Thavarajah Rooban, Rao Anita, Raman Uma, Rajasekaran Saraswathi T, Joshua Elizabeth, R Hemalatha, Kannan Ranganathan
Ragas Dental College and Hospital, Chennai, India.
Arch Oral Biol. 2006 Jun;51(6):512-9. doi: 10.1016/j.archoralbio.2005.11.005. Epub 2006 Jan 17.
The aim of this study was to ascertain the prevalence of oral lesions among 500 psychoactive substance users in a hospital-based population. The study group consisted of 500 consecutive patients attending TTK Hospital, a non-governmental organisation involved in rehabilitation of substance users. Patient history was recorded in a pre-determined format and clinical findings were recorded by a trained physician and dental surgeons. Psychoactive substances used by the patients were alcohol (97%), tobacco (72%), arecanut (57.2%), narcotics (6.8%), cannabis (3.2%) and benzodiazipines (1.8%). Ninety-one percent of patients had one or more oral lesions: dental caries (39%), gingivitis (37.6%), extrinsic stains (24%), oral submucous fibrosis (OSF) (8%), periodontitis (7.4%), leukoplakia (6.6%), melanosis (5.2%), nicotina palatini (2.2%) and erythroplakia (0.6%). For OSF, those using arecanut and alcohol had an odds ratio (OR) of 2.4 [95% confidence intervals (CI) 1.23-4.69, P=0.009], smokers using arecanut products and alcohol had an OR of 3.07 (95% CI 1.59-5.91, P=0.000), and smokers who chewed arecanut products and used drugs had an OR of 23.1 (95% CI 2.05-260, P=0.001) compared with the general population. Those who smoked and used alcohol, arecanut and drugs had a 20.67-fold higher risk of developing leukoplakia compared with those who did not engage in these habits. In conclusion, 91% of patients had one or more oral lesions that needed dental treatment, and most patients were not aware of their oral lesions. The high prevalence of OSF and leukoplakia in substance abusers compared with the general population emphasises the need for regular dental assessments in these patients.
本研究的目的是确定一家医院中500名精神活性物质使用者口腔病变的患病率。研究组由连续就诊于TTK医院的500名患者组成，TTK医院是一家参与物质使用者康复工作的非政府组织。患者病史以预先确定的格式记录，临床检查结果由一名经过培训的内科医生和牙科外科医生记录。患者使用的精神活性物质包括酒精（97%）、烟草（72%）、槟榔（57.2%）、麻醉药品（6.8%）、大麻（3.2%）和苯二氮卓类药物（1.8%）。91%的患者有一处或多处口腔病变：龋齿（39%）、牙龈炎（37.6%）、外源性色斑（24%）、口腔黏膜下纤维化（OSF，8%）、牙周炎（7.4%）、白斑（6.6%）、黑变病（5.2%）、尼古丁性口炎（2.2%）和红斑（0.6%）。对于口腔黏膜下纤维化，使用槟榔和酒精的患者的比值比（OR）为2.4 [95%置信区间（CI）1.23 - 4.69，P = 0.009]，使用槟榔制品和酒精的吸烟者的OR为3.07（95% CI 1.59 - 5.91，P = 0.000），咀嚼槟榔制品并使用毒品的吸烟者的OR为23.1（95% CI 2.05 - 260，P = 0.001），与普通人群相比。与不有这些习惯的人相比，吸烟且使用酒精、槟榔和毒品的人患白斑的风险高20.67倍。总之，91%的患者有一处或多处需要牙科治疗的口腔病变，且大多数患者未意识到自己的口腔病变。与普通人群相比，物质滥用者中口腔黏膜下纤维化和白斑的高患病率强调了对这些患者进行定期牙科评估的必要性。
