ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Methamphetamine Use Is Associated with a Greater Incidence of Dental Caries
Clinical Question In adult patients, does the use of methamphetamine increase the incidence of dental caries?
Clinical Bottom Line For adult patients using methamphetamine there is an increase in the incidence of dental caries. This is supported by two case control studies and one cross-sectional study that address dental caries in methamphetamine users, although the validity of the studies may be somewhat questionable. Both case control studies reveal that there is a higher incidence of caries in methamphetamine users. The cross-sectional study shows that there is consistency of the caries status found in methamphetamine users.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 26174081Rommel/2015100 adult crystal meth users and 100 age/gender matched controlsCase Control Study
Key resultsThe crystal meth-using group had a DMFT (Decayed, Missing, Filled Teeth) score of 12.3 ± 5.9, a DMFS (Decayed, Missing, Filled Surfaces) score of 32.5 ± 29.7, 3.4 ± 2.9 decayed teeth, and 4.7 ± 5.2 decayed surfaces. The control group had a DMFT score of 7.2 ± 5.9, a DMFS score of 17.9 ± 20, 0.7 ± 1.4 decayed teeth, and 0.9 ± 2.1 decayed surfaces. The crystal meth group had a higher DMFT score (p<0.001) and DMFS index (p<0.001), more teeth with carious lesions (p<0.001), and more surfaces with carious lesions (p<0.001) than the control group.
#2) 26610832Shetty/2015571 adult methamphetamine users (245 light users, 307 moderate/heavy users)Cross-Sectional Study
Key resultsThe light-methamphetamine user group had a mean DMFT score of 12.2 (95% CI: 11.4-13.0) and a Decayed Teeth mean of 1.81 (95% CI: 1.4-2.2). The moderate/heavy user group had a mean DMFT score of 13.1 (95% CI: 12.3-13.9) and a Decayed Teeth mean of 2.61 (95% CI: 2.2-3.0). In addition, 96% of the methamphetamine users in the study had experienced dental caries and 58% currently had untreated decay. Heavier use of methamphetamine suggests higher rates of tooth decay.
#3) 18245685Morio/200818 adult methamphetamine users and 18 age/gender matched controlsCase Control Study
Key resultsThe methamphetamine user group had decay in 61% ± 35% of anterior teeth, 61% ± 40% of premolars, and 86% ± 68% of molars while the non-user group had decay in 18% ± 34% of anterior teeth, 16% ± 32% of premolars, and 20% ± 33% of molars. In conclusion, methamphetamine users had a higher percentage of teeth with decay in anterior teeth (p<0.001), premolars (p<0.001), and molars (p<0.001) when compared to non-users.
Evidence Search "Dental Caries"[Mesh] AND "Methamphetamine"[Mesh] OR (("methamphetamine"[MeSH Terms] OR "methamphetamine"[All Fields]) AND ("dental caries"[MeSH Terms] OR ("dental"[All Fields] AND "caries"[All Fields]) OR "dental caries"[All Fields] OR "caries"[All Fields]))
Comments on
The Evidence
While “meth mouth” is a relatively well-known term, few clinical trials have been performed to validate that caries are directly associated with methamphetamine. In the Rommel study, bias may have occurred because the dental examiners assessed the control and crystal-meth-using groups separately. The dental examiners also individually selected the patients and were not blinded. In the Morio study, the number of patients involved in the research was inadequate, which likely affected the precision of the results. An increased sample size would have increased the precision of the results, which would then increase confidence in the estimates. Because the sample size was small, the percentages of the types of teeth affected by caries in this study may not be accurate across a larger population. Unfortunately, at this time there are no prospective cohort studies on this topic available that would provide superior evidence to confirm these findings.
Applicability At this time, research points to an association between methamphetamine use and an increased incidence of dental caries, but larger, more sophisticated studies must be completed to further validate the evidence. Additionally, the causes of “meth mouth” are multifactorial and need to be studied in further detail in order to better address and treat this condition.
Specialty/Discipline (General Dentistry) (Periodontics)
Keywords Methamphetamine, Dental Caries
ID# 3072
Date of submission: 04/13/2016spacer
E-mail gibsoncb@livemail.uthscsa.edu
Author Christopher Gibson
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Peggy Alexander, DDS, MPH
Faculty mentor/Co-author e-mail AlexanderP2@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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