Oral Healthcare Improves Substance Abuse Treatment

Dentistry Today


People who struggle with substance use disorder also often struggle with poor oral health, which can lead to damaged interpersonal skills, poor nutrition, increased oral and general infections, and debilitating oral pain. But a holistic approach to substance use disorder can alleviate many of these related issues, reports the University of Utah School of Dentistry.

Participants in substance use disorder treatment who had their major oral health problems addressed by a dental professional stayed in treatment approximately twice as long and had a more than 80% increase in completing their substance abuse treatment program, according to researchers at the school.  

“There is a powerful synergism between oral healthcare and substance use disorder,” said Glen Hanson, DDS, PhD, professor of pharmacology and toxicology, and first author of the study. “Those who received comprehensive dental care had a better quality of life as measured by substantial improvements in employment and drug abstinence as well as a dramatic decrease in homelessness.” 

While the study did not examine specific reasons for the different positive responses for the treatment participants compared to the controls, statistical analysis supports the idea that the improvements in substance abuse treatment outcomes were associated with the comprehensive dental care and not to other variables such as gender, type of drug abused, treatment facility, or age. 

Hanson and his colleagues joined collaborators at the Odyssey House and First Step House substance use clinics in Salt Lake City to develop the Facilitating a Lifetime of Oral Health Sustainability for Substance Use Disorder Patients and Families (FLOSS) program. While the project was designed to provide new dentists with the skills to care for underserved populations, Hanson discovered that the participants got more than an improved smile from the experience. 

Between 2015 and 2017, the clinics recruited patients for the study. First Step House allowed patients to self-select for dental care, with 158 males in dental and 862 males in control. Odyssey House identified participants with major oral health problems and then randomly assigned those to treatment or control, with 70 males and 58 females in dental and 97 males and 45 females in control. 

Patients in the FLOSS program received care at the School of Dentistry for treatments including extractions, root canals, restorations, and dentures. Hanson and his team then conducted a retrospective study of the data to explore the role of FLOSS in helping patients complete their substance use programs. 

After comprehensive dental care, self-selected and randomly selected FLOSS participants were more likely to continue and complete their substance use treatment program. The researchers believe that providing complete oral care as part of treating the whole patient is critical to resurrecting self-esteem and restoring important body functions as an essential first step on the path to recovery from drug use. 

“The experience is life changing not only for the patients but also dental providers such as dental students who now know how their work can dramatically alter their patients’ lives,” said Hanson. “I think if we do the same thing for patients experiencing other chronic health problems, like diabetes, we could see similar positive results for treatment outcomes.”

The study was published by the Journal of the American Dental Association.

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