Does Dental Care Improve Outcomes for Patients with Drug/Alcohol Addiction?

Researchers at the University of Utah have found a link between comprehensive dental care and substance abuse treatment outcomes for patients with drug and alcohol addiction. Additionally, providing patients with substance use disorders (SUD) with oral health care also had a positive effect on homelessness and the person’s ability to find a job.

The University of Utah School of Dentistry originally set out to create a program under a Health Resource Services Administration (HRSA) grant to help prepare dental professionals to care for patients receiving treatment for SUD through Project FLOSS (Facilitating a Lifetime of Oral Health Sustainability for Substance Use Disorder Patients and Families). Halfway through the three-year-program, the project’s partner treatment facilities—Odyssey House and First Step House—shared surprising data that led to the recent study. The paper, “Comprehensive Oral Care Improves Treatment Outcomes in Male and Female Patients With High-Severity and Chronic Substance Use Disorders,” was published in the Journal of the American Dental Association

Analyzing data from Project FLOSS, the team found a dramatic increase in the amount of time a patient who was receiving comprehensive dental care stayed in SUD treatment. Those who had their major oral health issues addressed by a dental professional stayed in treatment twice as long as those not receiving oral health care. Additionally, they demonstrated an 80% increase in completing the SUD program.

Between 2015 and 2017, First Step House allowed patients to self select for dental care (158 males in dental; 862 males in control), while Odyssey House identified patients, then randomly assigned them to treatment or control (70 males and 58 females in dental care; 97 males and 45 females in control), according to the study.

Patients who did not receive dental care stayed an average of 100 days in the SUD treatment program, whereas those receiving comprehensive dental care stayed an average of 300 days. Those receiving oral care were twice as likely to complete treatment, two to three times more likely to be employed, and two to three times more likely to abstain from drugs, and none were homeless.

“We had a lot of numbers and the only thing that correlated with the improvement was comprehensive dental care,” says Glen R. Hanson, DDS, PhD, lead author of the study, and a professor of dentistry, pharmacology and toxicology in the University of Utah School of Medicine. “The age didn’t matter [subjects ranged from ages 20 to 50]; sex didn’t matter; the drug didn’t matter—they all got the same benefit.”

Patients in the FLOSS program received extractions, root canal therapy, restorations, dentures, and more from third and fourth-year dental students at the University of Utah School of Dentistry. Those in the control group only received emergency dental care.

“Many were suffering pain for years,” says Hanson, “ to be able to eat normally and have normal nutrition are very rewarding and the person’s quality of life is dramatically improved”

It is well known that poor oral health negativity affects a person’s self-image, social interaction, and his or her ability to attain employment. Addressing a person’s oral health needs can greatly impact quality of life.

Clinicians can identify obvious signs of addiction during a dental appointment. Common oral manifestations, poor oral hygiene, and xerostomia are among the signs of potential substance abuse.

Based on these findings, Hanson believes integrating comprehensive dental care for older adults, patients with chronic disorders—such as prediabetes, Parkinson’s disease, and Alzheimer’s—may improve quality of life, and potentially slow disease progression.


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