10.1038/sj.bdj.2016.542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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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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Shetty V, Harrell L, Murphy DA, Vitero S, Gutierrez A, Belin TR, Dye BA, Spolsky VW. Dental disease patterns in methamphetamine users: Findings in a large urban sample. J Am Dent Assoc 2015; 146:875-85. [PMID: 26610832 PMCID: PMC5364727 DOI: 10.1016/j.adaj.2015.09.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 09/03/2015] [Accepted: 09/04/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND The authors used a large community sample of methamphetamine (MA) users to verify the patterns and severity of dental disease and establish a hierarchy of caries susceptibility by tooth type and tooth surface. METHODS Using a stratified sampling approach, 571 MA users received comprehensive oral examinations and psychosocial assessments. Three calibrated dentists characterized dental and periodontal disease by using National Health and Nutrition Examination Survey protocols. The authors also collected data on substance use history and other attributes linked to dental disease. RESULTS On all dental outcome measures, MA users evidenced high dental and periodontal disease, with older (≥ 30 years) and moderate or heavy MA users disproportionately affected. Women had higher rates of tooth loss and caries, as well as a greater prevalence of anterior caries. Current cigarette smokers were more likely to manifest 5 or more anterior surfaces with untreated caries and 3 or more teeth with root caries. Nearly 3% were edentulous, and a significant percentage (40%) indicated embarrassment with their dental appearance. CONCLUSIONS MA users have high rates of dental and periodontal disease and manifest a dose-response relationship, with greater levels of MA use associated with higher rates of dental disease. Women and current cigarette smokers are affected disproportionately. The intraoral patterns and hierarchy of caries susceptibility in MA users are distinctive. PRACTICAL IMPLICATIONS The prevalence and patterns of dental and periodontal disease could be used to alert dentists to possible covert MA use and to plan treatment. Concerns about dental appearance have potential as triggers for behavioral interventions.
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Affiliation(s)
- Vivek Shetty
- School of Dentistry, University of California, Los Angeles, Los Angeles, 90095-1668, USA
| | - Lauren Harrell
- School of Dentistry, University of California, Los Angeles, Los Angeles, 90095-1668, USA
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, 90095-1563, USA
| | - Debra A. Murphy
- Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, 90095-1563
| | | | - Alexis Gutierrez
- School of Dentistry, University of California, Los Angeles, Los Angeles, 90095-1668, USA
| | - Thomas R. Belin
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, 90095-1563, USA
| | - Bruce A. Dye
- National Institute of Health, National Institute of Dental and Craniofacial Research, Bethesda, MD, USA
| | - Vladimir W. Spolsky
- School of Dentistry, University of California, Los Angeles, Los Angeles, 90095-1668, USA
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Albini MB, Couto ACF, Invernici MDM, Martins MC, Lima AASD, Gabardo MCL, Machado MÂN. Perfil sociodemográfico e condição bucal de usuários de drogas em dois municípios do Estado do Paraná, Brasil. REVISTA DE ODONTOLOGIA DA UNESP 2015. [DOI: 10.1590/1807-2577.1068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
<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>
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Truong A, Higgs P, Cogger S, Jamieson L, Burns L, Dietze P. Oral health-related quality of life among an Australian sample of people who inject drugs. J Public Health Dent 2015; 75:218-24. [PMID: 25753928 DOI: 10.1111/jphd.12092] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 01/26/2015] [Indexed: 01/28/2023]
Abstract
OBJECTIVES People who inject drugs (PWID) have poor oral health. However, their oral health-related quality of life (OHRQoL) is unknown. Our study was designed to measure the OHRQoL of PWID. METHODS The Oral Health Impact Profile-14 (OHIP-14) was administered to 794 PWID recruited in Australian capital cities as part of the 2013 Illicit Drug Reporting System (IDRS). Three OHIP-14 summary indicators were examined: "Prevalence" (proportion reporting ≥1 item at least "fairly often"), "severity" (mean total OHIP-14 score), and "extent" (number of impacts reported at least "fairly often"). Associations between "prevalence" and "extent" and variables drawn from the health, drug use, and social domains were investigated. RESULTS All OHIP-14 summary indicators among IDRS participants were significantly higher than in the general Australian population. In multivariate analysis, the "prevalence" indicator was significantly and positively associated with female gender [adjusted odds ratio (AOR) = 1.75, 95% CI 1.27-2.38], those born in Australia (AOR = 2, 95% CI 1.25-3.23), not completing Year 10 compared with those who had completed Year 12 or a higher qualification (AOR = 1.59, 95% CI 1.03-2.44), and methadone treatment (AOR = 1.61, 95% CI 1.14-2.29). The "extent" indicator was significantly and positively associated with female gender [adjusted incidence rate ratio (AIRR) = 1.56, 95% CI 1.19-2.08], unemployment (AIRR = 1.59, 95% CI 1.01-2.44), and having an injecting career of 10-20 years (AIRR = 1.76, 95% CI 1.03-3.01). CONCLUSIONS PWID have poorer OHRQoL than the Australian general population. Poor OHRQoL was particularly common in female PWID and those with longer injecting careers. Interventions to improve the oral health of PWID may improve their OHRQoL.
