Dental health in Dutch drug addicts

Abstract The aim of this study was to describe the Dental health status of a group of Dutch 20–40-yr-old drug addicts (n=121) and to compare the results on DMFS with data of an age-comparable sample of the general adult population in the Netherlands (n=1532). Mean DMFT of the addicted group was 16.9. ANOVA showed that the mean DMFS of the addicted group differed statistically significantly from the DMFS of the general population of the same age (= 52.1 versus 38.9). Statistically significant differences in DMFS were also found between the various age groups. The percentage of addicted subjects with more than cervical plaque on one or more teeth was 76.5%, 82.4% and 88.2% in the three youngest age groups. In almost all addicted subjects, bleeding of the gingiva was present. Only 36% had visited the dentist less than a year ago and 18% brushed their teeth less than once a day. It is concluded that there is a large gap in dental health status and behavior between drug addicts and the general population. Dental care as an integral part of the care for drug addicts is advocated.     

Dental health in drug and alcohol addicts

The aim of this study was to describe the dental health status of a group of Dutch twenty- to forty-year-old drug addicts (n = 121) and to compare the results on DMFS with data of an in age comparable sample of the general non-addicted adult population in the Netherlands (n = 1532). The average DMFT of the addicted group was 16.9. The average DMFS of this group differed statistically significantly from the DMFS of the general non-addicted population of the same age (52.1 versus 38.9). Statistically significant differences in DMFS were also found between the various age groups. In the youngest three age groups the percentage of addicted subjects with cervical plaque on one or more teeth was 76.5%, 82.4% and 88.2%. Bleeding of the gingiva occurred in almost all addicted subjects. Only 36% of the addicts had visited their dentist less than a year ago and 18% of them brushed their teeth less than once a day. It is concluded that a large gap exists in dental health status and behaviour between drug addicts and the general non-addicted population. Dental care as an integral part of the care for drug addicts is advocated.     

Dental health in a group of drug addicts in Italy

The caries prevalence, periodontal health, and oral hygiene status were assessed in 124 drug addicts aged 18-34 yr in Mercato San Severino (Salerno), Italy. The years of drug addiction ranged from 1 to 15 yr. The majority used heroin (96%) but all the subjects indicated that they had used more than one drug. The percentage of drug addicts caries free was 6.5%, ranging from no caries free subjects in the group over 29 yr of age, to 11.4% in the group aged 26-29 yr old. Mean DMFT and DMFS scores for all age groups were 12.9 and 36.2, respectively; mean Periodontal Index (PI) and mean Simplified Oral Hygiene Index (OHI-S) scores were 1.37 and 1.71, respectively. The poor dental health in this target group indicates the need for more extensive collaboration between the social and dental health care sectors.     

Dental health in a group of drug addicts attending an addiction-clinic

The present study was undertaken to investigate the dental health of a group of parenteral drug addicts. The study population comprised 134 persons with a mean age of 25 yr (min. 18, max. 37) examined in 1977-81. Mean DMFT was 18.3 and mean DMFS was 50.2, approximately twice as much as found in comparable age groups in Denmark. Even free smooth surfaces were often involved. The oral hygiene was measured by the use of the Visible Plaque Index (VPI) and the Bleeding Index (BI). Both indices were high, mean VPI = 77.4 and mean BI = 71.3. 12-40% of the teeth selected had a loss of periodontal attachment of more than 4 mm. It is suggested that not only drug abuse, but also factors like low social status, low education and different barriers towards receiving dental treatment should be considered in a multifactorial cause-effect relationship. The effect of offering a free dental care system for this high-risk group will be dealt with in another paper.     

