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BMC Oral Health
Published in: BMC Oral Health 1/2020

01-12-2020 | Opioids | Research article

Dental caries and periodontal disease among people who use drugs: a systematic review and meta-analysis

Authors: Mohsen Yazdanian, Bahram Armoon, Alireza Noroozi, Rasool Mohammadi, Amir-Hosein Bayat, Elahe Ahounbar, Peter Higgs, Hormoz Sanaei Nasab, Azadeh Bayani, Morteza Hemmat

Published in: BMC Oral Health | Issue 1/2020

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Abstract

Background

The aim of our study was to perform a systematic review of the literature and meta-analysis in order to investigate relationship between drug use and oral health.

Methods

We searched for studies in English published before July 1, 2019 on PsycINFO, PubMed, SciELO, Scopus, and Web of Science. We assessed the relationship between drug use (methamphetamines, heroin; opiates; crack, cocaine and cannabis as dependent variables) and reported tooth loss, periodontal disease, or decayed, missing, and filled teeth index as an independent variable. The data were analyzed using Stata 12.0 software.

Results

We initially identified 1836 potential articles (with 1100 duplicates) and screened the remaining 736 titles and abstracts, comprising 54 studies. In the next step, we evaluated the full-texts; 44 studies were excluded, accordingly. In total, we included 10 publications in the meta-analysis. Drug type was associated with periodontal disease (OR 1.44; 95% CI 0.8–2.6) and pooled estimates showed that type of drug used increased the odds of the number of decayed, missed and filled teeth (DMFT) (OR 4.11; 95% CI 2.07–8.15) respectively.

