title: Dental disease patterns in methamphetamine users: Findings in a large urban sample.
abstract: BACKGROUND
  The authors used a large community sample of methamphetamine (MA) users to verify the patterns and severity of dental disease and establish a hierarchy of caries susceptibility by tooth type and tooth surface.
  
  
  METHODS
  Using a stratified sampling approach, 571 MA users received comprehensive oral examinations and psychosocial assessments. Three calibrated dentists characterized dental and periodontal disease by using National Health and Nutrition Examination Survey protocols. The authors also collected data on substance use history and other attributes linked to dental disease.
  
  
  RESULTS
  On all dental outcome measures, MA users evidenced high dental and periodontal disease, with older (≥ 30 years) and moderate or heavy MA users disproportionately affected. Women had higher rates of tooth loss and caries, as well as a greater prevalence of anterior caries. Current cigarette smokers were more likely to manifest 5 or more anterior surfaces with untreated caries and 3 or more teeth with root caries. Nearly 3% were edentulous, and a significant percentage (40%) indicated embarrassment with their dental appearance.
  
  
  CONCLUSIONS
  MA users have high rates of dental and periodontal disease and manifest a dose-response relationship, with greater levels of MA use associated with higher rates of dental disease. Women and current cigarette smokers are affected disproportionately. The intraoral patterns and hierarchy of caries susceptibility in MA users are distinctive.
  
  
  CONCLUSIONS
  The prevalence and patterns of dental and periodontal disease could be used to alert dentists to possible covert MA use and to plan treatment. Concerns about dental appearance have potential as triggers for behavioral interventions.
authors.forename: Vivek
authors.initials: V
authors.lastname: Shetty
authors.forename: Lauren
authors.initials: L
authors.lastname: Harrell
authors.forename: Debra A
authors.initials: DA
authors.lastname: Murphy
authors.forename: Steven
authors.initials: S
authors.lastname: Vitero
authors.forename: Alexis
authors.initials: A
authors.lastname: Gutierrez
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Belin
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Dye
authors.forename: Vladimir W
authors.initials: VW
authors.lastname: Spolsky
mesh_terms: D000328:Adult; D019969:Amphetamine-Related Disorders / Q000150:complications*; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000139:chemically induced; D005260:Female; D006801:Humans; D015141:Los Angeles; D008297:Male; D008694:Methamphetamine / Q000009:adverse effects*; D010510:Periodontal Diseases / Q000139:chemically induced; D012907:Smoking / Q000009:adverse effects; D014076:Tooth Diseases / Q000139:chemically induced*; D016388:Tooth Loss / Q000139:chemically induced; D014505:Urban Population
chemical_list: D008694:Methamphetamine
keywords: Dental disease; methamphetamine use; patterns; severity