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Abstract
Mental health disorders, particularly depression and anxiety, affect a significant number of the global population. Several pathophysiological pathways for these disorders have been identified, including the hypothalamic-pituitary-adrenal axis, autonomic nervous system, and the immune system. In addition, life events, environmental factors, and lifestyle affect the onset, progression, and recurrence of mental health disorders. These may all overlap with periodontal and/or peri-implant disease. Mental health disorders are associated with more severe periodontal disease and, in some cases, poorer healing outcomes to nonsurgical periodontal therapy. They can result in behavior modification, such as poor oral hygiene practices, tobacco smoking, and alcohol abuse, which are also risk factors for periodontal disease and, therefore, may have a contributory effect. Stress has immunomodulatory effects regulating immune cell numbers and function, as well as proinflammatory cytokine production. Stress markers such as cortisol and catecholamines may modulate periodontal bacterial growth and the expression of virulence factors. Stress and some mental health disorders are accompanied by a low-grade chronic inflammation that may be involved in their relationship with periodontal disease and vice versa. Although the gut microbiome interacting with the central nervous system (gut-brain axis) is thought to play a significant role in mental illness, less is understood about the role of the oral microbiome. The evidence for mental health disorders on implant outcomes is lacking, but may mainly be through behaviourial changes. Through lack of compliance withoral hygiene and maintenance visits, peri-implant health can be affected. Increased smoking and risk of periodontal disease may also affect implant outcomes. Selective serotonin reuptake inhibitors have been linked with higher implant failure. They have an anabolic effect on bone, reducing turnover, which could account for the increased loss.
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Affiliation(s)
- Jake Ball
- Centre for Rural Dentistry and Oral HealthCharles Sturt UniversityOrangeNew South WalesAustralia
| | - Ivan Darby
- Periodontics, Melbourne Dental SchoolThe University of MelbourneMelbourneVictoriaAustralia
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Oyapero A, Oyapero O, Akinleye A. Burden of tobacco, kola nut and alcohol consumption
and its association with periodontal disease, potentially
malignant lesions and quality of life among bus drivers,
Lagos State, Nigeria. POPULATION MEDICINE 2020. [DOI: 10.18332/popmed/118726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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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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Priyanka K, Sudhir KM, Reddy VCS, Kumar RK, Srinivasulu G. Impact of Alcohol Dependency on Oral Health - A Cross-sectional Comparative Study. J Clin Diagn Res 2017; 11:ZC43-ZC46. [PMID: 28764291 DOI: 10.7860/jcdr/2017/26380.10058] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 03/30/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Alcoholism is a chronic and progressive psychiatric illness characterised by a loss of control over alcohol consumption. Consumption of alcohol inevitably affects the oral cavity, oral mucosa and teeth. Literature indicates that alcohol dependents may have increased risk of dental caries, probing pocket depth and mucosal lesions. AIM To assess the impact of alcohol dependency on oral health status among alcoholics in comparison with non alcoholics. MATERIALS AND METHODS A total 76 alcoholic patients visiting Psychiatric Department were compared with matched non alcoholics. Subjects were categorised as alcohol dependents based on American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria. Non alcoholic subjects were selected by controlling for potentially confounding variables such as for cigarette, smoking and age. Data was collected by interview and clinical examination. Oral health status of subjects was assessed using a modified WHO proforma and salivary pH and plaque pH were assessed. Chi-square test was used for assessing socio demographic details and Mann-whitney U test was used for prevalence of dental caries and periodontal diseases, Unpaired t-test was used for plaque and salivary pH. RESULTS There was no statistically significant difference noted among alcoholic and nonalcoholic control group with respect to socio demographic details. Prevalence of dental caries was higher in alcohol dependent subjects with a mean DMFT of 5.92 compared to nonalcoholic subjects (4.51). Prevalence of periodontitis was higher (89.61%) in alcohol dependent subjects compared to controls (78.67%). Prevalence of mucosal lesions among alcohol dependent subjects was 31.5% which was higher than the controls (25%). Subjects who were categorised as alcoholics showed a lower plaque and salivary pH compared to non alcoholics. CONCLUSION Subjects categorised as alcohol dependent subjects had slightly lower mean plaque and salivary pH and a higher prevalence of dental caries, periodontitis and mucosal lesions compared with non alcoholic subjects.
