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Impact of Drug Abuse on Oral Health

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Impact of Drug Abuse on Oral Health

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Drug abusers are prone to oral tissue infections and cancers and have exacerbated oral disease that they often ignore. Please read the article to know the commonly abused substances and their adverse impact on oral health.

Medically reviewed by

Dr. Anuthanyaa. R

Published At July 15, 2021
Reviewed AtAugust 1, 2023

Introduction:

Drug abuse or substance abuse occurs due to direct consequences like multiple physical and mental issues. They are respiratory distress, liver cirrhosis, nephropathies, cardiac crisis, infectious diseases such as hepatitis, AIDS (acquired immunodeficiency syndrome), injury-associated disabilities, mental disorders (depression), and oral health issues.

Oral health complications are amongst the most prevalent comorbidities related to addictions that mainly involve the onset of tooth mobility and subsequent loss of the tooth, chronic periodontal disease, mucosal dysplasia, xerostomia, parafunctional habits like bruxism or night grinding, and regressive alterations of teeth or tooth (abrasion, resorption, erosion, and attrition).

How Is Drug or Substance Abuse Classified?

The main categories of illegal drug impact are evidently classified apart from the major detrimental or deleterious habits that impact systemic as well as oral health like,

  • Tobacco use.

  • Smoking.

  • Alcohol drinking.

Tobacco usage mainly constitutes nicotine components as potential carcinogens that interfere with systemic health status and are the leading risk factors for oral and lung cancers. At the same time, alcohol abuse is associated with acid reflux, tooth staining, and a faster build-up of dental plaque resulting in aggravated forms of gingival and periodontal diseases apart from systemically mainly impacting the heart and liver.

Oral health issues associated with drug abuse result from exposure to oral tissues by ingestion or biological interaction of these substances with the normal physiology that the oral cavity possesses. The effect of drugs on brain function also results in addictive behaviors like risk-taking, careless behavior, poor or compromised oral hygiene, and unwanted aggression. The commonly abused drugs are as follows:

  1. Opioid abuse.

  2. Amphetamine and club drug abuse.

  3. Marijuana abuse.

  4. Cocaine abuse.

  5. Prescription drugs and OTC drug abuse.

1. Opioid Abuse - Although opioids and opiates are not generally considered stimulant drugs, they have the properties of being both a depressant and a stimulant. The side effects of this substance abuse include grinding of teeth, cracked teeth, and damage to the jaw bone (for example, heroin causes sugar or sweet consumption cravings that damage the tooth enamel and root). A higher risk of oral infections that may be fungal or viral is commonly observed in these users.

Opioids act mainly by reducing pain and stimulating pleasure by acting on three main receptors distributed in the brain, peripheral nociceptors and the spinal cord -mu, kappa, and delta receptors. Thus as a mechanism of opioid action, tooth sensitivity and associated sensations of the tooth nerve or the dental pulp or root canal is also reduced, which would lead to the user ignoring the pain from cavities or gum disease.

Prescription opioid use, which is legal in most countries even when correctly prescribed by the doctor or dental surgeon, can be severely addictive to a substance abuser. Withdrawal symptoms of severe cravings, sleep issues, muscle and bone problems are seen in such substance abusers if they are prescribed opiate drugs.

2. Club Drugs and Amphetamine Abuse - Club drugs are derivatives of Amphetamine, like ECSTASY, MDMA and cause the users to be addicts of parafunctional habits like,

  • Grinding their teeth produces cracks.

  • Tooth wear like abrasions and abfractions.

Xerostomia or dry mouth associated with dehydration can also cause cracked enamel and tooth wear. One of the most commonly abused stimulants is methamphetamine, also known as meth, speed, crack, tweek, or chalk is a white crystalline powder that is available in smokable or injectable forms.

Meth is taken for recreation purposes to create euphoria as well as an aphrodisiac. Orally periodontal disease and rampant dental caries are manifestations commonly seen as “meth mouth.” Systemic manifestations include loss of appetite, hyperactivity, sweating, rapid breathing, and tachycardia or bradycardia.

3. Marijuana - Smoking marijuana is associated with a condition called “Cannabis Stomatitis” (gingival enlargement, erythroplakia, and chronic inflammation of the oral mucosa with hyperkeratosis and leukoplakia) which can lead to malignant oral cancers or throat cancers. The risk and aggressiveness of cannabis-related cancers are incidentally higher in the population below 50 years of age.

According to the American Dental Association, it has been hypothesized that the hydrocarbons present in cannabis are an energy source for dense colonization by the fungal species Candida albicans that cause oral candidiasis. This drug is also known to cause dry mouth or xerostomia, and methamphetamine causes the wearing of tooth enamel because of an imbalance of acids in the mouth. In addition, Cannabinoid hyperemesis can occur, causing frequent bouts of vomiting and the consequent stomach acids that produce oral manifestations like dental caries and rampant tooth decay.

4. Cocaine - It is a highly acidic and potent stimulant that, on contact with the surface of enamel, creates a breakdown of the enamel calcium hydroxyapatite crystals. It is available both in smokable and powdered form. The powdered form of cocaine is the most common of which “crack cocaine” leads to painful mouth sores and infectious ulcers. In the upper palate, oronasal communication can be established by the regular snorting of cocaine along with dentofacial destructive processes like sinonasal tract necrosis with long-term nasal cocaine abuse. Jaw spasms or mouth-related muscle spasms called “buccolingual dyskinesia” are a form of movement disorder caused by the regular consumption of cocaine.

