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Effects of Drug Abuse on Oral Health

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Effects of Drug Abuse on Oral Health Review Article DOI: 10.18231/2455-1732.2018.0016 Effects of drug abuse on oral health Deepmala1,*, Shweta Bali2, Meenu Taneja3, Priyanka3 1PG Student, 2Professor & HOD, 3,4Reader, Dept. of Periodontics and Oral Implantology, Santosh Dental College & Hospital, Ghaziabad, Uttar Pradesh, India *Corresponding Author: Email: [email protected] Abstract Drug abuse is one of major global concern among the social and medical ills of the twentieth century. Substance abuse ranks as one of the devastating and costly affairs in a present situation. These addictive drugs stimulating the brain, flooding it with neurotransmitters like dopamine which induces adaptive changes in the brain so that drug abuse may become compulsive for them. Thus drug abuse affect systemic as well as the oral health. This article discuss about the various drugs of abuse and their effect in the oral cavity along with the careful management of these addicts in the Dental clinic. Keywords: Hallucinogen, Cannabis, Narcotics, Addiction, LXE. Introduction occur. In heroin abuse, increased numbers of decayed, The use of illicit drug has increased worldwide. missing and filled teeth can be detected in the mouth. According to UNO (United nation office) on drug and Marijuana abuse can lead to acidic erosion of enamel crime 243 million people age (15-64yrs.) are users of caries due to cannabinoid hyper emesis in which illicit drug.1 Substance abuse is on rising trend more frequent episodes of vomiting occur. These patients common in males then females. WHO (World Health also develop dental caries, inflammation and Organization) estimated that 2 billion people hyperplasia of gingiva, uvulitis, leukoplakia, oral consuming alcohol and 76.3 million people have papilloma, and tongue carcinoma. Similarly high complication related to alcohol abuse. Substance Abuse incidence of oral cancer, leucoedema, leucoplakia and mental Health Services Administration year 2000 stomatitis, acute necrotizing ulcerative gingivitis, adult survey report that addicts are physically and periodontitis is associated with increased use of psychologically dependent on them and neglect their tobacco. Effects of alcohol misuse has found to be non- oral and systemic health and also reported that heavy carious tooth surface loss (Chemical Erosion), facial alcohol drinking and illicit drug use is increasing injury and mandible fracture, and addictive effects with worldwide and causes serious health problems.2 tobacco increases 80 times risk of cancer in patients of Addicts are physically as well as psychologically alcohol abuse.5 dependent on them. These addicts not only neglect their nutrition, health but as well as their oral health also. In Table 1: Commonly abused drug addition to the direct effects of drugs on oral health Substance abuse Type drug abuse may aggravate oral problem indirectly Narcotic Analgesic Opium, morphine, codeine, through its adverse effects on user’s behavior and Buprenorphine lifestyle. Irregular eating pattern, poor oral hygiene, Stimulants Amphetamine, cocaine irregular dental visits and consumption of more sweet Depressants Sedative-Hypnotics, food affects their oral health.3 barbiturate, benzodiazepine Systemic effects of substance abuse: Drug addiction Hallucinogens LSD(lysergic acid has many deleterious effects systemically such as diethylamide)oral tablets, depression, anxiety, memory loss, various PSP(snorted or smoked) neuropsychological disorders and even death can occur Cannabis Ganja, marijuana, hashish, because of internal bleeding or malignant charas, hashish oil, bhang 4 hyperthermia. Others Tobacco ,Alcohol, Heroin, Oral Manifestation of Drug Abuse: Many of the Ecstasy, Qat leaves abused substance have devastating consequences on oral health like mucosal ulceration dental Caries, tooth Effect of substance abuse on periodontal health: wear, meth mouth (Rampant dental caries), Xerostomia, Drug addicts have high tendency for moderate to severe Muscle Pain, Loss of sensation, grinding of teeth or periodontitis characterized by loss of attachment. bruxism. Cocaine can cause movement disorder Addicts have high rate of plaque and calculus manifest itself as transient chorea. Additionally deposition resulting from oral hygiene neglect, buccolingual dyskinesia commonly known as “crack xerostomia alteration in microbial profile.6 Alcohol dancing” or boca torcida means twisted mouth can abuse has been associated with increased risk of Santosh University Journal of Health Sciences, July-December, 2018;4(2):66-68 66 Deepmala et al. Effects of drug abuse on oral health periodontal problems like gingival infection, increased given. Minimum use of antibiotics and postpone the pocket depth and loss of