Conclusions

The analytical challenges of segregating the impact of individual drug types on oral health diseases mean that investigations on the direct relationship between oral health status and drug use are limited. Developing programs to improve potential confounding with various substances and addressing the dental health needs of people who use drugs is vital if we are to improve their overall quality of life.
Literature
1.
Degenhardt L, Hall W. Extent of illicit drug use and dependence, and their contribution to the global burden of disease. Lancet. 2012;379(9810):55–70.PubMedCrossRef
2.
Chitwood DD, Sanchez J, Comerford M, McCoy CB. Primary preventive health care among injection drug users, other sustained drug users, and non-users. Subst Use Misuse. 2001;36(6–7):807–23.PubMedCrossRef
3.
DeBeck K, Cheng T, Montaner JS, Beyrer C, Elliott R, Sherman S, Wood E, Baral S. HIV and the criminalisation of drug use among people who inject drugs: a systematic review. Lancet HIV. 2017;4(8):e357–74.PubMedPubMedCentralCrossRef
4.
Noroozi M. Ahounbar E, eddin Karimi S, Ahmadi S, Najafi M, Bazrafshan a, Shushtari ZJ, Farhadi MH, Higgs P, Rezaei F: HIV risk perception and risky behavior among people who inject drugs in Kermanshah, Western Iran. Int J Behav Med. 2017;24(4):613–8.PubMedCrossRef
5.
Armoon B, Noroozi M, Jorjoran Shushtari Z, Sharhani A, Ahounbar E, Karimi S, Ahmadi S, Farhoudian A, Rahmani A, Abbasi M. Factors associated with HIV risk perception among people who inject drugs: findings from a cross-sectional behavioral survey in Kermanshah, Iran. J Subst Use. 2018;23(1):63–6.CrossRef
6.
Hoggatt KJ, Frayne SM, Saechao FS, Yano EM, Washington DL. Substance use disorder-related disparities in patient experiences of Primary care. Health Equity. 2019;3(1):193–7.PubMedPubMedCentralCrossRef
7.
Noroozi M, Noroozi A, Sharifi H, Harouni GG, Marshall BD, Ghisvand H, Qorbani M, Armoon B. Needle and syringe programs and HIV-related risk behaviors among men who inject drugs: a multilevel analysis of two cities in Iran. Int J Behav Med. 2019;26(1):50–8.PubMedCrossRef
8.
Noroozi M, Marshall BD, Noroozi A, Armoon B, Sharifi H, Farhoudian A, Ghiasvand H, Vameghi M, Rezaei O, Sayadnasiri M. Do needle and syringe programs reduce risky behaviours among people who inject drugs in Kermanshah City, Iran? A coarsened exact matching approach. Drug Alcohol Rev. 2018;37:S303–8.PubMedCrossRef
9.
ZADOR D, WALL PML, WEBSTER I. High sugar intake in a group of women on methadone maintenance in South Western Sydney, Australia. Addiction. 1996;91(7):1053–61.PubMedCrossRef
10.
MORABIA A, FABRE J, GHEE E, ZEGER S, ORSAT E, ROBERT A. Diet and opiate addiction: a quantitative assessment of the diet of non-institutionalized opiate addicts. Br J Addict. 1989;84(2):173–80.PubMedCrossRef
11.
Kolarzyk E, Chrostek JM, Pach D, Janik A, Kwiatkowski J, Szurkowska M. Assessment of daily nutrition ratios of opiate-dependent persons before and after 4 years of methadone maintenance treatment. Przegla̧d lekarski. 2005;62(6):368–72.PubMed
12.
Mysels DJ, Sullivan MA. The relationship between opioid and sugar intake: review of evidence and clinical applications. J Opioid Manag. 2010;6(6):445–52.PubMedPubMedCentralCrossRef
13.
Nolan LJ, Scagnelli LM. Preference for sweet foods and higher body mass index in patients being treated in long-term methadone maintenance. Subst Use Misuse. 2007;42(10):1555–66.PubMedCrossRef
14.
Santolaria-Fernández FJ, Gómez-Sirvent JL, González-Reimers CE, Batista-López J, Jorge-Hernández J, Rodríguez-Moreno F, Martínez-Riera A, Hernández-García MT. Nutritional assessment of drug addicts. Drug Alcohol Depend. 1995;38(1):11–8.PubMedCrossRef
15.
Thavarajah R, Rao A, Raman U, Rajasekaran ST, Joshua E. R H, Kannan R: Oral lesions of 500 habitual psychoactive substance users in Chennai, India. Archives Oral Biol. 2006;51(6):512–9.CrossRef
16.
