Oral health a challenge for drug users—and for dentists

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Chemically eroded teeth from cocaine application to gums is one of the conditions seen among problematic drug users, according to a recent University of Queensland School of Dentistry report.

The report by Dr Hooman Baghai is published in last month’s issue of Addiction.

When he combined the results of 28 studies from around the world which collectively provided data on 4,086 patients with substance use disorder, report author Dr Baghaie found that people with substance use disorders had more tooth decay and periodontal disease than the general population, but were less likely to receive dental care.

“Drug use affects oral health through direct physiological routes such as dry mouth, an increased urge for snacking, the clenching and grinding of teeth, and chemical erosion from applying cocaine to teeth and gums,” Dr Baghaie said, adding that “the lifestyles of problematic drug users often include high sugar diets, malnutrition, poor oral hygiene, and lack of regular visits to a dentist.”

Dr Baghaie further noted that dental care can be compromised even more by difficulties in treating patients who may be drug affected or tolerant to painkillers and anaesthetics.

Since approximately three million people globally start using drugs each year, Dr Baghai believes dentists and doctors could take simple steps to improve the health of patients in this group.

“Dentists should screen their patients for substance use, notice any advanced dental or periodontal disease inconsistent with a patient’s age and consider referral to medical doctors for management,” he said.

“In patients with suspected substance use disorders, dentists should be aware of issues concerning treatment and consent when the patient is intoxicated and be alert to the possibility of resistance to painkillers.

“Doctors and clinicians who care for people with substance use disorders should screen for oral diseases and arrange for dental care as needed, consider using sugar-free preparations when prescribing methadone, and warn patients of the oral health risks associated with dry mouth and cravings for sweet foods.”

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  1. Thank you for this article. It is really a good reminder for every dental health professionals. It is true that we should be aware if the patient is intoxicated and be alert to the possibility of resistance to painkillers.


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