attachment.7 This occurs due treatment if drug is used with in 24 hour. to decreased resistance to infection by gram negative organisms during acute alcohol intoxication.8 Discussion Factors for Increase Orodental Diseases: Drug abuse results in several direct consequences Carbohydrate craving, use of carbohydrates additives in like multiple physical, mental and emotional problems. drug mix, masking of dental pain, poor nutrition, Medical problems includes cardiac arrest, respiratory xerostomia, lack of dental hygiene.9 depression, liver cirrhosis, nephropathy, infectious Factors Act as a Barrier to Care: Prolonged binging diseases such as tuberculosis, liver hepatitis AIDS, on drugs, Long waiting list for drug treatment and injury associated disability whereas mental disorder rehabilitation, Low self esteem or finance and poor include depression.13 acceptability of services.10 Medical complication that related to dentistry include Oral Management Implications in Substance Abuse: abscesses at the injection site, viral hepatitis, Human Identify the dental patients with substance abuse by Immunodeficiency Virus, endocarditis and anesthesia proper medical history, extra oral observation and related problems.14 clinical examination. Vital signs and needle tracks can The long term effects of drugs abuse is the risk of be detected while taking blood pressure at each visit. developing permanent brain damage. In some case it Pain tolerance may be decreased in these patients.11 may leads to death due to malignant hyperthermia, Patient may present with cutaneous manifestation i.e. internal bleeding fatal overdosing and allergic infection and cellulites of the area where drug has been reactions.15 As we all now oral health is a part of injected, delayed leg ulcer and nasal necrosis in cocaine general health so health and wellbeing are likely to be abusers. Pop scars i.e. localized infection heals with improved by all efforts at oral health promotion. characteristic irreversible scarring, gangrene of Rehabilitation center help these patients to take control extremities can be present with cocaine abusers.12 of their lives and focus more on their health. Hence Substance abusers have frequent missed appointment. these centers can play an important role in changing Facial or Oral Signs of Substance Abuse: Red face, patient’s behavior.16 Improved access to dental health blood shot eyes, enlarged parotid gland and breath odor care via these centers might lead to change the lifestyle are indicative of alcohol abuse. Periodontitis in and behavior of the patients and in turn in improve the adolescents is suggestive of marijuana abuse. Excessive success of withdrawal treatment. So for these we have bleeding during procedure, reduced salivary flow, large to come out with more oral health promotion programs cervical caries (Rampant caries) on buccal surface are at these centers and should prepare our self for such also indicators of patients with substance abuse. patients. Management of these Patients: There should be cautious use of local anesthesia in these patients also Conclusion the use of vasoconstrictor should be limited during The problem of Substance abuse has emerged has procedure. Non Steroid Anti Inflammatory Drugs a major issue in society and has become an area of (NSAIDs) for pain relieving should be used. For major focus for healthcare professionals. All dental care Alcoholic patients, acidic drugs example Aspirin and providers can expect to see number of substance NSAIDs should be avoided. Non alcoholic mouth rinses abusing patients. Extra caution has to be taken to should be prescribed and use of antibiotics should be minimize drug interactions, adverse effects while limited in these patients. Postpone the treatment if drug achieving this goal. Dentists should follow proper is used within 24 hours of appointment. Corticosteroid protocol while handling such kind of patients. Better can be used to reduce inflammation and swelling. Long dental care for patients who abuse illicit is needed to acting anesthesia should be used for endodontic and promote their oral health. Widespread education is surgical procedures. Comprehensive oral hygiene needed to prepare our community to handle the regime can be given like sialagogues, sugarless demands. In addition collaboration between the social chewing gums. Oral moisturizer can be prescribed. and health care sectors is required for their Application of regular neutral fluorides is management. recommended and antifungal treatment should be given in subsequent visit. References Special care in pregnant women as substance 1. Marques et al. The Impact of Oral Health Conditions Abuser: Substance used by pregnant women is a Socioeconomic states and use of specific substance on leading preventable cause of mental, physical and quality of life of
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