Oral manifestations of illicit drug use

IP International Journal of Comprehensive and Advanced Pharmacology, 2020

Oral side effects associated with drug use are well established, with aggressive caries, periodontitis, bruxism, poor oral hygiene and general neglect documented. Another factor such as high-cariogenic diet and lifestyle, social and psychological factors of poor oral health compounds in illicit drug users. Literature has shown that health-related quality of life in the mouth among injecting drug users is poor compared with the general population of Australia and the quality of life of addiction correlated with caries experience. Thus, the role of the dentist is very important in managing the oral health of individuals. Given their extensive recreational use, there is a possibility that dental practitioners will encounter patients who are regular users or past forbidden drugs. In this article we will tell about the effect of various drugs.

Journal of International Oral Health, 2019

IntroductIon Of the various problems associated with tooth decay, community behavior factors on oral and dental health have a significant role, because it is already known that the health status is strongly influenced by environmental factors, behavior, and health services. [1] This includes the etiology of dental caries, the risks that cause dental caries, and the factors of population distribution, environment, and community behavior toward dental health. [2] Because of this behavior factor to dental and oral health, several studies and surveys had been done to observe the behavior of a group of people to oral health. One of the maladaptive and nonfunctional behaviors in society is experienced by the user of narcotics and psychotropic drugs. [3] In Indonesia, there is an increase in the number of drug users by 0.065% of the population of 200 million or equal to 130,000 people, and by 1998, it was estimated to reach 1%-2% of the population. In 2017, the National Narcotics Agency revealed 46,537 drug cases throughout Indonesia, with details of approximately 58,500 suspects. And until 2017, the total number of active drug users in Indonesia reached 6 million people. Drug abuse is seen in the presence of impairment in social, occupational, or school functions, inability to control themselves and stop the use of drugs, and which may cause withdrawal symptoms if drug use is discontinued. [4] Such conditions are also called drug dependence, which is a compulsive-intensive condition of drug use to meet mental and psychological needs. [5] Drug abuse creates damaging effect, such as family relationship, learning ability, behavioral changes, declining in work productivity, health problems, and many others. [6] Based on the theory, the thought arises that with the changes in behavior in general, will affect the maintenance behavior of dental and oral health. In addition, almost all drugs work against the central nervous system that block the nervous Aims: The purpose of this study was to identify the description of dental caries and oral hygiene of drug users. Subjects and Methods: This descriptive study has 60 participants. Oral hygiene index-S (OHI-S) and caries severity with decay-missing-filling-T (DMF-T) index were performed. Subjective data collection on the knowledge and behavior of drug users was obtained from the results of questionnaires filled by respondents. Results: OHI-S of respondents was 1.8 and mean of DMF-T was 4.33, which means that the condition of dental and oral hygiene of the respondents was still not good. The mean results of OHI-S score for drug users <10 years of consumption was 1.03, those who consumed for 10-20 years was 2.06, and those who consumed over 20 years was 2.85. DMF-T of <10 years of drug users had mean DMF-T of 1.5, those who consumed drugs between 10 and 20 years was 2.6, and those who consumed over 20 years of 7.9. Conclusions: Overall, most drug users had good oral hygiene and above mean caries severity.

Iranian journal of public health, 2013

Oral health problems, among the most prevalent comorbidities related to addiction, require more attention by both clinicians and policy-makers. Our aims were to review oral complications associated with drugs, oral health care in addiction rehabilitation, health services available, and barriers against oral health promotion among addicts. Drug abuse is associated with serious oral health problems including generalized dental caries, periodontal diseases, mucosal dysplasia, xerostomia, bruxism, tooth wear, and tooth loss. Oral health care has positive effects in recovery from drug abuse: patients&#39; need for pain control, destigmatization, and HIV transmission. Health care systems worldwide deliver services for addicts, but most lack oral health care programs. Barriers against oral health promotion among addicts include difficulty in accessing addicts as a target population, lack of appropriate settings and of valid assessment protocols for conducting oral health studies, and poor ...

BMC Public Health, 2013

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.

Journal of Public Health Dentistry, 2015

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. 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 (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 to 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 (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.

