The oral health status of 36 long-term heroin addicts was measured using DMF, OHIS, and PI. Comparisons were made utilizing data from the National Center for Health Statistics. Age, sex, race, education, income, and geographic location were compared. The former addicts exhibited a significant increase in DMF, with significantly higher missing and decayed teeth, and fewer filled teeth. The periodontal condition of the former addict also showed health status. It would appear that long-term heroin addiction either contributes directly to lowered oral health status, or more likely, causes individuals to lead a life style which has ramifications to their oral health.

Aim:The purpose of this pilot study was to determine and compare the effects of two protocols aimed at reducing periodontal inflammation, upon the metabolic control of the diabetic condition in subjects with elevated baseline glycosylated hemoglobin (HbA1c). Methods and Materials:Forty-two non-smoking type 2 diabetes subjects with mildly elevated HbA1c (>7 but < 9%) and severely elevated (>9%) were randomized to one of two non-surgical periodontal therapy protocols. Patients in the "minimal therapy" (MT) group received scaling, root planning, and oral hygiene instructions on two occasions six months apart. Participants randomized to the "frequent therapy" (FT) protocol received scaling, root planing, and oral hygiene instructions at two-month intervals and were provided a 0.12% chlorhexidine rinse for home use twice daily. Neither systemic nor local antibiotics were provided to either group. Subjects were asked to report any changes in diabetic medications, nutrition, and physical activity. Data analyses (ANOVA, t-test, Mann-Whitney) grouped subjects according to baseline HbA1c (>7 and < 9%, or > 9%), treatment protocol (minimal or frequent), and +/-medication change. Results:In both MT and FT groups the clinical attachment level (CAL) remained unchanged but the other measures [gingival index (GI) and pocket dept (PD)] of periodontal health improved. Mean reductions in plaque showed improvement but calculus was worse in the FT group, likely due to the use of chlorhexidine. At six months, the largest reduction of HbA1c was 3.7; experienced by a subject receiving FT but no changes in diabetic medication. Among the MT and no medication change subjects, the maximum reduction was 1.6. Abstract © Seer PublishingConclusion: Overall, modest improvements in HbA1c were detected with a trend towards FT being better than MT. Although this pilot trial was under-powered to detect small between-group differences, the magnitude of our findings (0.6 mean improvement in HbA1c) matches closely findings from the only meta-analysis conducted on this topic to date. Larger scale studies must be undertaken on diabetic patients with periodontal problems.Clinical Significance: Preventive periodontal regimens for diabetic patients should be sufficiently intense and sustained to eliminate periodontal inflammation and should be closely coordinated with the patient's overall clinical diabetic management.

This study evaluated the health effects of routine and intensified dental care and disease prevention in persons with human immunodeficiency virus (HIV). We recruited 376 HIV-infected persons ages 19 to 61 with CD4 counts between 100 and 750 into a year-long two-arm randomized controlled trial. Control group subjects (n = 185) received professional dental protective treatment and checkups at baseline, 6 months, and 1 year, plus dental care. Enhanced care patients (n = 191) received bimonthly protective treatment and twice-daily chlorhexidine mouthrinses to treat gingivitis. Active decay, gingivitis, oral pain, impact of oral health on functioning, and global functional status improved in both groups. The mean depth of periodontal pockets decreased 0.18 mm (control group) versus 0.27 mm (enhanced group) (p < 0.04), as did an erythema index (-1.22 versus -1.78, p < 0.01). No effects on acquired immune deficiency syndrome (AIDS)-related complications, symptoms, or mortality were observed. We concluded that access to dental screening, prophylaxis, and repair will significantly improve oral health, functioning, and quality of life in persons with AIDS.

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