Dentists often are the first health care professionals to detect the abuses caused by alcohol and drug consumption, says a Chicago dentist.
"Those who suffer from substance abuse frequently neglect the care of their teeth and gums," explains David Miller, D.D.S., a general dentist who practices on Chicago's South Side.
"Addictions change the priorities of a person's life," he says. "Instead of caring for their health, most addicts spend their time caring for their addiction. And nowhere else in the body can the effects of an addiction be seen more dramatically than in the mouth."
Dr. Miller says that alcohol and drug addicts generally have poor oral hygiene, as well as more tooth decay and missing teeth.
"Addicts have more periodontal disease," he says. "Also, dentists who have addicts as patients see more grinding of teeth at night when they sleep. Addicts also have more yeast infections, which can lead to painful sore tongues and mouths."
Dr. Miller encourages addicts to seek dental care and to be open with dentists about their abuse problems. "Obviously, patients who are addicted to drugs or alcohol are not very likely to tell us about their problems, unless they are in recovery and truly want to kick their habits," he says. "However, it's important for those with addictions to inform their dentists about their abuse because this information dictates the use of medications and dental treatments in patients. For example, dentists do not want to use sedatives or hypnotics in patients with addictions. Also, commonly used anesthetics for simple procedures can create complications for people who are high."
Another tip-off for dentists who suspect drug abuse are patients who are more interested in prescriptions instead of dental care. "Every dentist can tell a story about patients who clearly want to get a prescription when it normally would not be warranted," says Dr. Miller. "Some patients get very aggressive, and others have even robbed dental offices of medications on the premises." However, he says, dentists cannot cavalierly distribute controlled substances -- not only are they monitored by state officials, but are contrary to dental ethics.
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