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Affiliation(s)
- Kakarla Priyanka
- Postgraduate Student, Department of Public Health Dentistry, Narayana Dental College, Chinthareddypalem, Nellore, Andhra Pradesh, India
| | - Kudlur Maheswarappa Sudhir
- Reader, Department of Public Health Dentistry, Narayana Dental College, Chinthareddypalem, Nellore, Andhra Pradesh, India
| | - V Chandra Sekhara Reddy
- Professor and Head, Department of Public Health Dentistry, Narayana Dental College, Chinthareddypalem, Nellore, Andhra Pradesh, India
| | - Rvs Krishna Kumar
- Reader, Department of Public Health Dentistry, Narayana Dental College, Chinthareddypalem, Nellore, Andhra Pradesh, India
| | - G Srinivasulu
- Senior Lecturer, Department of Public Health Dentistry, Narayana Dental College, Chinthareddypalem, Nellore, Andhra Pradesh, India
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Hayashi J, Hasegawa A, Hayashi K, Suzuki T, Ishii M, Otsuka H, Yatabe K, Goto S, Tatsumi J, Shin K. Effects of periodontal treatment on the medical status of patients with type 2 diabetes mellitus: a pilot study. BMC Oral Health 2017; 17:77. [PMID: 28431542 PMCID: PMC5399866 DOI: 10.1186/s12903-017-0369-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 04/12/2017] [Indexed: 01/22/2023] Open
Abstract
Background Studies have demonstrated that periodontal disease is associated with the development of systemic complications in patients with type 2 diabetes mellitus (T2DM). The purpose of this pilot study was to investigate which markers among various systemic disease parameters are affected by periodontal treatment in patients with T2DM. Methods Twelve patients with T2DM were given oral hygiene instructions and subsequent subgingival scaling and root planing. The periodontal status was recorded, and blood and urine samples were taken to measure various parameters of glucose control and systemic status at baseline and 1 month following the periodontal treatment. Serum concentrations of tumor necrosis factor-α and high-sensitivity C-reactive protein were measured by enzyme-linked immunosorbent assay. Results After the periodontal treatment, the glycated hemoglobin value was significantly improved. The levels of urinary N-acetyl-β-D-glucosaminidase and albumin, which are markers of renal dysfunction, also decreased significantly after treatment. Among the parameters measured in serum, the γ-glutamyl transpeptidase level, which is usually interpreted as a marker of liver dysfunction, was significantly reduced. The serum concentrations of tumor necrosis factor-α and high-sensitivity C-reactive protein were also significantly reduced by periodontal treatment. Conclusion Within the limitations of this pilot study, periodontal treatment may be effective not only in improving metabolic control, but also in reducing the risk of diabetic kidney and liver disease in patients with T2DM.
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Affiliation(s)
- Joichiro Hayashi
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado-shi, Saitama-ken, 350-0283, Japan.
| | | | - Kohei Hayashi
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado-shi, Saitama-ken, 350-0283, Japan
| | - Takafumi Suzuki
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado-shi, Saitama-ken, 350-0283, Japan
| | - Makiko Ishii
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado-shi, Saitama-ken, 350-0283, Japan
| | - Hideharu Otsuka
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado-shi, Saitama-ken, 350-0283, Japan
| | - Kazuhiro Yatabe
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado-shi, Saitama-ken, 350-0283, Japan
| | - Seiichi Goto
- Meikai University School of Dentistry, Saitama-ken, Japan
| | - Junichi Tatsumi
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado-shi, Saitama-ken, 350-0283, Japan
| | - Kitetsu Shin
- Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado-shi, Saitama-ken, 350-0283, Japan
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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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Barcia JM, Portolés S, Portolés L, Urdaneta AC, Ausina V, Pérez-Pastor GMA, Romero FJ, Villar VM. Does Oxidative Stress Induced by Alcohol Consumption Affect Orthodontic Treatment Outcome? Front Physiol 2017; 8:22. [PMID: 28179886 PMCID: PMC5263147 DOI: 10.3389/fphys.2017.00022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 01/10/2017] [Indexed: 12/26/2022] Open
Abstract
HIGHLIGHTS Ethanol, Periodontal ligament, Extracellular matrix, Orthodontic movement. Alcohol is a legal drug present in several drinks commonly used worldwide (chemically known as ethyl alcohol or ethanol). Alcohol consumption is associated with several disease conditions, ranging from mental disorders to organic alterations. One of the most deleterious effects of ethanol metabolism is related to oxidative stress. This promotes cellular alterations associated with inflammatory processes that eventually lead to cell death or cell cycle arrest, among others. Alcohol intake leads to bone destruction and modifies the expression of interleukins, metalloproteinases and other pro-inflammatory signals involving GSKβ, Rho, and ERK pathways. Orthodontic treatment implicates mechanical forces on teeth. Interestingly, the extra- and intra-cellular responses of periodontal cells to mechanical movement show a suggestive similarity with the effects induced by ethanol metabolism on bone and other cell types. Several clinical traits such as age, presence of systemic diseases or pharmacological treatments, are taken into account when planning orthodontic treatments. However, little is known about the potential role of the oxidative conditions induced by ethanol intake as a possible setback for orthodontic treatment in adults.
