Oral Health in Substance Use and Eating Disorders

Proper dental care may sound like a small thing, but it’s anything but trivial. In fact, oral health is an investment in your overall physical health, both now and far into the future. Lack of proper dental care can lead not only to tooth decay, gum disease and cracked or broken teeth, but to far more serious problems such as damage to the liver, lungs, stomach, heart and brain. Numerous people die because of general infection, called septicemia, which originates from bacteria entering the bloodstream via caries damaged root canals and from inflamed gums. Mayo Clinic notes that early tooth loss (before age 35), may be a risk factor for Alzheimer’s disease.

In spite of the considerable risks, dental and oral problems are common for people who struggle with substance abuse and addiction and/or eating disorders. People who are addicted to drugs and alcohol tend to neglect regular brushing and flossing and may make the situation worse by using drugs and alcohol to self-medicate dental pain. Addicted people often rather spend money on their drug of choice than spending it on a good dentist or dental hygienist. Dental health should be restored once substance abusers enter drug and alcohol treatment, good treatment facilities pay attention to oral health and hygiene.

Alcohol is especially detrimental to oral health, as most alcoholic beverages contain lots of sugar, consisting of empty calories with little nutritional value. According to the Journal of Indian Society of Periodontology, at least 20 percent of alcoholics are malnourished.

Too much sugar weakens enamel and causes decay. Alcohol and drugs often cause vomiting, as does “sticking the finger down” with eating disorders such as Bulimia. Drug and alcohol related or induced vomiting creates a harmful buildup of gastric acid that erodes teeth. Saliva is necessary for dental health, as it contains beneficial enzymes and antibodies that fight many pathogens. However, alcohol, opiates and amphetamines tend to cause dry mouth, as do many prescription psychotropic drugs. Thirst is often quenched by sugary drinks, which compounds the problem.

Heroin and other opiates are also hard on the teeth, primarily because heroin users fail to care for their teeth, and because they often crave sweet foods and beverages. Unfortunately, heroin and other opiates tend to mask pain, which causes people to ignore infection and other dental problems.

Cannabis is considered by many to be a safe drug, but use of cannabis is linked to a high rate of gum disease. Additionally, cannabis smoke is a carcinogen that can cause dangerous lesions in the mouth, which can lead to fully-fledged cancer of the tongue, throat or esophagus.

Stimulants, including amphetamines and methamphetamines, can cause users to grind the teeth, which may result in loosened or lost teeth and may create problems requiring root canals or other oral surgery. “Meth mouth”, a condition often experienced by meth users, is the result of toxic chemicals that corrode the inside of the mouth and teeth. Black and broken teeth are common, the perfect entry point for bacteria which cause caries and gum disease – and with this, cause toothaches.

People who are addicted are often ashamed or afraid to address problems with a dentist. However, most dentists understand that drug and alcohol users, who have the same right to medical care as non-users, have special dental needs that must be addressed.

For those in drug and alcohol treatment or rehab, proper oral hygiene and appropriate, restorative and preventative dental care should be made a priority. We at Paracelsus do this routinely and thus increase the chance of physical and mental recovery from drugs and alcohol as well as eating disorders and many other mental health challenges.

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