Dental profile of a community of recovering drug addicts: Biomedical aspects. Retrospective cohort study

Objectives: to obtain a biomedical oral profile of a community of adult drug addicts in treatment by analysing their dental health, with a view to determining whether the state of their oral health could be attributed primarily to their lifestyle and the direct consequences of drug abuse on their overall condition, rather than to the effects of the drugs used. Experimental Design: the study was conducted under the terms of an agreement between the Complutense University of Madrid’s (UCM) Odontology Faculty and the City of Madrid’s Substance Abuse Institute. Seventy drug addicts and 34 control group subjects were examined. The study assessed oral hygiene habits, systemic pathology, type of drugs used and the duration of use, oral pathology, oral health indices, risk of caries based on saliva tests, oral candidiasis and periodontal microbiology. Results: statistically significant differences (p<0.05) were found between the test and control groups for practically all the variables analysed. In the drug users group, dental hygiene was wanting, systemic and oral pathology prevailed and the decayed/missing/filled teeth or surface (DMFT/S) indices denoted very poor buccodental health. The saliva tests showed a substantial risk of caries and candidiasis rates were high. By contrast, with a single exception, the microbiological studies detected no statistically significant difference between drug users and control groups periodontal flora.Conclusions: drug-dependent patients had poor oral health and a significant increase in oral pathology, essentially caries and periodontal disease. Their risk of caries was high and the presence of candidiasis was representative of their poor general and oral health. Drug users’ poor buccodental condition was more closely related to lifestyle than to drug abuse itself. Key words:Buccal, dental, drug addicts.     

湖北省吸毒人员口腔健康行为的分析

目的 分析和评价吸毒人员的口腔健康行为。方法 对1999年湖北省戒毒中心收治的520名吸毒人员进行问卷调查。结果 吸毒人员每天刷牙2次或2次以上者占26％,刷1次者为49％,25％的人从不刷牙。33％的吸毒人员每天进甜食或甜饲料2次或以上。在过去的一年中,60％的吸毒人员牙龈出血,83％的人出现牙齿疼痛。只有10％的人看过医生,而60％的人从没有看过医生。结论 吸毒人员的口腔健康行为较差。     

Salivary secretion and dental caries experience in drug addicts

The flow rate and pH of parotid saliva, the total concentration of salivary proteins, inorganic phosphate, calcium and amylase and the DMF index were studied in young males making improper use of drugs. Patients were classified in the following main groups: (A) with predominance of amphetamines; that is, this drug was taken most frequently and in greatest dosage during the last year; (M) with predominance of marijuana; (AM) with predominance of amphetamine and marijuana; (N) without predominance. In patients belonging to groups A and AM, parotid salivary flow induced after stimulation by intra-oral citric acid was reduced to 26.2 and 41.1 per cent, respectively, of the values obtained in healthy control subjects. Total protein, phosphate concentration and the pH of the saliva were significantly decreased; on the other hand, calcium concentration showed a remarkable increase in the saliva of amphetamine-addicted patients. However, the product calcium × phosphate was significantly decreased. The caries index of patients belonging to groups A and AM was 74 and 90 per cent higher, respectively, compared with control values. In group M, parotid salivary flow rate and most of the parameters studied did not differ from those of the controls. The average caries index of those patients was only 28 per cent higher than the controls.     

Oral health status of drug addicts in the Czech Republic

Over the last decade, illicit drug use has become a very pronounced problem in the Czech Republic. Some branches of medicine such as psychiatry, internal medicine and neurology have tried to confront the situation by joint treatment of addicted patients. Dentistry has so far remained outside this multi-disciplinary care despite the fact that the status of dental and other tissues in the oral cavity influences general health and vice versa. The aim of the survey on the oral health of drug addicts that was conducted in the Czech Republic from 2000 to 2002 was to collect data to help dental professionals contribute to the complex care of drug addicts. The number of addicted persons examined was 400 and the subgroup of drug addicts consisted of 217 subjects (mean age 23.87 yrs, SD 6.70), all being treated in long term hospitals. Among other oral health features observed, the DMFT and CPITN indices are presented in this paper. The results show severe dental and periodontal tissue destruction in young addicts and two case reports are included. The above survey indicates that dental treatment should become a part of standard care for addicted patients in long-term hospitals. Furthermore, if severe oral tissue impairment in young persons whether in dental practice or during autopsy is encountered a drug addiction should be suspected. If so, the treatment of the person or examination of the dead body should accordingly be adjusted.     