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Affiliation(s)
- Jorge M. Barcia
- School of Medicine and Dentistry, Universidad Católica de Valencia San Vicente MártirValencia, Spain
| | - Sandra Portolés
- School of Medicine and Dentistry, Universidad Católica de Valencia San Vicente MártirValencia, Spain
| | - Laura Portolés
- School of Medicine and Dentistry, Universidad Católica de Valencia San Vicente MártirValencia, Spain
| | - Alba C. Urdaneta
- School of Medicine and Dentistry, Universidad Católica de Valencia San Vicente MártirValencia, Spain
| | - Verónica Ausina
- Facultad de Ciencias de la Salud, Universidad Europea de ValenciaValencia, Spain
| | - Gema M. A. Pérez-Pastor
- School of Medicine and Dentistry, Universidad Católica de Valencia San Vicente MártirValencia, Spain
| | - Francisco J. Romero
- School of Medicine and Dentistry, Universidad Católica de Valencia San Vicente MártirValencia, Spain
- Facultad de Ciencias de la Salud, Universidad Europea de ValenciaValencia, Spain
| | - Vincent M. Villar
- Department of Biomedical Sciences, Universidad Cardenal Herrera, CEUMoncada, Spain
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Teng PR, Lin MJ, Yeh LL. Utilization of dental care among patients with severe mental illness: a study of a National Health Insurance database. BMC Oral Health 2016; 16:87. [PMID: 27585979 PMCID: PMC5009687 DOI: 10.1186/s12903-016-0280-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 08/15/2016] [Indexed: 11/10/2022] Open
Abstract
Background The oral health of patients with severe mental illness is poor, in general, and this may be attributed, in part, to inadequate dental care. This study investigated dental care utilization among patients with severe mental illness using a national representative sample. Methods This study used Taiwan’s National Health Insurance Research Dataset for 2009. Patients with the diagnosis of severe mental illness (ICD-9-CM: 290–298) were recruited as the study sample, and others comprised the control. Any visit to a dentist was defined as positive in terms of dental care utilization. Regression analyses were applied to determine the odds of dental care utilization for each diagnostic entity of severe mental illness, compared with the general population and controlling for potential covariates. Results Only 40 % of 19,609 patients with severe mental illness visited the dentist within 12 months. This was significantly lower than the dental visit rate of 48.3 % for the control population (odds ratio [OR] = .72, 95 % confidence interval [CI] = .69–.74; P <0.0001). The odds of dental care utilization differed among the severe mental illness diagnostic categories; e.g., the odds were lowest among those with alcohol psychoses (OR = .54, CI = .43–.68), senile dementia (OR = .55, CI = .52–.59) and other organic psychoses (OR = .58, CI = .52–.65), and highest among those with mood disorder (OR = .89, CI = .85–.94), with schizophrenic patients occupying a mid-level position (OR = .63, CI = .59–.67). Conclusions Patients with severe mental illness received less dental care than the general population. Health care providers and caregivers of patients with severe mental illness should encourage them to visit the dentist regularly, in order to improve the oral health of these vulnerable patient groups.
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Affiliation(s)
- Po-Ren Teng
- Department of Psychiatry, Chang Bing Show Chwan Memorial Hospital, No. 6, Lu-Gong Road, Lu-Gang Township, Changhwa County, Taiwan
| | - Miao-Jean Lin
- Department of Psychiatry, Chang Bing Show Chwan Memorial Hospital, No. 6, Lu-Gong Road, Lu-Gang Township, Changhwa County, Taiwan
| | - Ling-Ling Yeh
- Department of Healthcare Administration, Asia University, No. 500, Lioufong Rd, Wufeng, Taichung, 41354, Taiwan.