5. Prescription and OTC Drugs - These drugs are the commonly used antihistamines and over-the-counter medications that cause regressive tooth alterations. Antihistamines produce dry mouth or xerostomia, and it is the common side effect that leads to gingival inflammation and ulcers (as the saliva is both antimicrobial and contains immunoglobulins or antibodies for oral defense). Prescription asthma medications, oral contraceptives, immunosuppressant drugs also cause xerostomia. Even frequent use of cough syrups can be detrimental to the tooth enamel containing calcium hydroxyapatite crystals that are affected because of high sugar content.

Conclusion:

Drug abuse is always considered an epidemic, and oral health complications are among the most noticeable side effects of drug abuse. Therefore, public awareness of the dangers of these substances and their adverse impact on systemic health, along with timely intervention and support management like behavioral counseling by the dental surgeon or physician, will synergistically impact the oro-systemic management of drug abusers.

Frequently Asked Questions

1.

Do Drugs Induce Tooth Decay?

Consumption of recreational drugs harm gums and teeth. Methamphetamine is one of the stimulants that are most frequently abused. Meth is used recreationally as an aphrodisiac and to induce euphoria. Orally, meth mouth is characterized by widespread tooth caries and periodontal disease.

2.

What Variables Influence Oral Health?

Several modifiable risk factors, such as sugar consumption, cigarette use, alcohol use, poor hygiene, and underlying social and economic determinants, are linked to numerous noncommunicable diseases (NCDs), including oral disorders.

3.

What Are the Four Possible Adverse Effects of Drug Abuse?

The following are the adverse effects of drug abuse:
- A feeling of pleasure or being high.
- Elevated mood.
- Changed visual, auditory, and taste perception.
- Extreme excitement or anxiousness.

4.

What Medications Induce Tooth Decay?

 
- One of the narcotics that possess the greatest risk to oral health is Methamphetamine. In a very short duration, the meth compound in Methamphetamine tears away tooth enamel, accelerating tooth decay.
- Drugs like anticholinergic (Dicyclomine, Scopolamine) and anti-depressive (Agomelatine, Doxepin) produce dry mouth and further contribute to an acidic environment in the oral cavity, leading to tooth decay.

5.

What Medicine Cause Discoloured Teeth?

 
It has long been recognized that several medicines can stain developing children's teeth. Tetracycline, Doxycycline, and antibiotics can interfere with the development of enamel in young infants (under the age of 8). Also capable of discoloring teeth are mouthwashes and rinses with Cetylpyridinium chloride and Chlorhexidine. Drugs used to treat hypertension, antipsychotics, and antihistamines can also stain teeth.

6.

What Drugs Causes Front Tooth Decay?

Methamphetamine is also known as ice, crystal meth, glass, shards, or puff. These drugs cause significant tooth decay in a relatively short period of time.

7.

How Does Smoking Lead to Poor Dental Hygiene?

Smoking affects the gums because it lowers the amount of oxygen in the blood, which prevents the infected gums from healing. Smoking increases dental plaque and accelerates the progression of gum disease compared to non-smokers.

8.

How Can Smoking and Alcohol Affect Oral Health?

Abuse of alcohol and cigarettes is harmful to oral and overall health and has negative consequences on the oral mucosa. The risk of mouth and throat cancer significantly rises when alcohol and cigarettes are combined.

9.

What Medicines Cause Bad Breath?

Some drugs may cause dry mouth, which can result in bad breath. Anticholinergics, sedatives, amphetamines, antidepressants, diuretics, decongestants, antihistamines, and various vitamin supplements are examples of medications.

10.

What Medicines Cause Teeth to Darken?

Tooth discoloration is an adverse effect of numerous drugs. As a result of receiving the common antibiotics Doxycycline or Tetracycline as a child, the patient's teeth may darken. Medications for high blood pressure, antipsychotics, and antihistamines can also stain teeth.

11.

What Are the Three Pillars of Oral Health?

The following are the three pillars of oral health:
- Brushing your teeth twice daily.
- Flossing every day.
- Using fluoride treatments, pastes, rinses, or both.

12.

What Is the Most Significant Role in Oral Health Care?

Bacteria are often controlled by the body's natural defenses and regular oral hygiene practices like twice daily brushing and flossing. In contrast, if oral hygiene is not practiced, germs may build up to a point where they could cause oral infections, including tooth decay and gum disease.

13.

What Are the Symptoms of Inadequate Oral Hygiene

The following are the symptoms associated with inadequate oral hygiene:
- Bad breath.
- Bleeding gums.
- Dry mouth.
- Tooth decay.
- Tooth erosion.
- Gum disease.

14.

How Does Nicotine Affect the Mouth?

Tobacco's nicotine slows down the salivary flow, causing symptoms of dry mouth. Less saliva creates a suitable environment for bacteria that produce acid, eventually leading to tooth decay.
Dr. Achanta Krishna Swaroop
Dr. Achanta Krishna Swaroop

Dentistry

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