TABLE 4.
Dental and periodontal conditions and treatment considerations in illegal drug users (modified from O'Neil Wiley Blackwell 2015 (81)
Used illegal drug | Psychiatric signs and symptoms | Physical examination findings | Dental conditions | Periodontal conditions | Dental treatment considerations |
---|---|---|---|---|---|
Cannabis |
Euphoria Hyperactivity Dissociation Tachycardia Paranoia Delusions Hallucinations |
Poor coordination Irritated conjunctiva |
Xerostomia Increased risk of caries Leukoplakia |
FRC users exhibit deeper PDs, higher AL score and higher odds of having severe periodontitis than non‐FRC users. Gingivitis; gingival enlargement and possible ulcerative conditions |
Avoid local anesthetic with epinephrine Xerostomia treatment products Topical fluoride treatment Avoid treatment at least 24 h from last drug use |
Cocaine and crack |
Euphoria Insomnia Paranoia Dissociation Aggressive behavior Delirium Restlessness |
Nasal septal and palatal necrosis and perforation Powder in nares Weigh loss Dilated pupils Tachycardia Skin abscess Slurred speech Vomiting Increased heart rate Wide QRS complex and QT/QTc prolongation |
Xerostomia Occlusal wear Generalized caries Bruxism Orofacial pain Graft failure Alterations of taste perception Keratinization of oral mucosa Discoloration of saliva Involuntary facial movements |
NUG Gingival ulceration and erythema Painful gingival retraction Periodontitis No alterations in microbiota composition and counts |
Avoid local anesthetic with epinephrine Occlusive guards Topical fluoride treatment Avoid treatment at least 24 h from last drug use |
Methamptemins; ecstasy and MDMA |
Euphoria Dissociation Panic reactions Impulsive behavior Depression Psychotic episodes |
Black rotting teeth Nasal septal necrosis Poweder in nares Mucus discharge from the naris Jaw clenching Jaw soreness Xerostomia Occlusal wear Generalized caries Bruxism |
Dehydration Dilated pupils Excessive sweating Tachycardia Skin abscess Weigh loss Burnt fingers Track marks |
Abbreviations: AL, attachment loss; FRC, frequent recreational cannabis; MDMA, 3,4‐Methylenedioxy‐Methamphetamine; NUG, necrotizing ulcerative gingivitis; PD, probing depth.