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Drug Abuse and the Relationship to Poor Oral Health

Alexis Epperson

Dental Hygiene Department, South College

RDH 1310: Dental Pharmacology

Professor Sarah McKinney, RDH

November 22, 2022

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Drug Abuse and the Relationship to Poor Oral Health

Introduction

According to Substance Abuse and Mental Health Services Administration, there is a rise

of drug use and substance abuse in the United States. In the past year, 39% of Americans

between the ages of 18 and 25 years were reported either using, misusing, or abusing drugs

(Staff, 2022). Drug use can impact an individual’s overall health and cause adverse effects on the

health of the individuals teeth and gums (Dental Health, 2022). The CDC (Centers for Disease

Control and Prevention) states that oral health is essential to general health and well-being (Oral

Health Fast Facts, 2021). This paper examines oral health status among drug users when

compared to the general population.

Review of Literature

Valadas (2020) conducted a literature review to highlight the most common oral lesions

present on drug addicts to alert dental professionals to also act as facilitators towards better

overall health by referring the patient to other medical providers in addition to providing proper

dental treatment. When compared to the general population, drug user’s presented with more oral

lesions and less knowledge regarding the relationship between drug use and oral health. The data

was collected from 41 articles that were published from the years 1991 and 2019. The review

found that the most common oral conditions present in drug users included caries, periodontitis,

xerostomia, and leukoplakia. The authors concluded that initial recognition from the dental team

can lead to better overall treatment of drug addicts through referrals to other health resources for

the individuals (Valadas et al., 2020).

Sharma (2018) conducted a study on drug addicts to determine if there was a relationship

between oral health status and the route of which drugs where administered into the body. The
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data was collected using a self-administered questionnaire and a clinical examination. The

questionnaire focused on the drug addicts oral hygiene practices and their drug addiction history:

the clinical examination was used to evaluate the current status of their oral health. The study

found that cocaine addicts presented with red and inflamed gingiva that was covered in a

removable white slough. Gingival trauma was found on patients who brushed during their high

state due to added force. Those who injected drugs were found to have limited motor activity

abilities and thus proper hygiene routines were unable to be achieved. Additionally, those who

abused opiates and amphetamines had higher prevalence of xerostomia induced caries. The

authors concluded that more studies need to be conducted that focus on the relationship between

oral health status and mode of administration. The general consensus is that periodontitis and

caries are more prevalent in drug addicts than the general population and that more effective

public health programs need to be established for this particular population (Sharma et al., 2018).

Sing et al. (2016) studied drug addicts who were recently admitted into a rehabilitation

center to determine their attitude towards oral health. The participants underwent a physical

examination to determine their oral health status and an interview about their drug use history

and oral hygiene history. The study found only 4% of the participants had reported visiting the

dentist in the past six months and 59% had not gone to the dentist in over a year. The data

indicated that carious lesions were present in all participants, less than 20% did not regularly

brush, 92% never used floss, 39% had fractured teeth, and 77% had periodontal pockets. The

authors concluded that those who are recovering from drug addiction have a special need for

dental care. Implementing oral health promotion programs will improve an addicts oral health,

but also will serve as a foundation that helps them create a new identity (Singh et al., 2016).
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Discussion

The results of the present study supports the claim that those who use, abuse, or misuse

drugs have a worse oral health status than the general population. The results strongly imply that

this is true due to the lack of knowledge that the drug users have about the connection between

general health and dental health. Furthermore, drug users are unaware about the link between

drug use and oral health. These findings may be explained by the concept that drugs have both

direct effects, such as clenching or grinding, and indirect effects such as lifestyle changes and

poor nutrition.

While previous research has focused on oral health conditions of drug users, this research

compared oral health conditions among drug users who did not partake in any dental hygiene and

those who maintained a level of oral hygiene: the results being that those who did maintain a

level of dental hygiene presented with better oral health (Sharma et al., 2016). Therefore, this

evidence can support the idea that drug users should have the same access, if not special public

health programs, as the general population to receive proper dental care and education.

Promoting dental hygiene to drug users can theoretically lessen the severity of their oral hygiene

conditions. Even the users are unwilling or not wanting to receive help for their addiction then at

least the research signifies that properly educating the importance of maintaining a basic level of

hygiene will reduce the prevalence of oral conditions.

All three articles have supporting research that emphasis about specific oral conditions

associated with specific drugs. These consistent results found throughout several studies

indicates that dental professionals have the unique opportunity to potentially be the first medical

provider to recognize drug use, misuse, or abuse within an individual. Therefore, it is critical that

dental professionals have the ability to not only recognize and treat the oral lesions but give
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referrals to help the individual build the support team needed to recover from their addiction.

To further research the conclusions drawn from drug abuse and the relationship to poor

oral health, it would be useful to explore the idea of conducting a study that focused directly on

improving the dental hygiene habits of addicts over a set time period to provide a consistent

evaluation on the addicts oral health status. Although the present results clearly support the idea

that their oral hygiene status would improve, a proper study would be needed to confirm the

conclusions drawn from this research.

Conclusion

Many health problems are associated with abusing drugs; however, the oral health

damages caused by abuse are often overlooked or not treated due to a lack of concern or

knowledge. Drug addicts need education during their addiction to have a superior chance at

reducing the severity of their conditions. In conclusion, there is a need to reform public health

policies to mandate oral health programs to enable addicts to receive the care they need during

their addiction in addition to when they are in recovery.

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References

Centers for Disease Control and Prevention. (2021, January 25). Oral Health Fast Facts. Centers

for Disease Control and Prevention. Retrieved November 17, 2022, from

https://www.cdc.gov/oralhealth/fast-facts/index.html

Dentalhealthorg. (2022). Drugs, alcohol and your oral health. Oral Health Foundation Better Oral

Health for All . Retrieved November 17, 2022, from

https://www.dentalhealth.org/drugs-alcohol-and-your-oral-health

Singh, R., Chandra, S., Sahu, S. K., Pandey, V., & Kaur, G. (2016). Evaluation of oral health

status among drug addicts in rehabilitation centre. International Archives of Integrated

Medicine, 3(3), 65-69.

https://www.iaimjournal.com/wp-content/uploads/2016/02/iaim_2016_0303_10.pdf

Sharma, A., Singh, S., Mathur, A., Aggarwal, V. P., Gupta, N., Makkar, D. K., Batra, M., &

Gijwani, D. (2018). Route of drug abuse and its impact on oral health-related quality of

life among drug addicts. Addiction & Health, 10(3), 148–155.

https://doi.org/10.22122/ahj.v10i3.567

Staff, C. (2022). Drug use statistics and Demographics. Caron Treatment Centers. Retrieved

November 17, 2022, from https://www.caron.org/addiction-101/drug-use/statistics-and-

demographics#:~:text=53%20million%20or%2019.4%25%20of,drugs%20in%20the%20l

ast%20year

Valadas, L. A. R., Lima Fernandes, M., Silva, M. I. G., do Carmo de Oliveira Citó, M., Maia

Oliveira, I. C., Leite Dias, M., de Mello Fiallos, A. C., Freire Vasconcelos, L., Ximenes

dos Santos, L. K., Rodrigues de Carvalho, A. M., Oliveira Chagas, F., & Florenço de
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Sousa, F. C. (2020). Oral manifestations of drug abuse: a review of literature. Journal of

Young Pharmacists, 12(1), 11–14.

https://doi.org/10.5530/jyp.2020.12.3