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Saini GK, Gupta ND, Prabhat KC. Drug addiction and periodontal diseases. J Indian Soc Periodontol 2014; 17:587-91. [PMID: 24174750 PMCID: PMC3808011 DOI: 10.4103/0972-124x.119277] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Accepted: 08/25/2013] [Indexed: 11/10/2022] Open
Abstract
The prevalence of drug addiction is increasing globally. Drug abuse damages many parts of the body such as oral cavity, lungs, liver, brain, heart etc., Addicts suffer from physical, psychological, emotional and behavioral problems. Their nutrition is also compromised. There is certainly an impact of all these factors on the health of periodontium. Dentists should be aware of the effects of drugs while treating the drug addicts. This article correlates the studies done on the impact of abused drugs such as alcohol, tobacco, opiates, cannabis, amphetamines etc., on general and periodontal health.
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Affiliation(s)
- Gurpreet Kaur Saini
- Department of Periodontology, Bhojia Dental College, Baddi, Himachal Pradesh, India
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Kim HS, Son JH, Yi HY, Hong HK, Suh HJ, Bae KH. Association between harmful alcohol use and periodontal status according to gender and smoking. BMC Oral Health 2014; 14:73. [PMID: 24950716 PMCID: PMC4114163 DOI: 10.1186/1472-6831-14-73] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 06/17/2014] [Indexed: 01/15/2023] Open
Abstract
Background the aim of this study is to assess the association of harmful alcohol use based on the alcohol use disorders identification test (AUDIT) score with periodontal status according to gender and smoking in a representative sample of Korean adults. Methods This study analyzed 5,291 participants older than 19 years whose data of harmful alcohol use and periodontal status were available. Harmful alcohol use was defined by the WHO guidelines for the administration of AUDIT. The periodontal status was assessed by the Community Periodontal Index (CPI). Multivariate logistic regression analysis was performed with adjustment for socio-demographic variables, oral and general health behavior, oral health status and systemic conditions. All analyses considered a complex sampling design, and multivariate analysis was also performed in the subgroups. Results Multivariate logistic regression analysis revealed a marginal association between harmful alcohol use and higher CPI in the total sample. The adjusted odds ratio (OR) of harmful alcohol use was 1.16 (0.97 to 1.38) for higher CPI. Higher CPI was significantly associated with harmful alcohol use in men (OR: 1.28; 95% CI: 1.03-1.60) and non-smokers (OR: 1.29; 95% CI: 1.06-1.57). Conclusion Periodontal status is significantly associated with harmful alcohol use in men and non-smokers in a representative sample of Korean adults.
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Affiliation(s)
| | | | | | | | | | - Kwang-Hak Bae
- Department of Preventive and Public Health Dentistry, School of Dentistry, Seoul National University, 28, Yeongeuon-dong, Jongno-gu, 110-749 Seoul, Republic of Korea.
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McNeely J, Wright S, Matthews AG, Rotrosen J, Shelley D, Buchholz MP, Curro FA. Substance-use screening and interventions in dental practices: survey of practice-based research network dentists regarding current practices, policies and barriers. J Am Dent Assoc 2013; 144:627-38. [PMID: 23729460 PMCID: PMC3699308 DOI: 10.14219/jada.archive.2013.0174] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Dental visits represent an opportunity to identify and assist patients with unhealthy substance use, but little is known about how dentists are addressing patients' use of tobacco, alcohol and illicit drugs. The authors surveyed dentists to learn about the role their practices might play in providing substance-use screening and interventions. METHODS The authors distributed a 41-item Web-based survey to all 210 dentists active in the Practitioners Engaged in Applied Research and Learning Network, a practice-based research network. The questionnaire assessed dental practices' policies and current practices, attitudes and perceived barriers to providing services for tobacco, alcohol and illicit drug use. RESULTS One hundred forty-three dentists completed the survey (68 percent response rate). Although screening was common, fewer dentists reported that they were providing follow-up counseling or referrals for substance use. Insufficient knowledge or training was the most frequently cited barrier to intervention. Many dentists reported they would offer assistance for use of tobacco (67 percent) or alcohol or illicit drugs (52 percent) if reimbursed; respondents who treated publicly insured patients were more likely to reply that they would offer this assistance. CONCLUSIONS Dentists recognize the importance of screening for substance use, but they lack the clinical training and practice-based systems focused on substance use that could facilitate intervention. Practical Implications. The results of this study indicate that dentists may be willing to address substance use among patients, including use of alcohol and illicit drugs in addition to tobacco, if barriers are reduced through changes in reimbursement, education and systems-level support.