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Affiliation(s)
- Arthur Truong
- Centre for Population Health, Burnet Institute, Melbourne, VIC, Australia.,Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia
| | - Peter Higgs
- Centre for Population Health, Burnet Institute, Melbourne, VIC, Australia.,National Drug Research Institute, Curtin University, Fitzroy, VIC, Australia
| | - Shelley Cogger
- Centre for Population Health, Burnet Institute, Melbourne, VIC, Australia.,Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA, Australia
| | - Lucinda Burns
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Paul Dietze
- Centre for Population Health, Burnet Institute, Melbourne, VIC, Australia.,Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia
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De-Carolis C, Boyd GA, Mancinelli L, Pagano S, Eramo S. Methamphetamine abuse and "meth mouth" in Europe. Med Oral Patol Oral Cir Bucal 2015; 20:e205-10. [PMID: 25662544 PMCID: PMC4393984 DOI: 10.4317/medoral.20204] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 10/28/2014] [Indexed: 11/13/2022] Open
Abstract
With easy chemical synthesis from its precursor, methamphetamine (MA) is now widespread in many countries. The abuse of methamphetamine is associated with several negative effects on health, because MA is a neurotoxin and a dangerous central nervous system stimulant. It changes levels of neurotransmitters in the brain, releasing dopamine and inhibiting nor epinephrine uptake which increases sympathetic nervous system activity and can lead to cardiac arrhythmia, hypertension and tachypnea. The consequences of MA abuse are clearly manifested in oral diseases (like “meth mouth”) which is characterised by extensive caries, teeth grinding with ensuing dental wear and trismus. The present review was designed to fill the gap in knowledge about methamphetamine abuse in the European Union (EU) and to illustrate the main clinical effects of prolonged use. After describing the pharmacology and systemic effects of methamphetamine and concentrating on its effects on the mouth, the present review compares the epidemiology and incidence of abuse in the world, particularly the USA and the EU.
Key words:Methamphetamine, “Meth mouth”, drug abuse, oral health.
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Affiliation(s)
- Carlo De-Carolis
- School of Dentistry, University of Perugia, Strada vicinale delle corse, 60180 Perugia, Italy,
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The oral health of heroin drug users: case study in Bosnia and Herzegovina. BMC Public Health 2013; 13:1202. [PMID: 24355082 PMCID: PMC3878313 DOI: 10.1186/1471-2458-13-1202] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 12/12/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Injection drug use is a major public health problem. Oral health problems and the appearance of dental disease among injection drug users (IDUs) are caused by their lifestyle. The aim of the present study was to examine the relations between socioeconomic factors, drug use, and oral hygiene habits on the oral health of heroin drug users. METHODS A cross-sectional survey on oral health was carried out as part of UNICEF's research on the biological and behaviours survey among injection drug users in Sarajevo, Banja Luka and Zenica in Bosnia and Herzegovina. A sample of 519 IDUs participated in the survey. Respondent Driven Sampling (RDS) was used to obtain the sample. The data were obtained through face-to-face interviews using a structured questionnaire related to socio-demographic characteristics, duration of drug injection, frequency of drug injection in the last month and oral health. RESULTS Older participants (OR = 1.06; 95% CI = 1.02 -1.10), part-time employment (OR = 3.57; 95% CI = 1.02 - 12.20) and unemployment (OR = 3.23; 95% CI = 1.23 - 8.33) in comparison to full-time employment as the referent category, and longer duration of drug injection (OR = 1.06; 95% CI = 1.003 - 1.12) were predictors of bad oral health. A higher level of education (OR = 0.56; 95% CI = 0.39 - 0.79), more frequent tooth brushing (OR = 0.59; 95% CI = 0.49 - 0.71), and regular dental checkups (OR = 3.30; 95% CI = 1.42 - 7.67) were predictors of good oral health. CONCLUSIONS Socioeconomic characteristics of IDUs as well as their lifestyles may contribute to oral health problems. Heroin drug users have specific dental needs, and programmes to improve their oral health should be an integral part of strategies to prevent addictions including treatments and harm reduction programmes.
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