Oral manifestations of illicit drug use

Abstract

The use of illicit and misuse of licit drugs is a global public health problem, with illicit drug use being responsible for 1.8% of the total disease burden in Australia in 2011. Oral adverse effects associated with illicit drug use are well-established, with aggressive caries, periodontitis, bruxism, poor oral hygiene and general neglect documented. Other factors such as a high cariogenic diet and lifestyle, social and psychological factors compound the poorer oral health in illicit drug users. Literature has shown that the oral health-related quality of life among injecting drug users is poorer compared with the Australian general population and the overall quality of life of addicted people correlates with caries experience. Thus, the role of the dentist is imperative in managing the oral health of these individuals. Given their widespread recreational use, it is likely that dental practitioners will encounter patients who are regular or past users of illicit drugs. The aim of this article is to describe the prevalence and mechanism of action of commonly used illicit drugs in Australia, including cannabis, methamphetamine, cocaine and heroin and to inform dentists about the common orofacial presentations of their side effects to help with patient management.Abbreviations and acronyms: CBD = cannabidiol; CNS = central nervous system; MA = methamphetamine; ONJ = osteonecrosis of the jaw; THC = delta-9 tetrahydrocannabinol.

Dental Caries Experience and Associated Factors Among Brazilian Homeless Persons: A Cross-Sectional Study

“…The effect of illicit drugs use on the dental caries experience was not significant in the present study. This result is opposite from several studies that report the deleterious effects of drug abuse on oral health conditions (White et al, 1997;De Palma et al, 2005;Teoh et al, 2019). However, a positive correlation between drug use and worse oral health conditions is associated to deleterious habits commonly observed in drug users, that favor the development of oral diseases.…”

Illicit drug use and oral health

“…When left untreated over time, as they often are, these diseases typically become more severe, often more painful and more difficult and expensive to treat, and they may affect chewing function, dental aesthetics and oral well-being even more severely. A dry mouth (xerostomia) is frequently reported among illicit drug users and methadone patients (31,51), and beyond increasing the risk of dental decay and periodontitis, it causes discomfort and often a sense of 'burning mouth', unpleasant taste and bad breath, and difficulties with eating and speaking (8). Jaw clenching and tooth grinding (bruxism) are frequently reported by stimulant drug users (15,31,(52)(53)(54), and this condition is often accompanied by temporomandibular joint pain and tooth wearing and occlusal attrition (54,55).…”

“…A dry mouth (xerostomia) is frequently reported among illicit drug users and methadone patients (31,51), and beyond increasing the risk of dental decay and periodontitis, it causes discomfort and often a sense of 'burning mouth', unpleasant taste and bad breath, and difficulties with eating and speaking (8). Jaw clenching and tooth grinding (bruxism) are frequently reported by stimulant drug users (15,31,(52)(53)(54), and this condition is often accompanied by temporomandibular joint pain and tooth wearing and occlusal attrition (54,55). Lesions of the oral mucosa, including leukoplakia, squamous cell carcinoma and fungus infections (candida albicans) and enlarged gingiva are seen in users of cannabis or/and opioids (31,56).…”

“…Jaw clenching and tooth grinding (bruxism) are frequently reported by stimulant drug users (15,31,(52)(53)(54), and this condition is often accompanied by temporomandibular joint pain and tooth wearing and occlusal attrition (54,55). Lesions of the oral mucosa, including leukoplakia, squamous cell carcinoma and fungus infections (candida albicans) and enlarged gingiva are seen in users of cannabis or/and opioids (31,56). Among cocaine users, painful retracted gingiva at site of drug application (15) and oronasal tissue destructions, including palate perforation, are reported (15,55).…”

Oral Manifestations of Illicit Drug Use

“…In this issue of the ADJ we publish a paper reviewing the oral effects of illicit drug use . This paper is noteworthy because it covers illicit drug use in the context of both ‘recreational drug use' and also misuse of prescription medications.…”