The condition of oral mucosa and periodontium in drug addicts

The condition of the parodontium and oral hygiene were assessed in two 29-case groups of drug addicts before withdrawal treatment (hospital) and after it (in MONAR centre). The control group comprised 29 non-addicts. The PI index of Russel and OHI-S index were calculated. It was found that the mean value of PI and OHI-S was significantly greater before withdrawal treatment than after it, and in relation to controls. The values of both indices increased significantly with the duration of addiction. The authors concluded that drug-addiction through psychic deterioration leads to abandoning of oral hygiene which is the main cause of paradontal changes.     

Anxiety and dental fear in a group of parenteral drug addicts

The aim of the study was to evaluate whether general anxiety and dental anxiety were more common in a group of parenteral drug addicts. 41 drug addicts (mean = 27.4 yr) attending a dental clinic in Aarhus in Denmark participated. A randomly sampled reference group comprising 350 individuals living in Aarhus and with similar age distribution was selected from the Central Person Register. Questionnaires with social and educational data and three self-report rating scales, namely Corah's dental anxiety scale (CDAS) and Spielberger's State-Trait anxiety inventory's two scales (STAI-State and STAI-Trait) were completed by the participants. Response rates were 95.6% and 89.3% for drug addicts and controls, respectively. Median CDAS, STAI-State, and STAI-Trait were 10, 46 and 44 in the addicts which was statistically significantly higher than in the general population. These differences were still present when the addicts were compared to a subsample from the reference group with a better matching of educational and social background factors. Spearman's correlation coefficient between CDAS and STAI-State, CDAS and STAI-Trait, and STAI-State and STAI-Trait were 0.57, 0.49 and 0.50, respectively, which were significant and moderately high correlations. Finally, anxiety levels were similar irrespective of caries experience.     

Anxiety and dental fear in a group of parenteral drug addicts

Abstract — The aim of the study was to evaluate whether general anxiety and dental anxiety were more common in a group of parenteral drug addicts. 41 drug addicts =27.4 yr) attending a dental clinic in Aarhus in Denmark participated. A randomly sampled reference group comprising 350 individuals living in Aarhus and with similar age distribution was selected from the Central Person Register. Questionnaires with social and educational data and three self-report rating scales, namely Corah's dental anxiety scale (CDAS) and Spielberger's State-Trait anxiety inventory's two scales (STAI-State and STAI-Trait) were completed by the participants. Response rates were 95.6% and 89.3% for drug addicts and controls, respectively. Median CDAS, STAI-State, and STAI-Trait were 10, 46 and 44 in the addicts which was statistically significantly higher than in the general population. These differences were still present when the addicts were compared to a subsample from the reference group with a better matching of educational and social background factors. Spearman's correlation coefficient between CDAS and STAI-State, CDAS and STAI-Trait, and STAI-State and STAI-Trait were 0,57, 0.49 and 0.50, respectively, which were significant and moderately high correlations. Finally, anxiety levels were similar irrespective of caries experience.     

Saliva secretion rate in a group of drug addicts (short communication)

Abstract – Stimulated saliva secretion rate was measured in 40 parenteral drug addicts who had a preferencc for opiates. Illicit drug abuse or intake of legally prescribed medicine within the last 24 h were recorded. Mean saliva secretion rate for the whole group of drug addicts was 1.51 ml/min with no statistical difference from a control group (P>0.30). However, drug addicts who had taken legally prescribed tranquillizers or sedatives had a reduced saliva secretion rate (1.01 ml/min), whereas no decrease was found among the individuals who had taken opiates within the last 24 h (1.42 ml/min, P>0.10).     

Five-year evaluation of a dental care delivery system for drug addicts in Denmark

The present study describes the experiences and results of the first 5-year period of a municipal dental clinic offering free dental care to drug addicts. One of the many problems was the instability of this socially deprived group whose erratic life style made it impossible to maintain regular dental care. The DMFS level of the drug addicts was 50.2 and mean caries increment per yr was 2.5 (1.3 new surfaces and 1.2 surfaces with recurrent decay). The caries increments among the present drug abusers and the individuals on methadone maintenance were higher than among the previous drug addicts, 3.1 and 1.3 surfaces per yr respectively, but this difference was not statistically significant. Only slight improvement in oral hygiene (VPI) could be demonstrated whereas gingivitis (BI) remained unaltered. Traumatic injuries of the orofacial region were frequent. The mean time expenditure concerning dental treatment was 5 hr per individual in the initial treatment phase but decreased to 1-2 h per individual per yr. Broken appointments and last minute cancellations were as a rule related to drug/alcohol abuse. The mean number of fillings was 8.2 per individual in the initial treatment phase and 1.7 per yr for individuals in a maintenance phase. The poor dental health of the drug addicts seems closely related to their life style habits and the clue to an improvement would probably follow the cure of the drug abuse and a concurrent resocialization.     

