ABSTRACTS

RESEARCH SUMMARY Oral health sensations associated with illicit drug abuse

C. McGrath and B. Chan reveal that the majority of young adults who use common recreational drugs can develop both short and long-term oral complications. Br Dent J 2005; 198: 159–162

Objectives COMMENT To investigate oral health sensations (short term oral health The study examines the self-reported oral symptoms of 129 effects) associated with illicit drug abuse. In addition, to identify recreational drug users attending drug rehabilitation programmes variations in oral health sensations produced by different illicit in Hong Kong and other parts of China. All had used more than one drugs. type of recreational drug, in particular 4- Methylenedioxymethamphetine (MDMA, ecstasy), Subject methamphetamine or ketamine. Over 30% of this group had also Young adults in a drug rehabilitation programme in Hong Kong, used heroin. Almost all respondents reported side-effects affecting China. the mouth, particularly oral dryness, a habit of grinding or clenching their teeth, pain of the muscles of mastication and Method abnormal sensation in the mouth (eg numbness and/or sensitivity Self-completed questionnaire about their previous pattern of of teeth). The present results therefore reveal that young adults drug abuse and oral health sensations experienced (recalled). commonly experienced, at least, transient oral symptoms as a consequence of using recreational drugs. Results It is known that recreational drugs can give rise to a variety of All (119) subjects were poly-drug abusers (abused one or more orofacial complications that may be observed by practitioners and illicit drugs in the past). Amphetamine-based drugs such as most dental specialists (eg cocaine: ulceration, oronasla fistula and methamphetamine (‘speed’) and methylenedioxymethamphetine caries, ecstasy: attrition, massateric pain).1,2 Studies have (‘ecstasy’) were commonly abused. A wide range of oral health suggested that some groups of recreational drug users have sensations were reported on recall of their abuse of illicit drugs; difficulty in accessing dental services,3 or attend intermittently, most frequently dry mouth (95%, 113). Types of illicit drugs however, as such habits remain, and are becoming increasingly abused were associated with oral health sensations reported (P < common, it is likely that some individuals attending for dental care 0.001). ‘Ecstasy’ abusers more frequently reported chewing (P < will have either oral symptoms or signs reflecting a recreational 0.001), grinding (P < 0.001), and TMJ tenderness (P < 0.001) com- drug habit. It would seem sensible that persons with such pared to non-‘ecstasy’ abusers. symptoms, particularly when long-standing, are referred to appropriate specialists for investigation and treatment of the oral Conclusion disease, and ultimately perhaps referral for management of any Illicit drug abuse produces many oral health sensations. Types of recreational drug abuse likely to compromise quality of life. drugs abused were associated with oral sensations produced. Clinical collaborations within multi-agency preventative programmes may also be advantageous.4 IN BRIEF It must also be remembered that dental healthcare staff and students can themselves be alcohol and/or drug misusers,5-7 hence  Illicit drug abuse continues to be a growing problem worldwide. all healthcare staff (and the General Dental Council) have a duty of  This study reports on the oral health sensations experienced care to both colleagues and patients to be aware of relevant issues (recalled) among a young adult population in a drug rehabilitation and act in a friendly and appropriate manner to the benefit of all. programme.  Illicit drug abuse produces many oral health sensations and different S. Porter, Academic Head, Oral Medicine, Division of Maxillofacial types of illicit drugs produce different oral sensations. Diagnostic, Medical and Surgical Sciences, Eastman Dental Institute  Such information is important in understanding the underlying pathological processes that bring about drug-related oral manifestations. Moreover, it may also enable clinicians to identify 1. Meechan J G. Drug Abuse and Dentistry. Dent Update 1999; 26: 182-190. drug abuse from patients’ reported symptoms and thus facilitate a 2. Scully, C, Flint, S, Porter, S, Moos, K. Oral and Maxillofacial Diseases. 3rd Edition. more comprehensive and multidisciplinary approach to the London: Martin Dunitz, 2004 pp 549-567. management of addiction. 3. Sheridan J, Aggleton M, Carson T. Dental health and access to dental treatment: a comparison of drug users and non-drug users attending community pharmacies. Br Dent J 2001; 191: 453-457. 4. Warburton A L, Shepherd J P. Alcohol-related violence and the role of the oral and maxillofacial surgeon in multi-agency prevention. Int J Oral Maxillofac Surg 2002; 31: 657-663. 5. Underwood B, Fox K. A survey of alcohol and drug use among UK based dental undergraduates. Br Dent J 2000; 189: 314-317. 6. Plasschaert A J, Hoogstraten J, van Emmerik B J, Webster D B, Clayton R R. Substance use among Dutch dental students. Commun Dent Oral Epidemiol 2001; 29: 48-54. 7. Newbury-Birch D, Lowry R J, Kamali F. The changing patterns of drinking, illicit drug use, stress, anxiety and depression in dental students in a UK dental school: a longitudinal study. Br Dent J 2002; 15: 646-649.

147 BRITISH DENTAL JOURNAL VOLUME 198 NO. 3 FEBRUARY 12 2005