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Affiliation(s)
- Jennifer McNeely
- Department of Population Health, Department of Medicine, Division of General Internal Medicine, NYU School of Medicine, 227 E. 30 Street, Room 623, New York, NY 10016, (p) 212/ 263-4975 (f) 646/ 501-2706,
| | - Shana Wright
- Department of Psychiatry, Department of Population Health, NYU School of Medicine, 423 E. 23 Street, 12N-147, New York, NY 10010, (p) 212/ 686-7500 x3178 (f) 212/ 951-5848,
| | - Abigail G. Matthews
- EMMES Corporation, 401 N. Washington Street, Suite 700, Rockville, MD 20850, (p) 301/ 251-1161 x 2819 (f) 301/ 576-3696,
| | - John Rotrosen
- Center of Excellence on Addiction, NYU School of Medicine, VA New York Harbor Healthcare System, 423 E. 23 Street, Room 17014W, New York, NY 10010, (p) 212/ 951-3294 (f) 212/ 951-6891,
| | - Donna Shelley
- Department of Population Health, Department of Medicine, Division of General Internal Medicine, NYU School of Medicine, 227 E. 30th Street, Room 608, New York, NY 10016, (p) 646-501-2526 (f) 646/ 501-2706,
| | - Matthew P. Buchholz
- PEARL Practice-Based Research Network, New York University College of Dentistry, 380 Second Avenue, Suite 302, New York, NY 10010, (p) 646/ 429-9925 (f) 212/ 995-4568,
| | - Frederick A. Curro
- Director of Clinical Operations, PEARL Network, Director of Regulatory Affairs, Bluestone Center for Clinical Research, New York University College of Dentistry, 380 Second Avenue, Suite 302, New York, NY 10010, (p) 212/ 998-9555 (f) 212/ 995-4568,
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Lages EJP, Costa FO, Lages EMB, Cota LOM, Cortelli SC, Nobre-Franco GC, Cyrino RM, Cortelli JR. Risk variables in the association between frequency of alcohol consumption and periodontitis. J Clin Periodontol 2011; 39:115-22. [PMID: 22092940 DOI: 10.1111/j.1600-051x.2011.01809.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2011] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Investigate the association between the frequency of alcohol consumption and periodontitis. Moreover, evaluate the influence of biological, behavioural, and social risk variables in this association. METHODS Sample was comprised by 542 subjects of both genders, 35-55 years of age, who underwent a complete periodontal examination, and was divided into four groups according to the frequency of alcohol use, based on alcohol use disorders identification test (AUDIT) and Cut-down, Annoyed, Guilty, Eye-opener (CAGE) instruments: (1) no or occasional alcohol use (NA), (2) moderate alcohol use (MA), (3) intense alcohol use (IA) and (4) alcohol dependence (DA). Associations between the occurrence of periodontitis and potential risk variables were analysed by univariate and multivariate logistic regression stratified by smoking status when appropriate. RESULTS The prevalence of periodontitis in NA, MA, IA and DA groups were 17.2%, 24.0%, 29.6% and 53%, respectively. Alcohol odds ratio (OR) estimates significantly increased with an increase in consumption frequency (DA>IA>MA>NA) and were approximately two times higher in smokers (OR = 3.43 to 7.91) compared to non-smokers (OR = 1.22 to 3.02). CONCLUSION Occurrence of periodontitis among alcohol users were high and the frequency of alcohol consumption increased the odds of periodontitis incrementally mainly in smokers.
