Dental disease patterns in methamphetamine users

Findings in a large urban sample



      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.


      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.


      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.


      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.

      Practical Implications

      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.

      Key Words

      Abbreviation key:

      DMFT (Decayed, missing, or filled teeth), MA (Methamphetamine), NHANES (National Health and Nutrition Examination Survey)
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      Dr. Shetty is a professor, School of Dentistry, University of California, Los Angeles, 23-009 UCLA Center for Health Sciences, 10833 Le Conte Ave., Los Angeles, CA 90095-1668.


      Dr. Harrell is a research associate, School of Dentistry, and a post-graduate fellow, Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA.


      Dr. Murphy is a professor, Integrated Substance Abuse Programs, University of California, Los Angeles, CA.


      Dr. Vitero is a medical director, Dental Services, AIDS Project Los Angeles, Los Angeles, CA.


      Dr. Gutierrez is a lecturer, School of Dentistry, University of California, Los Angeles, CA.


      Dr. Belin is a professor, Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA.


      Dr. Dye is a dental epidemiology officer, National Institutes of Health, National Institute of Dental and Craniofacial Research, Bethesda, MD.


      Dr. Spolsky is an associate professor, School of Dentistry, University of California, Los Angeles, CA.

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      • Correction
        The Journal of the American Dental AssociationVol. 147Issue 1
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          In the December article titled “Dental Disease Patterns in Methamphetamine Users: Findings in a Large Urban Sample” by Vivek Shetty, DDS, DrMedDent, and colleagues (JADA. 2015;146[12]:875-885), Dr. Shetty’s e-mail address should be . This has been updated in the online version of the article. JADA regrets the error.
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