The condition of teeth and the need for teeth treatment in drug addicts

The condition of teeth was studied in 30 drug addicts aged 21-34 years (drug addiction duration 3-16 years) comparing the results with those obtained in a similar group of 30 age-matched subjects without drug addiction. The needs for stomatological treatment were determined also. It was found that drug addicts had twice the number of teeth with active caries and missing teeth, and four times less filled teeth as compared with controls. Most drug addicts had lost 45-100% chewing ability, and loss of teeth included all anatomical groups. The mean number of teeth requiring treatment per one addict was 8, and 2.8 teeth required removal. Only 3 addicts were not in need of prosthetic treatment, the remaining ones (90%) should have been given permanent of removable replacements (including complete denture). Drug addiction was found to produce intensification of caries and mutilation of the stomatognathic system.     

Assessment of the referral system for surgical removal of third molars at the Dental Faculty,King Saud University

Introduction: There is compelling evidence that prophylactic extraction of third molars is a health problem that needs to be addressed. In particular, the vast amount of evidence demonstrating complications after removal of third molars, rather than supporting the necessity of removal or the negative effects of retention, raise this concern. Objective: The aim of this study was to investigate the referral system for third molar extraction at our institution by assessing patient opinions and the experience of the oral surgeons and the referring dentists. The main outcome measures of concern were the reasons for third molar extraction, patient awareness about the surgery and the comorbidities that may accompany the surgery. Methods: Pilot cross-sectional survey questionnaires were distributed at the Dental Faculty Clinic at King Saud University, from 15 March 2015 to 30 June 2016 by the staff in charge of the patient waiting area, oral surgery clinic, primary care clinic and specialist clinic. Results: Of 400 potential respondents, 226 completed the survey (response rate: 54%). Of these patients, 91% knew why they had been referred to the oral surgery department, but 73.5% did not understand the surgical extraction procedure or its complications. In total, 45.2% of the patients referred had no signs or symptoms, and 36% were referred for prophylactic reasons. In conclusion, our system needs reassessment. To combat the subjective health practice of routinely referring patients for prophylactic extraction, the role of primary care should be emphasised by implementing a system for regular patient check-ups, and public awareness should be increased.Key words: Wisdom tooth, removal, retention, surgery     

Electrodermal activity, dental anxiety, and fear of dentistry in a group of parenteral drug addicts

Abstract — The present study was undertaken in order to evaluate whether electrodermal activity was a useful tool with which to measure dental anxiety in a group of drug addicts. Electrodermal activity was compared to the subjects' self-reported feelings during ordinary dental treatment sessions. In the first part of the study the level of electrodermal activity during treatment sessions was videotaped and recorded on paper by means of a polygraph. The patients were interviewed using a semi-structured questionnaire dealing with the addicts' dental anxiety and fear. In connection with the interviews the addicts completed Corah's Dental Anxiety Scale (CDAS). There was no recognizable pattern in electrodermal activity when this was compared with the patients' feelings during the treatments. Median CDAS was 9.5. In the second part of the study, electrodermal activity was recorded on the polygraph only. This group also completed a CDAS questionnaire. No correlation between the patients' self-reported highest level of anxiety and level of electrodermal activity, number of fluctuations or amplitude in relation to specific dental stimuli was found; agreement was found in two, three and none of 10 cases respectively. Median CDAS was 10.0. It could be concluded that, although the study revealed apprehension and situational anxiety among the addicts, no correlation to electrodermal activity was found. This discrepancy between the physiological and cognitive data probably reflects the uncertainty of these measures under the given circumstances.