Pereira AC, Da Cunha FL. Meneghim MdC, Werner CW: dental caries and fluorosis prevalence study in a nonfluoridated Brazilian community: trend analysis and toothpaste association. ASDC J Dent Child. 2000;67(2):132–5 183.PubMed
17.
Brown C, Krishnan S, Hursh K, Yu M, Johnson P, Page K, Shiboski CH. Dental disease prevalence among methamphetamine and heroin users in an urban setting a pilot study. J Am Dent Assoc. 2012;143(9):992–1001.PubMedPubMedCentralCrossRef
18.
Leung WK, Chu CH. Dental caries and periodontal status of 12-year-old school children in rural Qinghai, China. Int Dental J. 2003;53(2):73–8.CrossRef
19.
Shetty V, Mooney LJ, Zigler CM, Belin TR, Murphy D, Rawson R. The relationship between methamphetamine use and increased dental disease. J Am Dent Assoc. 2010;141(3):307–18.PubMedPubMedCentralCrossRef
20.
Murphy DA, Harrell L, Fintzy R, Vitero S, Gutierrez A, Shetty V. Soda consumption among methamphetamine users in the US: impact on Oral health. Oral Health Prev Dentistry. 2016;14(3):227.
21.
In S-W, Son E-W, Rhee D-K, Pyo S. Methamphetamine administration produces immunomodulation in mice. J Toxic Environ Health A. 2005;68(23–24):2133–45.CrossRef
22.
Tapsoba H, Bakayoko-Ly R. Oral health status of 12-year-old schoolchildren in the province of Kadiogo, Burkina Faso. Community Dent Health. 2000;17(1):38–40.PubMed
23.
Drugs UNOo, Crime. World drug report 2010. Austria: United Nations Publications; 2010.
24.
Nives P, Marina K, Irina F, Željko V. Caries prevalence in heroin addicts. Acta Clinica Croatica. 2013;52(4):436–43.
25.
Leone CW, Oppenheim FG. Physical and chemical aspects of saliva as indicators of risk for dental caries in humans. J Dent Educ. 2001;65(10):1054.PubMed
26.
Ravenel MC, Salinas CF, Marlow NM, Slate EH, Evans ZP, Miller PM. Methamphetamine abuse and oral health: a pilot study of "meth mouth". Quintessence Int. 2012;43(3):229–37.PubMed
27.
Morio KA, Marshall TA, Qian F, Morgan TA. Comparing diet, oral hygiene and caries status of adult methamphetamine users and nonusers - a pilot study. J Am Dent Assoc. 2008;139(2):171–6.PubMedCrossRef
28.
Cretzmeyer M, Walker J, Hall JA, Arndt S. Methamphetamine use and dental disease: results of a pilot study. J Dent Child. 2007;74(2):85–92.
29.
Mallatt ME. Meth mouth: a national scourge. J Indiana Dent Assoc. 2005;84(3):28–9.PubMed
30.
García-Godoy F, Hicks MJ. Maintaining the integrity of the enamel surface: the role of dental biofilm, saliva and preventive agents in enamel demineralization and remineralization. J Am Dent Assoc. 2008;139:25S–34S.PubMedCrossRef
31.
Saini TS, Edwards PC, Kimmes NS, Carroll LR, Shaner JW, Dowd FJ, Saini T, Kimmes NS. Etiology of xerostomia and dental caries among methamphetamine abusers. Oral Health Prev Dentistry. 2005;3(3):189–95.
32.
Colon P Jr. Dental disease in the narcotic addict. Oral Surg Oral Med Oral Pathol. 1972;33(6):905–10.PubMedCrossRef
33.
Marshall BDL, Werb D. Health outcomes associated with methamphetamine use among young people: a systematic review. Addiction. 2010;105(6):991–1002.PubMedCrossRef
34.
Shetty V, Harrell L, Murphy Debra A, Vitero S, Gutierrez A, Belin TR, Dye BA, Spolsky VW. Dental disease patterns in methamphetamine users: findings in a large urban sample. J Am Dent Assoc. 2015;146(12):875–85.PubMedPubMedCentralCrossRef
35.
Sadat Sajadi F, Moradi M, Pardakhty A, Yazdizadeh R, Madani F. Effect of fluoride, Chlorhexidine and fluoride-chlorhexidine mouthwashes on salivary Streptococcus mutans count and the prevalence of Oral side effects. J Dent Res Dent Clin Dent Prospects. 2015;9(1):49–52.PubMedPubMedCentralCrossRef
36.
Steinhoff M, Buddenkotte J, Aubert J, Sulk M, Novak P, Schwab VD, Mess C, Cevikbas F, Rivier M, Carlavan I, et al. Clinical, cellular, and molecular aspects in the pathophysiology of rosacea. J Investig Dermatol Symp Proc. 2011;15(1):2–11.PubMedPubMedCentralCrossRef
37.
