School of Dentistry, University of California, Los Angeles, Los Angeles, CA 90095-1668, USA.
J Am Dent Assoc. 2010 Mar;141(3):307-18. doi: 10.14219/jada.archive.2010.0165.
Methamphetamine (MA) use has been linked anecdotally to rampant dental disease. The authors sought to determine the relative prevalence of dental comorbidities in MA users, verify whether MA users have more quantifiable dental disease and report having more dental problems than nonusers and establish the influence of mode of MA administration on oral health outcomes.
Participating physicians provided comprehensive medical and oral assessments for adults dependent on MA (n=301). Trained interviewers collected patients' self-reports regarding oral health and substance-use behaviors. The authors used propensity score matching to create a matched comparison group of nonusers from participants in the the Third National Health and Nutrition Examination Survey (NHANES III).
Dental or oral disease was one of the most prevalent (41.3 percent) medical cormorbidities in MA users who otherwise were generally healthy. On average, MA users had significantly more missing teeth than did matched NHANES III control participants (4.58 versus 1.96, P<.001) and were more likely to report having oral health problems (P<.001). Significant subsets of MA users expressed concerns with their dental appearance (28.6 percent), problems with broken or loose teeth (23.3 percent) and tooth grinding (bruxism) or erosion (22.3 percent). The intravenous use of MA was significantly more likely to be associated with missing teeth than was smoking MA (odds ratio=2.47; 95 percent confidence interval=1.3-4.8).
Overt dental disease is one of the key distinguishing comorbidities in MA users. MA users have demonstrably higher rates of dental disease and report long-term unmet oral health needs. Contrary to common perception, users who smoke or inhale MA have lower rates of dental disease than do those who inject the drug. Many MA users are concerned with the cosmetic aspects of their dental disease, and these concerns could be used as behavioral triggers for targeted interventions.
Dental disease may provide a temporally stable MA-specific medical marker with discriminant utility in identifying MA users. Dentists can play a crucial role in the early detection of MA use and participate in the collaborative care of MA users.
据传闻，甲基苯丙胺（MA）的使用与猖獗的牙科疾病有关。作者试图确定 MA 使用者的牙科共病的相对流行率，验证 MA 使用者是否具有更多可量化的牙科疾病，并且报告他们比非使用者有更多的牙科问题，并确定 MA 给药方式对口腔健康结果的影响。
参与的医生为依赖 MA 的成年人（n=301）提供全面的医疗和口腔评估。经过培训的访谈员收集了患者对口腔健康和物质使用行为的自我报告。作者使用倾向评分匹配从第三次全国健康和营养检查调查（NHANES III）的参与者中创建了非使用者的匹配对照组。
牙科或口腔疾病是 MA 使用者中最常见的共病之一（41.3％），他们通常身体健康。平均而言，MA 使用者的缺牙数量明显多于匹配的 NHANES III 对照组参与者（4.58 与 1.96，P<.001），并且更有可能报告存在口腔健康问题（P<.001）。MA 使用者的重要亚组对他们的牙齿外观（28.6％）、牙齿断裂或松动（23.3％）以及磨牙或侵蚀（22.3％）表示担忧。与吸食 MA 相比，MA 的静脉使用更有可能与缺牙相关（比值比=2.47；95％置信区间=1.3-4.8）。
明显的牙科疾病是 MA 使用者的主要共病之一。MA 使用者的牙科疾病发生率明显更高，并报告长期未满足的口腔健康需求。与普遍看法相反，吸食或吸入 MA 的使用者的牙科疾病发病率低于注射该药物的使用者。许多 MA 使用者对其牙科疾病的美容方面表示担忧，这些担忧可以作为针对干预措施的行为触发因素。
牙科疾病可能提供具有时间稳定性的 MA 特定医学标志物，在识别 MA 使用者方面具有鉴别力。牙医可以在早期发现 MA 的使用中发挥关键作用，并参与 MA 使用者的协作护理。
