“(Meth) Will Hurt You and Hurt Your Teeth”: Teen, Parent, and Dental Practitioner Perspectives on Implementing Crystal Meth Use Prevention Messaging in the Dental Office Setting

Abstract

Objectives. Crystal methamphetamine (“meth”) use among youth living in rural areas is higher than the national average. Given how drastically meth affects teeth (i.e., “meth mouth”), engaging dental professionals as one of multiple channels in rural areas to deliver meth prevention messaging is a novel approach. The objective of this research was to assess the feasibility and acceptability of incorporating meth use prevention messaging into dental visits with teenagers. Methods. We conducted phenomenological, qualitative research with dental practitioners, teens, and parents/guardians in three communities in North Idaho, from 2015 to 2016. We recruited practitioners using a snowball sampling strategy and placed phone calls to dental practices and contacted teens and parents through schools, libraries, local sporting events, and word-of-mouth. Using NVivo 12-Plus, parent- and teen-specific codebooks and themes were developed from guides and transcripts. Transcripts of the dentists and hygienists were reviewed to ascertain the main ideas and themes. Results. Overall, practitioner, teen, and parent participants viewed meth prevention messages delivered by dental professionals as acceptable and feasible. Compared to those in private practice, public health dental providers were invested in meth prevention and were eager to help. Barriers to overall acceptability and feasibility included hygienists’ low self-efficacy to deliver a communication-based intervention, infrequency of dental visits impacting the ability to reach enough teens through this venue, and the fact that teens could feel “targeted” by providers. Teens also raised concerns about scary messages exacerbating preexisting dental visit anxiety. Facilitators included the following: dental practitioners already engaging in health education with their patients, parents, and teens seeing dental professionals as appropriate purveyors of antimeth messaging and support for increased meth prevention efforts given the impact of meth use in their communities. Conclusions. Well-crafted, developmentally appropriate meth prevention messages would likely be well received by teens and supported by parents in dental offices. These data are being used to develop a novel, theory-based communication and behavioral strategy to integrate dental professionals into the delivery of messages aimed at preventing the initiation of meth use among rural Idaho teens.

Crystal methamphetamine and its effects on mental and oral health: A narrative review

“…Some common treatment options include behavioral therapies, such as cognitive-behavioral therapy (CBT) and contingency management, which can help individuals identify and change negative patterns of thinking and behavior associated with drug abuse ( Pabst et al, 2017 ). In clinical practice, medication-assisted treatments based on bupropion and naltrexone have also been shown to help reduce cravings and withdrawal symptoms ( Skeer et al, 2022 ), while some addicts benefit from antidepressants, antipsychotics, and substitution/replacement therapy ( Panenka et al, 2013 ). Nonetheless, residential treatment programs are always preferable, especially for individuals with severe MA addiction ( Skeer et al, 2022 ), as they provide a structured environment, allowing them to focus on recovery and develop healthy coping skills ( Shiao et al, 2021 ).…”

“…In clinical practice, medication-assisted treatments based on bupropion and naltrexone have also been shown to help reduce cravings and withdrawal symptoms ( Skeer et al, 2022 ), while some addicts benefit from antidepressants, antipsychotics, and substitution/replacement therapy ( Panenka et al, 2013 ). Nonetheless, residential treatment programs are always preferable, especially for individuals with severe MA addiction ( Skeer et al, 2022 ), as they provide a structured environment, allowing them to focus on recovery and develop healthy coping skills ( Shiao et al, 2021 ). Inpatient treatment can be particularly useful for individuals who have co-occurring mental health conditions or who require medical detoxification ( Skeer et al, 2022 ).…”

“…Nonetheless, residential treatment programs are always preferable, especially for individuals with severe MA addiction ( Skeer et al, 2022 ), as they provide a structured environment, allowing them to focus on recovery and develop healthy coping skills ( Shiao et al, 2021 ). Inpatient treatment can be particularly useful for individuals who have co-occurring mental health conditions or who require medical detoxification ( Skeer et al, 2022 ). If this is not an option, outpatient treatment programs should be offered instead, as they allow individuals to receive treatment while continuing to live at home and attend work or school ( Rhodus & Little, 2005 ).…”

“…Meth mouth is a term that describes an oral condition frequently found in MA users, and includes the characteristics such as xerostomia, extensive carious lesions, enamel erosion, bruxism, and muscle trismus ( Pabst et al, 2017 ). While xerostomia is attributed to the reduction in the salivary flow due to MA use ( Skeer et al, 2022 ), increased consumption of sugary beverages and food, combined with reduced oral hygiene ( Shiao et al, 2021 ), would lead to severe dental problems. Consequently, oral management of meth mouth involves a combination of dental treatment and supportive care ( Kamp et al, 2019 , Tsui et al, 2020 ), which may involve a range of procedures, such as fillings, extractions, and periodontal surgery ( Shetty et al, 2010 ).…”