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Affiliation(s)
- Eugênio J P Lages
- Department of Periodontology, Dentistry School, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Souza DMD, Rocha RFD. Low caloric value of ethanol itself increases alveolar bone loss in ligature-induced periodontitis in male rats. Braz Oral Res 2010; 23:460-6. [PMID: 20027455 DOI: 10.1590/s1806-83242009000400017] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Accepted: 07/30/2009] [Indexed: 11/22/2022] Open
Abstract
This study aimed at morphometrically evaluating the influence of variable caloric values of ethanol consumption on alveolar bone loss in periodontitis in male rats. Thirty-six male rats were randomized into four groups of nine rats each, as follows: Test group A (low) - rats were fed an ethanol-containing liquid diet (ethanol representing 22% of total caloric value); Control group A -rats were fed a pair-fed control diet (ethanol replaced by isocaloric amounts of carbohydrate); Test group B (high) -rats were fed an ethanol-containing liquid diet (ethanol representing 36% of total caloric value); Control group B -rats were fed a pair-fed control diet for Test B. Following anesthesia, cotton ligatures were placed around the cervix of the right upper second molar. At eight weeks, the maxillary bones were removed and alveolar bone loss was analyzed by measuring the distance between the cementoenamel junction and the alveolar bone crest at buccal and palatal sites of the upper second molar. The unligated groups showed no significant differences between the bone loss values observed for the low and high caloric values of ethanol (p > 0.05). In the ligated groups, the rats receiving low caloric values of ethanol showed significantly greater bone loss compared to the isocaloric rats (p < 0.05); however, the rats receiving high caloric values of ethanol showed no significant differences compared to the controls. Analysis of the results demonstrated that, in male rats, ethanol itself affected ligature-induced bone loss when representing a low value in the total caloric value.
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Affiliation(s)
- Daniela Martins de Souza
- Pindamonhangaba College (FAPI), Christian Life University Foundation, Pindamonhangaba, SP, Brazil.
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Jamieson LM, Gunthorpe W, Cairney SJ, Sayers SM, Roberts-Thomson KF, Slade GD. Substance use and periodontal disease among Australian Aboriginal young adults. Addiction 2010; 105:719-26. [PMID: 20148786 DOI: 10.1111/j.1360-0443.2009.02851.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To investigate the effects of tobacco, marijuana, alcohol and petrol sniffing on periodontal disease among Australian Aboriginal young adults. DESIGN Cross-sectional nested within a long-standing prospective longitudinal study. Setting Aboriginal communities in Australia's Northern Territory. PARTICIPANTS Members of the Aboriginal Birth Cohort study who were recruited from birth between January 1987 and March 1990 at the Royal Darwin Hospital, Northern Territory, Australia. Data were from wave III, when the mean age of participants was 18 years. MEASUREMENTS Clinical dental examination and self-report questionnaire. FINDINGS Of 425 participants with complete data, 26.6% had moderate/severe periodontal disease. There was elevated risk of periodontal disease associated with tobacco [prevalence ratio (PR) = 1.59, 95% CI = 1.06-2.40], marijuana (PR = 1.44, 95% CI = 1.05-1.97) and petrol sniffing (PR = 1.83, 95% CI = 1.08-3.11), but not alcohol (PR = 0.92, 95% CI = 0.67-1.27). Stratified analysis showed that the effect of marijuana persisted among tobacco users (PR = 1.47, 95% CI 1.03-2.11). It was not possible to isolate an independent effect of petrol sniffing because all petrol sniffers used both marijuana and tobacco, although among smokers of both substances, petrol sniffing was associated with an 11.8% increased prevalence of periodontal disease. CONCLUSIONS This is the first time that substance use has been linked with periodontal disease in a young Australian Aboriginal adult population, and the first time that petrol sniffing has been linked with periodontal disease in any population. The role of substance use in periodontal disease among this, and other, marginalized groups warrants further investigation.
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Affiliation(s)
- Lisa M Jamieson
- Australian Research Center for Population Oral Health, The University of Adelaide, South Australia, Australia.
