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A research paper review by Dr Mark Alexander Hughes BA.BDentSc.(Dubl)
Harley Street Dental Studio, 42 Harley Street, London W1G 9PR
 View profile of Dr Mark Hughes, cosmetic dentist
It is widely recognised within the dental profession and in Oral Health research that there is often excessive deterioration of the health of the dentition and the oral soft tissues in those that suffer from drug and or alcohol addiction (1). This can often be quite severe, especially with severe and chronic drug dependency (2). A significant gap is regularly seen between the oral health status of such individuals and that of the general population (1,2,4).
Numerous studies, clinicians and researchers have all shown this to be the case, highlighting the fact that dental care should be an integral part of the overall care of the client that is receiving addiction treatment. Assessment of oral health status and a treatment plan for rehabilitation should be carried out as soon possible, as early intervention is crucial to limiting the extent of treatment required. Some of the research has highlighted deficiencies in the communication and collaboration between social care and dental health care (2).
The effects on the teeth and oral tissues range from dental caries (tooth decay) to periodontitis (gum diseases), dento-oral infections (tooth abscesses) and breakdown of the bite from attrition, erosive or mechanical wear (2,4). Early intervention is not only important for health reasons but also because extensive dental breakdown often requires lengthy, complicated or specialist care and is usually very expensive if done to a very high standard. Indeed severe dental breakdown and subsequent rehabilitation requires a lifetime of maintenance, whereas most dental disease is completely preventable.
Many systemic diseases have a physical presentation or symptom orally and so early detection of severe general illnesses can be provided by a dentist; early medicine often described the mouth as the mirror of the body.
From a psychological standpoint, the effects of a debilitated dentition can be quite profound especially if the appearance is adversely affected. Overall health will of course suffer with secondary diseases and infections from the mouth but of course the diet may suffer with a loss of ability to chew with ease or comfort, having a knock-on effect to general health.
It seems obvious, therefore, considering the evidence of the studies described, that a full dental and oral health examination should be routine as part of the initial health examination for anyone being treated for drug and or alcohol addiction. Good collaboration between all the health practitioners involved in treating the patient is key to a successful outcome for the client.
References
Click here to link to abstracts of the following studies
1. Dental health in Dutch drug addicts
Bert Molendijk, Gussje Ter Horst, Marcel Kasbergen, Gert-Jan Truin, Jan Mulder
Community Dentistry and Oral Epidemiology
Volume 24, Issue 2, Page 117-119, Apr 1996
2. Dental health in a group of drug addicts in Italy
Italo Francesco Angelillo, Guido Maria Grasso, Gaetano Sagliocco, Paolo Villari, Marcello Mario D'Errico
Community Dentistry and Oral Epidemiology
Volume 19, Issue 1, Page 36-37, Feb 1991
3. Differences in dental treatment plan and planning for drug-addicted and non-drug- addicted patients
Guusje ter Horst, Bert Molendijk, Elvi Brouwer, Hans G. C. Verhey
Community Dentistry and Oral Epidemiology
Volume 24, Issue 2, Page 120-123, Apr 1996
4. Dental health in a group of drug addicts attending an addiction-clinic
F. Scheutz
Community Dentistry and Oral Epidemiology
Volume 12, Issue 1, Page 23-28, Feb 1984
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