Professional Documents
Culture Documents
Related Disorders
Substance abuse is the regular use of a drug other than its accepted medical purpose or in
dosages greater than those that are considered appropriate
The most common drugs of abuse are alcohol and prescription drugs
There is no classic cultural, socioeconomic, or educational profile for a substance abuser
Alcohol
Clinical Pattern of Alcohol Use
• Genetics: GABRA2 & CHRM2 are the 2 genes involved in the predisposition. ALDH2
substantially, but not completely, protects carrier from developing alcoholism by making
them ill after consuming.
• Biopsychosocial: Parent-child influences
• Environmental: psychological stress, family, peers, and social forces. Lifestyle, culture,
and advertisements
Signs of Alcoholism
Dental professionals often have the first opportunity to treat early signs and symptoms of oral
complications for the substance abuser. It is very important to recognize the characteristics of each
patient before treatment as it is rare that a patient will disclose information about an addiction.
• Assess the patient by gathering a thorough medical history, keeping in mind that it may
be less reliable because many patients with drug abuse problems are in denial.
• Interview the patient and be motivational, empathetic, and non-judgmental. Patient's need to
understand the importance of the information as a health-safety measure and that all
information will remain confidential.
• Screen the patient using the CAGE questionnaire & 5 A's – Ask, Advise, Assess, Assist, Arrange
– used in tobacco intervention but may also be used with substance abusers.
• Vital signs are important because high blood pressure and fluctuations are common in
substance abusers
• Durning the Extraoral Exam, look for signs of substance abuse such as: red puffy eyes, dilated
or constricted pupils, needle track marks, slurred speech, drowsiness
• Intraoral exam looking for drug induced xerostomia, generalized poor oral hygiene,
chipped or fractured teeth, rampant carries
• Dental Hygiene Diagnosis: this consists of making your decision of patient care based on
the patient's oral condition and abuse habits.
• Develop a treatment plan to meet the induvial needs of the patient as identified by the
dental hygiene diagnosis. Priorities and goals are determined by the severity of the
problem.
• Implement – The clinical procedures are greatly influenced by the many health
problems that can result from drug use
• Evaluate by developing a continuing care plan to prevent progression or reoccurrence of disease
Dental Implications
Xerostomia is often a side effect of opiates, amphetamines, barbiturates, hallucinogens, marijuana, and
alcohol. The resulting decreased salivary flow makes users much more susceptible to dental caries and
periodontal diseases. Chemically dependent patients often crave sugar, which leads to the consumption
of large quantities of sweetened carbonated beverages, thereby increasing enamel erosion. Drug addicts
may also be at a higher risk of bruxism, dentin hypersensitivity, and NUG.
Dental Considerations
Treatment
Review Questions
True/False: The most common drugs of abuse are alcohol and prescription drugs
A) Opiates
B) Amphetamines
C) Barbiturates
D) Marijana