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Review
. 2022 Oct;90(1):62-87.
doi: 10.1111/prd.12450.

Illegal drugs and periodontal conditions

Alessandro Quaranta  1   2 , Orlando D'Isidoro  3 , Adriano Piattelli  4   5 , Wang Lai Hui  2 , Vittoria Perrotti  6
Affiliations
Review

Illegal drugs and periodontal conditions

Alessandro Quaranta et al. Periodontol 2000. 2022 Oct.

Abstract

In recent years, the practice of dentistry and periodontology has become complicated by several risk factors, including the treatment of an increasing number of patients with substance use disorder. This review presents an update in the current literature of the impact of illegal drug use on periodontal conditions and their possible effect as risk factors or indicators. The main illegal drugs that may have an impact on periodontal health and conditions are described, including their effect, medical manifestations, risks, and the overall effect on oral health and on the periodontium. Where available, data from epidemiologic studies are analyzed and summarized. The clinical management of periodontal patients using illegal drugs is reported in a comprehensive approach inclusive of the detection of illicit drug users, screening, interviewing and counseling, the referral to treatment, and the dental and periodontal management. With regard to the impact of illegal substance use on periodontal conditions, there is moderate evidence that regular long-term use of cannabis is a risk factor for periodontal disease, manifesting as a loss of periodontal attachment, deep pockets, recessions, and gingival enlargements. Limited evidence also shows that the use of cocaine can cause a series of gingival conditions that mostly presents as chemical induced-traumatic lesions (application of cocaine on the gingiva) or necrotizing ulcerative lesions. There is a scarcity of data regarding the impact of other drug use on periodontal health. There is evidence to suggest that regular long-term use of cannabis is a risk factor for periodontal disease and that the use of cocaine can cause a series of periodontal conditions. The dental treatment of subjects that use illegal substances is becoming more common in the daily clinical practice of periodontists and other dental clinicians. When the clinicians encounter such patients, it is essential to manage their addiction properly taking into consideration the impact of it on comprehensive dental treatment. Further studies and clinical observations are required to obtain sound and definitive information.

Keywords: amphetamine; cannabis; cocaine; illegal drugs; oral health; periodontology.

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Conflict of interest statement

The authors declare that there is no conflict of interest related to this manuscript.

Figures

FIGURE 1
FIGURE 1
Clinical presentation of a 25‐year‐old Caucasian male patient (cannabis user) with generalized Stage IV, Grade C periodontitis
FIGURE 2
FIGURE 2
Radiographic full status of the patient in Figure 1 showing severe bone loss with multiple angular intrabony defects
FIGURE 3
FIGURE 3
Clinical presentation of a 20‐year‐old Caucasian male patient with plaque‐induced gingivitis and cannabis‐induced gingival enlargement
FIGURE 4
FIGURE 4
Cocaine‐induced keratosis of the attached gingiva resulting from repeated gingival rubbing of the illegal substance
FIGURE 5
FIGURE 5
Clinical presentation of a patient with deep narrow recession and bone dehiscence on the lower left central incisor induced by cocaine use
FIGURE 6
FIGURE 6
Chemical traumatic lesion localized at the level of the mucogingival junction in a crack user
FIGURE 7
FIGURE 7
Chemical traumatic lesion of the lip caused by crack use
FIGURE 8
FIGURE 8
Clinical presentation of a patient (MDMA user) with cheilitis related to poor nutrition. MDMA, 3,4‐Methylenedioxy‐Methamphetamine
FIGURE 9
FIGURE 9
Clinical presentation of a patient (MDMA user) with generalized gingival recessions and abrasions. MDMA, 3,4‐Methylenedioxy‐Methamphetamine
FIGURE 10
FIGURE 10
Clinical presentation of “meth mouth” in a MDMA user (right side). MDMA, 3,4‐Methylenedioxy‐Methamphetamine
FIGURE 11
FIGURE 11
Clinical presentation of “meth mouth” in a MDMA user (left side). MDMA, 3,4‐Methylenedioxy‐Methamphetamine
See this image and copyright information in PMC

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References

    1. United Nations office on drugs and crime world drug report 2016 . www.unodc.org/wdr2016. Accessed May 26, 2022.
    1. Sanz M, van Winkelhoff AJ, Working Group 1 of Seventh European Workshop on Periodontology . Periodontal infections: understanding the complexity–consensus of the Seventh European Workshop on Periodontology. J Clin Periodontol. 2011;38:3‐6. - PubMed
    1. Nunn ME. Understanding the etiology of periodontitis: an overview of periodontal risk factors. Periodontol. 2000;2003(32):11‐23. - PubMed
    1. Genco RJ. Current view of risk factors for periodontal diseases. J Periodontol. 1996;67:1041‐1049. - PubMed
    1. Genco RJ, Borgnakke WS. Risk factors for periodontal disease. Periodontol. 2013;62(1):59‐94. - PubMed