Narbutaitė J, Vehkalahti MM, Milčiuvienė S. Dental fluorosis and dental caries among 12-yr-old children from high- and low-fluoride areas in Lithuania. Eur J Oral Sci. 2007;115(2):137–42.PubMedCrossRef
38.
Ghaffari M, Rakhshanderou S, Ramezankhani A, Buunk-Werkhoven Y, Noroozi M, Armoon B. Are educating and promoting interventions effective in oral health?: a systematic review. Int J Dent Hyg. 2018;16(1):48–58.PubMedCrossRef
39.
Ghaffari M, Rakhshanderou S, Ramezankhani A, Noroozi M, Armoon B. Oral health education and promotion programmes: meta-analysis of 17-year intervention. Int J Dent Hyg. 2018;16(1):59–67.PubMedCrossRef
40.
Moher D, Liberati A, Tetzlaff J, Altman DG, Group P: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. In.; 2010.
41.
Do L, Roberts-Thomson K. Dental caries experience in the Australian adult population; 2007.
42.
ACdO S, Marques A, Pannuti CM, RFM L, Lotufo-Neto F. Evaluation of periodontitis in hospital outpatients with major depressive disorder. J Periodontal Res. 2014;49(1):77–84.CrossRef
43.
Savage A, Eaton KA, Moles DR, Needleman I. A systematic review of definitions of periodontitis and methods that have been used to identify this disease. J Clin Periodontol. 2009;36(6):458–67.PubMedCrossRef
44.
Savage A, Eaton KA, Moles DR, Needleman I. A systematic review of definitions of periodontitis and methods that have been used to identify this disease. J clin Periodontol. 2009;36(6):458-67.PubMedCrossRef
45.
Albandar JM. Epidemiology and risk factors of periodontal diseases. Dental Clinics. 2005;49(3):517–32.PubMed
46.
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.PubMedCrossRef
47.
48.
Rooban T, Rao A, Joshua E, Ranganathan K. Dental and oral health status in drug abusers in Chennai, India: a cross-sectional study. J Oral Maxillofacial Pathol. 2008;12(1):16.CrossRef
49.
Reece A. Dentition of addiction in Queensland: poor dental status and major contributing drugs. Aust Dent J. 2007;52(2):144–9.PubMedCrossRef
50.
Kayal RA, Elias WY, Alharthi KJ, Demyati AK, Mandurah JM. Illicit drug abuse affects periodontal health status. Saudi Med J. 2014;35(7):724–8.PubMed
51.
D’Amore MM, Cheng DM, Kressin NR, Jones J, Samet JH, Winter M, Kim TW, Saitz R. Oral health of substance-dependent individuals: impact of specific substances. J Subst Abus Treat. 2011;41(2):179–85.CrossRef
52.
Gupta T, Shah N, Mathur V, Dhawan A. Oral health status of a group of illicit drug users in Delhi, India. Community Dent Health. 2012;29(1):49.PubMed
53.
Thomson WM, Poulton R, Broadbent JM, Moffitt TE, Caspi A, Beck JD, Welch D, Hancox RJ. Cannabis smoking and periodontal disease among young adults. Jama. 2008;299(5):525–31.PubMedPubMedCentralCrossRef
54.
Shetty V, Harrell L, Clague J, Murphy D, Dye B, Belin T. Methamphetamine users have increased dental disease: a propensity score analysis. J Dent Res. 2016;95(7):814–21.PubMedPubMedCentralCrossRef
55.
Rommel N, Rohleder NH, Wagenpfeil S, Härtel-Petri R, Jacob F, Wolff K-D, Kesting MR. The impact of the new scene drug “crystal meth” on oral health: a case–control study. Clin Oral Investig. 2016;20(3):469–75.PubMedCrossRef
56.
Zhang J, Kai FY. What's the relative risk?: a method of correcting the odds ratio in cohort studies of common outcomes. Jama. 1998;280(19):1690–1.PubMedCrossRef
57.
58.
Shekarchizadeh H, Khami MR, Mohebbi SZ, Ekhtiari H, Virtanen JI. Oral health of drug abusers: a review of health effects and care. Iran J Public Health. 2013;42(9):929.PubMedPubMedCentral
59.
Boyer EM, Thompson N, Hill T, Zimmerman MB. The relationship between methamphetamine use and dental caries and missing teeth. Am Dental Hygienists’ Assoc. 2015;89(2):119–31.
60.
Williams N, Covington J 3rd. Methamphetamine and meth mouth: an overview. J Tennessee Dental Asso. 2006;86(4):32.
61.
Group NDPS. The 3rd national epidemiological sampling survey of oral health. Beijing: People’s Medical Publishing House; 2008. p. 72–91.
62.
