Dentition of addiction in Queensland: poor dental status and major contributing drugs

Abstract

Background: Although it is said that drug addiction is associated with poor dental health, there is little research in this area. In particular, there is little work comparing the effects of the different drugs of addiction. Methods: A cross-sectional patient survey of dental health was undertaken in a family practice comparing opiate and other drug addicts (DA) with non-addicts (NA). The age range was restricted to 19-45 years. Damaged teeth were counted and a semi-quantitative score applied to severity to allow the calculation of an overall dental index. A medical review only was undertaken; recognized dental diagnostic criteria were not applied. Results: There were 233 and 47 respondents in the DA and NA groups, respectively. The mean ages and gender ratios were similar in both groups. DA used more addictive drugs than NA (all P<0.001). DA had more absent, traumatized, major cavitated and extracted teeth (all P<0.05). Addicts had a worse severity index (P<0.02) and dental index (13.13±24.00 vs. 4.74±16.03; P<0.005). Furthermore, dental pathology developed in DA at younger ages than in NA with 56.8% vs. 5.4% of patients younger than 38 years having dental indices more than 10 respectively (OR = 22.98, 95% CI = 5.57-200.65, P<0.0000001). At multivariate analysis age, gender, and dose and/or duration of tobacco, methadone, morphine, and alcohol were significantly associated with these pathologies. Conclusion: These data are consistent with published dental reports and basic science information that drug addiction has a deleterious effect on dental health, that in addiction this effect is rapid and severe, and that tobacco, methadone, morphine and alcohol contribute importantly to these changes.

Opiate agonists and antagonists modulate taste perception in opiate-maintained and recently detoxified subjects

“…The majority of studies find that this dietary change does not significantly affect body mass index (BMI), as this is in the normal range (Forrester et al, 2005;Kolarzyk et al, 2005b;Morabia et al, 1989) (but see also (Nolan and Scagnelli, 2007)). The principal result of this increased sugar intake in opiate addicts, and also in those on opiate-substitution therapy, such as methadone or buprenorphine, is that they typically have poor oral and dental health, compared to non-intravenous drug users, or non-addicts (Reece, 2007;Robinson et al, 2005;Titsas and Ferguson, 2002).…”

The Importance of Oral Health in Treatment Outcomes for the Chemically Dependent Population

“…According to research published by AS Reece, drug addiction has a deleterious effect on dental health and these changes, associated with addiction, are rapid and severe [12]. Oral lesions can indicate more serious systemic problems such as: STDs, and Diabetes type II.…”

An intriguing association between dental and mental pathology in addicted and control subjects: a cross-sectional survey

“…[42][43][44] Several recent papers from this clinic and elsewhere document the increased incidence of pathologies associated with ageing in SUD patients. In addition to greying of the hair, these pathologies include severe dental disease, 45,46 atherosclerotic coronary disease, 30,31 osteoporosis, 47,48 neuropsychiatric disorders 16,49 and lowered sperm count. 50,51 Direct demonstration that this is related to lower circulating stem cell counts has also been reported in this group 52 and the suggestion that this may in turn be associated with disorders of DNA repair may be implied by the fi nding of an elevated incidence of cervical malignancy amongst substance dependent females.…”

“…53,54 The hypothesis that addiction might be accelerating the ageing process was further strengthened by our recent demonstration from clinical biochemical and immunological results that various immune and biochemical markers followed an altered and apparently progeroid time course in SUD patients compared to medical controls. 55 Considerations such as these prompted us to examine whether a possible link might exist, at least at the statistical level, between the dental and mental disorders previously described in our clinic population, 45,53 for much the same reasons as Kirkpatrick and colleagues sought confi rmation of the view that schizophrenia might represent a systemic disorder 14,15 in that both the limbic system and the dentition 56 require appropriate stem cell function to maintain optimum health and function. Moreover, there have been several recent reports of an oral-systemic disease link, for which aggressive periodontitis is a marker.…”

“…45 Teeth were examined by a medically trained practitioner only as dental services were not readily available to these patients. Teeth were scored as 'absent' if they were not clinically detected in the mouth.…”