Differences in dental treatment plan and planning for drug‐addicted and non‐drug‐addicted patients

Abstract

This study investigated whether dental treatment plans and planning of general practitioners are different for addicted and identical non-addicted patients. Dental practitioners (n = 500) were sent a questionnaire with information on and questions about treatment for either an addicted or an identical non-addicted patient; response rate was 41 %. Loglinear analysis showed that after controlling for the influence of four demographic variables (sex, age number of patients and number of National Health Service insured patients), the treatment plans made for addicted patients were less elaborate than those for non-addicted. For the addicted, fillings or frames were proposed more often, whereas for non-addicted patients more often crowns or bridges were proposed. Extraction instead of filling was more often proposed for the addicted patient. Less elaborate treatment for addicted patients corresponds to the way dentists specialized in treating drug addicts work, with one exception: extraction should be avoided whether a patient is addicted or not. Treatment planning did not differentiate for addicted and non-addicted patients, whereas dentists specialized in treating addicted patients do recommend an adjusted treatment plan for the addicted.

Drug users: oral health-related attitudes and behaviours

“…Even services dedicated to drug users tend to opt for less complex treatment for similar reasons. 34 During periods of drug use these participants had only been concerned about treatment for pain relief. Again, this type of emergency attendance is not compatible with registration with a dentist.…”

Oral health of substance-dependent individuals: Impact of specific substances

“…Individuals with heavy substance use are at increased risk for poor oral health for a variety of reasons, including limited access to dental care (Johnson, Hearn, & Barker, 2008; Khocht, Schleifer, Janal, & Keller, 2009; Sheridan, Aggleton, & Carson, 2001; ter Horst, Molendijk, Brouwer, & Verhey, 1996), poor dietary (Laslett, Dietze, & Dwyer, 2008; Morio, Marshall, Qian, &Morgan, 2008; Titsas and Ferguson, 2002) and oral hygiene habits (Barbadoro, Lucrezi, Prospero, & Annino, 2008; Friedlander, Marder, Pisegna, & Yagiela, 2003; Morio et al, 2008), negative attitudes about oral health and health care (Robinson, Acquah, & Gibson, 2005), and direct physical effects of the substance on oral health. There are several mechanisms by which drugs can directly affect oral health, including increased xerostomia (dry mouth) due to hyposalivation (lack of salivary flow), poor diet and self-care leading to higher rates of dental caries, enamel erosion, and periodontal disease (Friedlander et al, 2003; Hamamoto and Rhodus, 2009; Morio et al, 2008; Versteeg, Slot, van der Velden, & van der Weijden, 2008).…”

“…Most studies that have examined oral health among substance users are cross-sectional or case studies and have assessed only one type of substance (Araujo et al, 2004; Hornecker et al, 2003; Khocht et al, 2009; Manarte et al, 2009; Morio et al, 2008; Versteeg et al, 2008; Shetty et al, 2010) and include small samples (Araujo et al, 2004; Johnson et al, 2008; Khocht et al, 2009; Morio et al, 2008; Robinson et al, 2005; Sheedy, 1996). Many studies and reviews that have addressed the issue of substance use and oral health were conducted internationally, with little work focused in the United States, where the stigma of substance use and perceptions of and access to treatment for oral health may be different (Barbadoro et al, 2008; Blanksma and Brand, 2004; Cho, Hirsch, & Johnstone, 2005; Johnson et al, 2008; Laslett et al, 2008; Molendijk, Ter Horst, Kasbergen, Truin, & Mulder, 1996; Pilinova, Krutina, Salandova & Pilin, 2003; Reece, 2007; Robinson et al, 2005; Sheridan et al, 2001; ter Horst et al, 1996). Understanding how specific types of substances affect oral health can potentially help target interventions to certain groups at risk.…”

Cambios en los hábitos de salud oral en pacientes infectados por el virus de la inmunodeficiencia humana

“…En 2002 la frecuencia de consultas fue similar a la observada en la población general española 8 , y superior a la observada en otros países europeos 25 . Ter Horst y cols 26 , en un estudio realizado entre 500 dentistas señalaron que los planes de tratamiento eran menos elaborados para pacientes usuarios de drogas que para no consumidores, con una mayor propuesta de obturaciones simples y prótesis removibles frente a prótesis fijas. Este hecho podría justificar el notable nú-mero de obturaciones y prótesis de nuestro colectivo de estudio en 2002.…”