The Relationship Between Methamphetamine Use and Increased Dental Disease

Abstract

Background Methamphetamine (MA) use has been linked anecdotally to rampant dental disease. The authors sought to determine the relative prevalence of dental comorbidities in MA users, verify whether MA users have more quantifiable dental disease and report having more dental problems than nonusers and establish the influence of mode of MA administration on oral health outcomes. Methods Participating physicians provided comprehensive medical and oral assessments for adults dependent on MA (n = 301). Trained interviewers collected patients' self-reports regarding oral health and substance-use behaviors. The authors used propensity score matching to create a matched comparison group of nonusers from participants in the the Third National Health and Nutrition Examination Survey (NHANES III). Results Dental or oral disease was one of the most prevalent (41.3 percent) medical cormorbidities in MA users who otherwise were generally healthy. On average, MA users had significantly more missing teeth than did matched NHANES III control participants (4.58 versus 1.96, P < .001) and were more likely to report having oral health problems (P < .001). Significant subsets of MA users expressed concerns with their dental appearance (28.6 percent), problems with broken or loose teeth (23.3 percent) and tooth grinding (bruxism) or erosion (22.3 percent). The intravenous use of MA was significantly more likely to be associated with missing teeth than was smoking MA (odds ratio = 2.47; 95 percent confidence interval = 1.3-4.8). Conclusions Overt dental disease is one of the key distinguishing comorbidities in MA users. MA users have demonstrably higher rates of dental disease and report long-term unmet oral health needs. Contrary to common perception, users who smoke or inhale MA have lower rates of dental disease than do those who inject the drug. Many MA users are concerned with the cosmetic aspects of their dental disease, and these concerns could be used as behavioral triggers for targeted interventions. Clinical Implications Dental disease may provide a temporally stable MA-specific medical marker with discriminant utility in identifying MA users. Dentists can play a crucial role in the early detection of MA use and participate in the collaborative care of MA users.

Nurture trumps nature in a longitudinal survey of salivary bacterial communities in twins from early adolescence to early adulthood

“…These may include dietary behaviors and oral hygiene, as well as more pathological factors such as smoking, alcohol, and consumption of illicit drugs such as methamphetamines that are well known to have severe negative effects on dental health (Shetty et al 2010). Crucially, cases and controls must be age-matched for correct conclusions to be drawn, given changes in the oral microbiome over adolescence.…”

Perfil sociodemográfico e condição bucal de usuários de drogas em dois municípios do Estado do Paraná, Brasil

“…Porém, observou-se que, quanto maior o consumo de drogas, maior foi o índice. Em suma, a literatura revela que existe diferença no padrão de distribuição de cárie entre usuários e não usuários de drogas, sendo que aqueles são os mais acometidos 9 .…”

“…Isto caracteriza um quadro de gengivite generalizada na maioria dos drogaditos, corroborando estudos que indicam o uso das drogas como um possível fator de risco para a doença periodontal [7][8][9]24 . Neste estudo, não se pode excluir a presença de bolsas periodontais nos usuários de drogas.…”

“…Desta forma, a qualidade e o estilo de vida adotados por um indivíduo determinam a sua condição de saúde bucal, pois o consumo abusivo de drogas é considerado fator de risco para as doenças bucais em populações de todo o mundo [8][9][10][11] .…”

“…As principais alterações bucais identificadas nos drogaditos são a xerostomia, o elevado índice de dentes cariados, perdidos e obturados (CPOD), a redução da capacidade tampão salivar, o bruxismo, as perdas dentárias, a doença periodontal, a halitose, a queilite angular e as lesões nos tecidos moles [8][9][10] .…”