Oral health a challenge for drug users – and for dentists

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

Report author Dr Hooman Baghaie said 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.

“The lifestyles of problematic drug users often include high sugar diets, malnutrition, poor oral hygiene, and lack of regular visits to a dentist. 

“Dental care can be further compromised by difficulties in treating patients who may be drug affected or tolerant to painkillers and anaesthetics.”

Dr Baghaie’s review, published in the journal Addiction, combined the results of 28 studies from around the world which collectively provided data on 4086 patients with substance use disorder.

The research indicates one in 20 people between the ages of 15 and 64 years uses drugs each year, with approximately 10% of this number having a drug dependence or substance use disorders.

Dr Baghaie said approximately three million people globally began using drugs each year.

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.”

(Source: The University of Queensland, Addiction)