HJAR May/Jun 2022

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2022 51 acidic. With the possibility of acid reflux, this combination of sugars and gastric acids can wear away at the enamel. Cosmetically, stains originating from red wine and brown liquors can stain teeth and look unappeal- ing. Chronic alcoholics are more prone to carcinoma of the tongue, have prolonged bleeding, and often have poor healing. 14 In order to prescribe medication to ef- fectively control pain in treating patients, healthcare providers must understand the pharmacology and the duration of these drugs patients have used. 15 Often times, the recovering addict is under contract with a pain specialist. It is essential for all health- care providers to communicate collabora- tively and plan treatment accordingly in the care of their patients. In general, patients with a chemical de- pendency or with a past history of sub- stance misuse are difficult to anesthetize adequately. It is absolutely contraindicated to anesthetize while a patient is intoxicated or under the influence of a substance. Alco- hol affects the cardiovascular, respiratory, and metabolic systems and can lead to seri- ous complications. It is unwise to mix this combination when treating patients. 16 It is paramount that the healthcare pro- vider not only take a thorough medical his- tory, but also examine by looking, listening, and providing a platform for open commu- nication. The interaction between the patient and provider is essential for extracting vital information to understand the context of the patient’s problems with addiction. This leads to having full comprehension of the risk factors associated with the patient’s substance use and ensures treating in the safest method with optimal outcomes. n disease is common with methamphetamine drug use. The term “meth mouth”is used to describe the deterioration of the decayed and blackened presentation of the dentition. Meth mouth has been compared to bottle caries in infants. These patients crave sug- ary drinks and have a suppression of appe- tite along with any routine or daily dental care. Xerostomia causes reduction of saliva, which in turn promotes dental caries at a high rate. The short-term psychological ef- fects of euphoria and long-term effects of depression and memory loss can result in total neglect of oral care. 11 In chronic use of methamphetamine, bruxism and jaw clenching are well-docu- mented. The large intake of acidic carbon- ated drinks and xerostomia mixture result in rampant decay and deterioration of teeth. As this grinding habit continues, teeth are broken due to the weak, carious condition of the teeth. Temporomandibular dysfunc- tion (TMD) and joint pain is a common find- ing among those with this addiction. 12 The dentist must be acutely aware in treating these patients, as the duration of meth- amphetamine can last up to 24 hours, and local anesthetic with a vasoconstrictor is contraindicated. Alcoholism and misuse of alcohol is often a concealed condition since it can be hidden cleverly. Many responsible and financially secure individuals have succumbed to this socially acceptable and legal form of drug use and are highly functioning alcoholics. 13 This intoxicating and potentially addictive substance is created from fermented sugars and can include added sugars. A faster for- mation of plaque is noted, which can lead to caries, given that alcohol is chemically Niki Carter, DMD, MPH Dental Director Delta Dental of Arkansas REFERENCES 1 U.S. Dept. of Health and Human Services.“What is the U.S. OpioidEpidemic?”Oct.27,2021 .https://www.hhs.gov/opioids/ about-the-epidemic/index.html 2 Shekarchizadeh,H.; Khami,M.R.; Mohebbi,S.Z.; et al.“Oral healthstatusand itsdeterminantsamongopiatedependents: a cross-sectional study.” BMC Oral Health 19, no. 5 (2019). https://doi.org/10.1186/s12903-018-0691-3 3 American Dental Association, Council on Den- tal Practice. “Dentist Well-Being Program Direc- tory.” ADA Policy Statements (2005). https://www. d e n t i s t w e l l b e i n g . c o m /p d f /A DA _ D e n t i s t _ WellBeing_Program_Dir.pdf 4 Khalsa,J.;Treisman,G;McCance-Katz,E.;Tedaldi,E.“Medical Consequences of Drug Abuse and Co-occurring Infections.” Substance Abuse 29, 3 (2008): 5-16. https://www.ncbi.nlm . nih.gov/pmc/articles/PMC2654580/ 5 Shekarchizadeh,H.; Khami,M.R.; Mohebbi,S.Z.; et al.“Oral Health of DrugAbusers:AReview of Health Effects and Care.” IranJPublicHealth42,9(Sep2013):929-40.https://pubmed. ncbi.nlm.nih.gov/26060654/ 6 Denisco, R.; Kenna, G.; O’Neil, M.G.; et al. “Prevention of prescription opioid abuse: the role of the dentist.”Journal of theAmerican DentalAssociation 142,7 (July 2011): 800-810. https://jada.ada.org/article/S0002-8177( 14)62264-9/fulltext 7 National Institute on Drug Abuse, NIH. “Most Commonly UsedAddictiveDrugs.”July,2018. https://archives.drugabuse. gov/publications/media-guide/most-commonly-used-addic- tive-drugs#:~:text=Marijuana,for%20medical%20and%20 recreational%20use. 8 Johns Hopkins Medicine. “Substance Abuse/Chemi- cal Dependency.” Accessed April, 2022. https://www. hopkinsmedicine.org/health/conditions-and-diseases/ substance-abuse-chemical-dependency 9 Teoh, L.; Moses, G.; McCullough, M.J.“Oral manifestations of illicit drug use.” Australian Dental Journal 64, 3 (Sept. 2019):213-222. https://pubmed.ncbi.nlm.nih.gov/31309583/ 10 Hansen, C.; Alas, H.; Davis Jr., E. “Where Is Mari- juana Legal? A Guide to Marijuana Legalization.” Jan. 6, 2022. https://www.usnews.com/news/best- states/articles/where-is-marijuana-legal-a-guide-to- marijuana-legalization 11 NIDA. “What are the long-term effects of meth- amphetamine misuse?” Jan. 12, 2022. https:// nida.nih.gov/publications/research-reports/ methamphetamine/what-are-long-term-effects- methamphetamine-misuse 12 Rommel, N.; Rohleder, N.H.; Koerdt, S; et al. “Sympatho- mimetic effects of chronicmethamphetamine abuse on oral health: a cross-sectional study.”BMC Oral Health 16, art. 59 (May 26,2016) .https://bmcoralhealth.biomedcentral.com/ articles/10.1186/s12903-016-0218-8 13 Solomons,Y.F.; Moipolai,P.D.“Substance abuse: caseman- agementanddentaltreatment.”SouthAfricanDentalJournal 69,7 (Aug 2014): 298,300-15 .https://pubmed.ncbi.nlm.nih . gov/26548211/ 14 Edwards,R.; Mosher,V.“Alcohol abuse,anaesthesia,and in- tensivecare.”Anaesthesia35,5(May,1980):474-489.https:// associationofanaesthetists-publications.onlinelibrary.wiley. com/doi/10.1111/j.1365-2044.1980.tb03825.x 15 Hussain,F.; Frare,R.; Py Berrios,K.L.“Dental Management of Patients with a History of Substance Abuse with Special Consideration for Addicted Pregnant Women and Addicted Dental Care Providers.” Oral Health. March 1, 2013. https:// www.oralhealthgroup.com/features/dental-management- of-patients-with-a-history-of-substance-abuse-with-special- consideration-for/ 16 Xin, L.Q.; Kumar, D. “Efficacy of Local Anesthetics on Al- coholics.” International Journal of Advanced Research 2, 2 (2014):44-47 .http://www.journalijar.com/uploads/565_IJAR- 2594.pdf