Methamphetamine Users Have Increased Dental Disease: A Propensity Score Analysis

V Shetty; L Harrell; J Clague; D A Murphy; B A Dye; T R Belin

doi:10.1177/0022034516640478

Methamphetamine Users Have Increased Dental Disease: A Propensity Score Analysis

J Dent Res. 2016 Jul;95(7):814-21. doi: 10.1177/0022034516640478. Epub 2016 Mar 18.

Authors

V Shetty¹, L Harrell², J Clague², D A Murphy³, B A Dye⁴, T R Belin³

Affiliations

¹ School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA vhetty@ucla.edu.
² School of Dentistry, University of California, Los Angeles, Los Angeles, CA, USA Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA.
³ Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, CA, USA.
⁴ National Institutes of Health, National Institute of Dental and Craniofacial Research, Bethesda, MD, USA.

Abstract

Methamphetamine (MA) users are assumed to have a high burden of tooth decay. Less clear is how the distribution and severity of dental caries in MA users differ from the general population. Using a covariate-balancing propensity score strategy, we investigated the differential effects of MA use on dental caries by comparing the patterns of decayed, missing, and filled teeth in a community sample of 571 MA users with a subset of 2,755 demographically similar control individuals selected from a National Health and Nutrition Examination Survey (NHANES) cohort. Recruited over a 2-y period with a stratiﬁed sampling protocol, the MA users underwent comprehensive dental examinations by 3 trained and calibrated dentists using NHANES protocols. Propensity scores were estimated with logistic regression based on background characteristics, and a subset of closely matched subjects was stratified into quintiles for comparisons. MA users were twice as likely to have untreated caries (odds ratio [OR] = 2.08; 95% confidence interval [95% CI]: 1.55 to 2.78) and 4 times more likely to have caries experience (OR = 4.06; 95% CI: 2.24 to 7.34) than the control group of NHANES participants. Additionally, MA users were twice as likely to have 2 more decayed, missing, or filled teeth (OR = 2.08; 95% CI: 1.29 to 2.79) than the NHANES participants. The differential involvement of the teeth surfaces in MA users was quite distinctive, with carious surface involvement being highest for the maxillary central incisors, followed by maxillary posterior premolars and molars. Users injecting MA had significantly higher rates of tooth decay compared with noninjectors (P = 0.04). Although MA users experienced decayed and missing dental surfaces more frequently than NHANES participants, NHANES participants had more restored surfaces, especially on molars. The high rates and distinctive patterns of dental caries observed could be used 1) to alert dentists to covert MA use in their patients and 2) as the basis for comprehensive management strategies.

Keywords: NHANES controls; distinctive patterns; epidemiology; high rates; methamphetamine use; propensity score matching.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adult
Amphetamine-Related Disorders / complications*
Case-Control Studies
DMF Index
Dental Caries / epidemiology
Dental Caries / etiology
Female
Humans
Male
Methamphetamine*
Nutrition Surveys
Propensity Score
Stomatognathic Diseases / epidemiology
Stomatognathic Diseases / etiology*

Substances

Methamphetamine

Abstract

Publication types

MeSH terms

Substances

Grants and funding