Baghaie Hooman, Kisely Steve, Forbes Malcolm, Sawyer Emily, Siskind Dan J
School of Dentistry, The University of Queensland, Herston, QLD, Australia.
School of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.
Addiction. 2017 May;112(5):765-779. doi: 10.1111/add.13754. Epub 2017 Mar 16.
Substance use disorders are associated commonly with comorbid physical illness. There are fewer data on dental disease in these conditions, in spite of high rates of dry mouth (xerostomia), as well as the associated indirect or life-style effects such as poverty and lack of access to care. We compared the oral health of people with substance use disorders (SUDs) with non-using controls.
This was a systematic search for studies from the last 35 years of the oral health of people reporting SUDs. We used MEDLINE, PsycInfo, OVID, Google Scholar, EMBASE and article bibliographies. Results were compared with the general population. Oral health was assessed in terms of dental caries and periodontal disease using the following standardized measures: the mean number of decayed, missing and filled teeth (DMFT) or surfaces (DMFS) and probing pocket depth. Non-carious tooth loss was assessed clinically.
We identified 28 studies that had sufficient data for a meta-analysis, comprising 4086 SU patients and 28 031 controls. People with SUD had significantly higher mean scores for DMFT [mean difference = 5.15, 95% confidence interval (CI) = 2.61-7.69 and DMFS (mean difference = 17.83, 95% CI = 6.85-28.8]. They had more decayed teeth but fewer restorations, indicating reduced access to dental care. Patients with SUD also exhibited greater tooth loss, non-carious tooth loss and destructive periodontal disease compared to controls.
Patients with substance use disorders have greater and more severe dental caries and periodontal disease than the general population, but are less likely to have received dental care.
物质使用障碍通常与共病的躯体疾病相关。尽管口干（口腔干燥症）发生率很高，且存在贫困和难以获得医疗服务等相关间接或生活方式影响，但关于这些情况下牙科疾病的数据较少。我们比较了物质使用障碍（SUD）患者与非使用者对照的口腔健康状况。
这是一项对过去35年报告有SUD患者口腔健康研究的系统检索。我们使用了MEDLINE、PsycInfo、OVID、谷歌学术、EMBASE和文章参考文献。将结果与一般人群进行比较。使用以下标准化测量方法从龋齿和牙周疾病方面评估口腔健康：龋失补牙平均颗数（DMFT）或龋失补牙面平均个数（DMFS）以及探诊袋深度。临床上评估非龋性牙齿缺失情况。
我们确定了28项有足够数据进行荟萃分析的研究，包括4086名SUD患者和28031名对照。SUD患者的DMFT平均得分显著更高[平均差值 = 5.15，95%置信区间（CI）= 2.61 - 7.69]，DMFS也是如此（平均差值 = 17.83，95% CI = 6.85 - 28.8）。他们有更多的龋齿但补牙较少，表明获得牙科护理的机会减少。与对照组相比，SUD患者还表现出更多的牙齿缺失、非龋性牙齿缺失和破坏性牙周疾病。
物质使用障碍患者比一般人群有更严重的龋齿和牙周疾病，但接受牙科护理的可能性较小。