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de Souza DM, Ricardo LH, Prado MDA, Prado FDA, da Rocha RF. The effect of alcohol consumption on periodontal bone support in experimental periodontitis in rats. J Appl Oral Sci 2009; 14:443-7. [PMID: 19089245 PMCID: PMC4327297 DOI: 10.1590/s1678-77572006000600010] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2006] [Accepted: 11/06/2006] [Indexed: 11/30/2022] Open
Abstract
Objective: The aim of this study was to evaluate the effect of the alcohol consumption on the periodontal bone support (PBS) in experimental periodontitis in rats. Materials and Methods: Sixty-three male rats were divided into seven groups: G1 (control); G2 (10% ethanol); G3 (nutritional control of G2); G4 (20% ethanol); G5 (nutritional control of G4); G6 (30% ethanol) and G7 (nutritional control of G6). The groups G3, G5 and G7 received controlled diets with equivalent caloric amounts to those consumed in G2, G4 and G6 respectively, with the ethanol replaced by sucrose. After anesthesia, ligatures were installed around the mandibular first molar, leaving the contralateral teeth unligated. After 8 weeks, the rats were killed and their mandibles were radiographed to measure the percentage of PBS on the distal aspect. Results: The intragroup analyses showed that presence of ligatures induced periodontitis (p<0.05). Unligated groups did not show significant differences among the percentages of PBS (p=0.1969). However, in ligated groups the rats that received alcohol (G2:48.71%±3.88; G4:47.66%±2.54; G6:47.32%±3.24) and the nutritional control group associated with a high concentration of ethanol (G7:47.40%±3.24) presented a significantly lower percentage of PBS than the other groups (G1:52.40%±2.75; G3:52.83%±2.41; G5:50.85%±4.14). Conclusions: These results demonstrated that alcohol consumption in rats may result in a direct effect on alveolar bone loss and increased development of periodontitis. In addition, they suggest that heavy caloric consumption of ethanol may also present an indirect effect on periodontal tissue as a consequence of malnutrition.
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Souza DMD, Ricardo LH, Kantoski KZ, Rocha RFD. Influence of alcohol consumption on alveolar bone level associated with ligature-induced periodontitis in rats. Braz Oral Res 2009; 23:326-32. [DOI: 10.1590/s1806-83242009000300017] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Accepted: 08/22/2008] [Indexed: 11/21/2022] Open
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Amaral CDSF, Vettore MV, Leão A. The relationship of alcohol dependence and alcohol consumption with periodontitis: A systematic review. J Dent 2009; 37:643-51. [DOI: 10.1016/j.jdent.2009.04.011] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2008] [Revised: 03/05/2009] [Accepted: 04/21/2009] [Indexed: 01/22/2023] Open
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Khocht A, Schleifer SJ, Janal MN, Keller S. Dental care and oral disease in alcohol-dependent persons. J Subst Abuse Treat 2009; 37:214-8. [PMID: 19150205 DOI: 10.1016/j.jsat.2008.11.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2008] [Revised: 10/22/2008] [Accepted: 11/24/2008] [Indexed: 12/30/2022]
Abstract
Dental/Oral health of alcohol-dependent persons and substance abusers is often neglected. It is not clear that alcohol dependence has effects on oral health beyond those expected in nonalcoholic persons of similar socioeconomic status (SES). Study objectives were to examine the personal dental care habits, ability to access professional dental care, and the types of services received and to examine their effect on the oral health of alcohol-dependent persons and substance abusers. Forty Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised-diagnosed alcohol-dependent persons and a comparison group of 25 non-alcohol-dependent subjects matched for race, age, gender, and SES were recruited. Subjects were medically healthy. Each subject received a comprehensive oral/dental examination, and an interview was conducted to record personal dental hygiene habits, ability to access professional dental care, and types of dental services provided. No statistical differences were found between the oral care habits of the groups. Forty-four percent of all subjects had access to charity professional dental care. Tooth extraction was the main dental service they received. Seventy-five percent of subjects brushed their teeth once or more per day. In the non-alcohol-dependent group, brushing frequency was inversely associated with plaque levels (p < .05); in the alcohol-dependent group, brushing frequency showed no statistical effect on plaque levels. Access to professional dental care was inversely associated with periodontitis in the alcohol-dependent group (p < .05). Alcohol dependence may increase plaque levels above that seen in race, gender, age, and SES-matched controls, but professional dental care can limit the subsequent development of periodontal disease in these people.
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Affiliation(s)
- Ahmed Khocht
- Temple University School of Dentistry, Department of Periodontology, Philadelphia, PA 19140, USA.