Truong A, Higgs P, Cogger S, Jamieson L, Burns L, Dietze P. Oral health-related quality of life among an a ustralian sample of people who inject drugs. J Public Health Dent. 2015;75(3):218–24.PubMedCrossRef
63.
Smit D, Naidoo S. Oral health effects, brushing habits and management of methamphetamine users for the general dental practitioner. Br Dent J. 2015;218(9):531.PubMedCrossRef
64.
Supic ZT, Petrovic R, Milicevic MS, Trajkovic G, Bukumiric Z. The oral health of heroin drug users: case study in Bosnia and Herzegovina. BMC Public Health. 2013;13(1):1202.PubMedPubMedCentralCrossRef
65.
Heng CK, Badner VM, Schiop LA. Meth mouth. N Y State Dent J. 2008;74(5):50.PubMed
66.
Mateos-Moreno MV, del Río-Highsmith J, Riobóo-García R, Solá-Ruiz MF, Celemín-Viñuela A. Dental profile of a community of recovering drug addicts: Biomedical aspects. Retrospective cohort study. Medicina oral, patologia oral y cirugia bucal. 2013;18(4):e671.PubMedPubMedCentralCrossRef
67.
Laslett AM, Dietze P, Dwyer R. The oral health of street-recruited injecting drug users: prevalence and correlates of problems. Addiction. 2008;103(11):1821–5.PubMedCrossRef
68.
Brennan D, Spencer J, Roberts-Thomson K. Dental knowledge and oral health among middle-aged adults. Aust N Z J Public Health. 2010;34(5):472–5.PubMedCrossRef
69.
Robinson P, Acquah S, Gibson B. Drug users: oral health-related attitudes and behaviours. Br Dent J. 2005;198(4):219.PubMedCrossRef
70.
71.
Shaner JW. Caries associated with methamphetamine abuse. N Y State Dent J. 2002;68(10):20.
72.
73.
Robbins JL, Wenger L, Lorvick J, Shiboski C, Kral AH. Health and oral health care needs and health care-seeking behavior among homeless injection drug users in San Francisco. J Urban Health. 2010;87(6):920–30.PubMedPubMedCentralCrossRef
74.
Nathwani NS, Gallagher JE. Methadone: dental risks and preventive action. Dental Update. 2008;35(8):542–8.PubMedCrossRef
75.
76.
Gift HC, Atchison KA, Dayton CM. Conceptualizing oral health and oral health-related quality of life. Soc Sci Med. 1997;44(5):601–8.PubMedCrossRef
77.
Gift HC, Atchison KA. Oral health, health, and health-related quality of life. Med Care. 1995;33:NS57.PubMedCrossRef
78.
Eke PI, Dye B, Wei L, Thornton-Evans G, Genco R. Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res. 2012;91(10):914–20.PubMedCrossRef
79.
Saini TS, Edwards PC, Kimmes NS, Carroll LR, Shaner JW, Dowd FJ, Saini T, Kimmes NS. Etiology of xerostomia and dental caries among methamphetamine abusers. Oral Health Prev Dent. 2005;3(3):189.PubMed
80.
Du M, Bedi R, Guo L, Champion J, Fan M, Holt R. Oral health status of heroin users in a rehabilitation Centre in Hubei province, China. Community Dent Health. 2001;18(2):94–8.PubMed
81.
Khocht A, Janal M, Schleifer S, Keller S. The influence of gingival margin recession on loss of clinical attachment in alcohol-dependent patients without medical disorders. J Periodontol. 2003;74(4):485–93.PubMedCrossRef
82.
83.
Ma H, Shi X-c, Hu D-y, Li X. The poor oral health status of former heroin users treated with methadone in a Chinese city. Med Sci Monit. 2012;18(4):PH51.PubMedPubMedCentralCrossRef
84.
Cho C, Hirsch R, Johnstone S. General and oral health implications of cannabis use. Aust Dent J. 2005;50(2):70–4.PubMedCrossRef
85.
Button KS, Ioannidis JP, Mokrysz C, Nosek BA, Flint J, Robinson ES, Munafò MR. Power failure: why small sample size undermines the reliability of neuroscience. Nat Rev Neurosci. 2013;14(5):365.PubMedCrossRef
Metadata
Title
Dental caries and periodontal disease among people who use drugs: a systematic review and meta-analysis
Authors
Mohsen Yazdanian
Bahram Armoon
Alireza Noroozi
Rasool Mohammadi
Amir-Hosein Bayat
Elahe Ahounbar
Peter Higgs
Hormoz Sanaei Nasab
Azadeh Bayani
Morteza Hemmat
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2020
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-020-1010-3

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