# Oral Health Disparities among Illicit Drug Users in the US: Secondary Analysis using Data from NHANES 2017–2018

## TL;DR

This study finds varied oral health effects among US adults using different illicit drugs, suggesting a need for integrated dental and substance abuse care.

## Contribution

The study reveals heterogeneous associations between specific illicit drug use and dental caries, emphasizing the need for integrated healthcare approaches.

## Key findings

- Heroin use was associated with fewer missing teeth in current users and fewer decayed teeth in former users.
- Marijuana and cocaine use did not show statistically significant associations with dental caries after adjustment.
- Illicit drug use impacts dental health differently depending on the drug type.

## Abstract

This study used data from the National Health and Nutrition Examination Survey (NHANES) to examine associations between the use of four illicit drugs (cocaine, heroin, marijuana, and methamphetamine) and the dental caries experience among adults in the US using the Decayed, Missing and Filled Teeth (DMFT) index.

Data from NHANES 2017–2018, a cross-sectional study that included adults aged 18–69 years, was used in this study. A self-reported questionnaire was used to collect data related to drug use, and a calibrated dental examination was performed to diagnose caries. The associations among the illicit drug use, DMFT score, and score of each component were analyzed using zero-inflated negative binomial regression.

Marijuana was the most commonly used drug among the participants (60.9%). In adjusted zero-inflated negative binomial models, current heroin was associated with fewer missing teeth (IRR = 0.50, 95% CI: 0.25 – 0.82) and former heroin use with fewer decayed teeth (IR R= 0.61, 95% CI: 0.41 – 0.97). The associations for marijuana and cocaine were not statistically significant after adjustment.

Illicit drug use shows heterogenous associations with the development of caries; however, the impact differs according to the type of drug. The findings of this study emphasize the requirement for comprehensive dental management and integration of substance-abuse screening within oral healthcare services.