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Amaral CDSF, Luiz RR, Leão ATT. The relationship between alcohol dependence and periodontal disease. J Periodontol 2008; 79:993-8. [PMID: 18533775 DOI: 10.1902/jop.2008.070525] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the relationship between alcohol dependence and periodontal disease. METHODS A cross-sectional study of 49 alcoholic and 49 non-alcoholic men was conducted at Philippe Pinel Institute, Rio de Janeiro, Brazil. Subjects were screened for alcohol dependence using the CAGE (cut-down, annoyed, guilty, eye-opener) questionnaire and the criteria of the International Statistical Classification of Diseases, 10th Revision. Sociodemographic data and periodontal clinical parameters, such as visible plaque, bleeding on probing, probing depth (PD), and clinical attachment level (CAL), were collected. Groups were controlled for smoking. Intergroup comparisons of sociodemographic data and mean percentage of clinical parameters were analyzed by the chi(2) and Mann-Whitney tests. The independent effect of alcohol dependence on CAL and PD was assessed by multiple linear regression analysis, adjusting for the effects of plaque, age, income, education, and living conditions. RESULTS A significant linear relationship was found between alcohol dependence and mean CAL (P < or =0.013) and mean PD (P < or =0.001). CONCLUSION Alcohol dependence may be associated with an increased severity of CAL and PD.
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Affiliation(s)
- Cristine da Silva Furtado Amaral
- Department of Dental Clinic, Division of Graduate Periodontics, Federal University of Rio de Janeiro, Avenida Oswaldo Cruz 95, Rio de Janeiro, RJ, Brazil.
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Abstract
BACKGROUND The authors reviewed the clinical features, epidemiology, diagnosis, medical treatment, orofacial findings and dental treatment of geriatric patients with alcoholism. TYPES OF STUDIES REVIEWED The authors conducted MEDLINE searches for the period 1995 through 2004 using the terms "alcoholism," "geriatric," "pathophysiology," "treatment" and "dentistry." They selected reports published in English in peer-reviewed journals for further review. RESULTS Physiological changes associated with aging permit the harmful effects of drinking alcohol to arise at lower levels of consumption than in younger people. Excessive use of alcohol exacerbates the medical and emotional problems associated with aging and predisposes the person to adverse drug reactions with medications controlling these illnesses. CLINICAL IMPLICATIONS The incidence of dental disease in this population is extensive because of diminished salivary flow and a disinterest in performing appropriate oral hygiene techniques. Concurrent abuse of tobacco products worsens dental disease and heightens the risk of developing oral cancer. Identification of patients who abuse alcohol, a cancer-screening examination, preventive dental education, and use of saliva substitutes and anticaries agents are indicated. Clinicians must take precautions when performing surgery and when prescribing or administering analgesics, antibiotics or sedative agents that are likely to have an adverse interaction with alcohol.
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Affiliation(s)
- Arthur H Friedlander
- VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, Calif. 90073, USA.
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Goddard G, Brown C, Ahmad ASG. Oral Disease Prevalence Among HIV-Positive American Indians in an Urban Clinic. J Psychoactive Drugs 2005; 37:313-9. [PMID: 16295015 DOI: 10.1080/02791072.2005.10400525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Abstract-According to Centers for Disease Control and Prevention (CDC) estimates, there have been almost 930,000 AIDS cases diagnosed at the end of 2003 in the United States. About 3,000 of those infected were American Indian and Alaska Natives (AI/ANs). Persons with HIV and AIDS have been shown to have increased risk of dental and periodontal disease. Unfortunately, there are no publications on dental disease and AI/ANs with HIV/AIDS. This study addresses this shortcoming by examining the relationship between dental health, drug use, and HIV among AI/AN patients in an urban setting. The study included a consecutive chart review of 51 AI/AN HIV-positive dental patients seen from 2001 to 2004 at the Native American Health Center in San Francisco. Results showed that 55% had moderate or severe periodontal disease, 80.4% had tooth decay, and 88.2% had missing teeth. Substance users had more dental caries or decayed teeth than non-substance users (88% versus 73%). The average rate for decayed, missing or filled teeth (DMFT) among the total sample was 18.73%. This chart review study suggests that dental disease is more prevalent in AI/ANs with HIV/AIDS when compared to the general population and AI/AN data from the Indian Health Service.
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Affiliation(s)
- Greg Goddard
- Dental Department, Native American Health Center, Oakland, CA 94601, USA.
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The influence of gingival margin recession on loss of clinical attachment in alcohol-dependent patients without medical disorders. Br Dent J 2003. [DOI: 10.1038/sj.bdj.4810662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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