BMC Oral Health, 2019

Background: In addition to numerous general health problems, drug dependents manifest various oral health disorders. Our aim was to investigate the oral health status and its determinants among in-treatment opiate dependents. Methods: As part of a comprehensive cross-sectional survey on opiate dependents admitted to methadone maintenance centers in Tehran, Iran, we conducted a clinical study in two centers from different socioeconomic areas. A trained dentist conducted face to face interviews and clinical oral examinations based on World Health Organization (WHO) criteria for Decayed, Missing, Filled Teeth (DMFT) index and Community Periodontal Index (CPI) on volunteer patients. Student's t-test, Mann-Whitney U, Kruskal Wallis, and Chi 2 tests, in addition to linear and logistic regression models served for statistical analysis (p < 0.05). Results: A total of 217 patients (98% men), with a mean age of 43.6 years (SD 12.3) participated in the study. Opium was the main drug of abuse reported by 70% of the participants followed by crystalline heroin (22%). Of the participants, 24.4% were totally edentulous. The mean DMFT score of participants was 20.3 (SD 7.8). Missing teeth comprised the main part of the index followed by decayed and filled teeth. Older patients (p < 0.001) and the patients with a lower socioeconomic status (p = 0.01) had higher DMFT scores. None of the dentate patients had a healthy periodontium. Maximum CPI mostly consisted of shallow pockets (66%) followed by calculus in 15%, deep pockets in 11%, and bleeding in 8% of the participants. Older participants (p = 0.02) and those who started drug abuse at a younger age (p = 0.01) were more likely to develop periodontal pockets. Conclusions: Opiate dependents had a poor oral health status in terms of the dentition status and periodontal health. Missing teeth comprised the main part of their dental caries history and none had a healthy periodontium. Oral health care should be integrated into the package of general health services available in treatment centers.

International Journal of Environmental Research and Public Health

Substance-abuse disorders are universally associated with comorbid illness. Tobacco is a widely abused substance across the globe and presents a critical public health problem. The precise correlation between tobacco use and dental caries remains unclear. Thus, the present study aimed to evaluate the correlation between tobacco use and dental caries. Methodology: Based on selection criteria, a total of 270 (age 20–50 years) participants were included in the study, and were categorized as group A (n = 135), consisting of tobacco users, and group B (n = 135), comprising healthy controls (non-users). The Decayed, Missing, and Filled index (DMFT) was used to measure caries status. The Simplified Oral Hygiene index was used to evaluate oral health. Results: The tobacco group reported the use of cigarettes; smokeless tobacco in indigenous forms, such as gutka (areca nut, tobacco, and slaked lime), betel nut chewing; and a combination. Individuals with tobacco habits had a higher prevalenc...

BMC Oral Health, 2015

Background: The aim of this cross-sectional study was to evaluate the impact of oral health conditions, socioeconomic status and use of specific substances on quality of life of alcohol and drug addicted persons, receiving care at outpatient treatment facilities in Brazil. Methods: A random sample of 262 participants, mean age 37 years, from Psychosocial Care Centers for Alcohol and Drugs (CAPS AD) located in three cities in the state of São Paulo, Brazil, were clinically examined for caries experience (DMFT index) by a calibrated examiner. They were asked to complete a series of questionnaires, including the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), socioeconomic characteristics, and the World Health Organization Quality of Life assessment (WHOQOL), which were considered the outcome variables of the study. Associations between oral health status, socioeconomic characteristics, substance involvement with WHOQOL were investigated by means of the chi-square test and multiple logistic regression analysis with a level of significance α < 0.05. Results: The mean DMF index of the group was 13.0. Subjects with DMFT >14 (OR = 2.25; CI 95% = 1.30-3.89); low-income (OR = 2.41; CI 95% = 1.22-4.77) and users of cocaine/crack (OR = 2.02; CI 95% = 1.15-3.59) were more likely to have poor general quality of life. Conclusion: This study demonstrated that the general quality of life of addicted persons was associated with caries experience, low income and cocaine/crack use.

Addiction & Health, 2018

Background Various studies have tested quality of life (QOL) among drug addicts, however very few have reported any association between oral health-related quality of life (OHRQOL) and mode of drug administration among drug addicts. Hence, the present study was conducted aiming to evaluate the impact of mode of administration of drugs on OHRQOL among drug addicts. Methods Data was collected using respondent-driven sampling (RDS) method among 313 male drug addicts in Sri Ganganagar, Rajasthan, India, using self-administered questionnaires on oral hygiene aids and drug addiction history. OHRQOL was recorded using Oral Health Impact Profile (OHIP-14) questionnaire. The chi-square test, t-test, and Kruskal-Wallis test were used for statistical analysis. Findings In this study, 56.2% of the drug addicts reported practicing oral hygiene aids. The main drugs abused were heroin, cocaine, and amphetamines as 51.4%, 35.1%, and 13.4%, respectively. Most of the drug addicts were employed (82.4%...

2021

Background: Promoting oral health is a complicated issue among drug abusers and opium is the most frequent drug abused in Iran. This study aims to find the oral health determinants of opium users in Kerman, Iran. Methods: This cross-sectional study was a part of the second phase of Kerman coronary artery disease risk factors study (KERCADRS, 2014-2018). In this survey, the data of 1140 opium users were analyzed. The information about using a toothbrush, dental floss, number of dental visits at last year, age of first use of opium, duration, and opium consumption frequency was recorded. The total number of decayed, missing, and filled teeth (DMFT) index and Community Periodontal Index (CPI) was recorded by an oral examination. Poisson and logistic regressions analyses were used for assessing the relationship among variables. Findings: The mean age of participants was 52 ± 12 years. 74.4% were men and 24.6% were women. The average DMFT index was 15.7 ± 7.6 and the prevalence of a heal...