DTUK1210

May 3-9, 2010United Kingdom Edition Excellent Quality Excellent Value ...Why compromise All trade marks acknowledged. Offers subject to availability not valid with any other offers, price match or special pricing arrangements. All prices exclude VAT. Offer valid until 30th June 2010. Terms and conditions apply. E. & O.E. www.precisiondental.co.uk Tel: 020 8236 0606 5020 8236 0070 A-Silicone Fast Set Putty Hydrophilic Impression Material from £27.50 per pack (base + catalyst) • Super hydrophilic, thixotropic – NO SLUMPING • Convenient handling and easy to mix • Exceptional dimensional stability • Ample working time yet reduced setting time • Soft on insertion in the mouth for greater patient comfort • Easily removed from the mouth with optimum elastic recovery • Excellent storage stability • For best results use with Uposil Wash material Superior Quality impressions Light-cured Universal Microhybrid Composite only £12.50 per 4g syringe Proud to be assosiated with Tribune_apr10:Precision 16/4/10 15:12 Page 1 D rugs have featured in the press a lot recently. This is mainly due to the tragic deaths of two teenagers who had taken Methadrone (not to be confused with Methadone) – a weed killer otherwise known as ‘Mi- aow Miaow’. Britain is a drug-taking society; we drink alcohol and take prescrip- tion and pharmaceutical drugs for all sorts of reasons. Many drugs, both illegal and those prescribed can be harmful to our mouths. Indeed, it is estimated that about 40 per cent of people take at least one type of medi- cine that can damage the teeth. Health damage While it is easy to judge, it is im- portant to remember that far more health problems and drug-related deaths occur as a result of taking le- gal drugs such as prescribed medi- cines, alcohol and tobacco, than from illegal substances. Nonethe- less, regular use of illegal drugs can cause significant health damage. As a society, we tend to either dismiss concerns about drugs or sensationalise the danger, but neither approach is very helpful. The most important thing is to be well informed – that way you can provide accurate information about drugs because so often our patients receive inaccurate informa- tion from their friends. Here is the lowdown on some of the most com- monly used drugs: Cocaine. Often referred to as coke, charlie, blow or nose candy. While cocaine is often snorted, many users prefer to rub the cocaine over their gums, which can lead to inflammation, bleeding and ulcera- tion (particularly labially in the up- per anterior region). When mixed with saliva, the drug creates an ex- tremely acidic solution, which leads to erosion and over time, exposure of dentine, which obviously results in sensitivity. Crack cocaine. Also called free- base or rock. This is usually smoked through a pipe. The smoke directly contacts the inside of the mouth and can be carcinogenic. Heroin. Also called ‘H’ or smack, heroin users tend to have a relentless sweet tooth, which can increase the risk of tooth decay if dental hygiene is neglected. Decay most commonly occurs along the gingival margins. Methamphetamine.Alsocalled speed, ice or meth. This drug was developed by a Japanese chemist in 1919, and was used during World War II to help soldiers stay alert. After the war, a massive supply of meth formerly used by the Japa- nese military, became available, skyrocketing addiction. Meth caus- es severe tooth decay in a very short time and it has been noted that us- ers lose their teeth abnormally fast due to a combination of side effects. Indeed the term ‘meth mouth’ has been used to describe the exten- sive damage typically caused by this drug. It is reported to attack the immune system, so users are often more prone to infections such as AUG. It is also highly acidic and causes erosion. Other side effects include dry mouth, bruxism and jaw clenching. Ecstasy. Also called ‘E’, the love drug and eckies. Ravers and anti- drug activists have long debated whether ecstasy causes brain dam- age, but both ignored a more seri- ous and immediate problem few can deny – damaged teeth. This is as a result of the jaw clenching and tooth grinding that usually accom- panies partaking of this club drug. Ecstasy users often carry a dummy and if one isn’t handy a lollipop will suffice, although recently orthodon- tic retainers have replaced these as the ‘en-vogue’ look at clubs. Such mouthwear is not only fashion- able, it also helps ease the discom- fort caused by bruxism. Research has shown that friction involved in bruxism combined with an abra- sive dry mouth leads to extreme tooth wear which is often worsened by the consumption of carbonated acidic beverages needed to cool off ecstasy users raised temperatures. It goes without saying that users who experience nausea and vom- iting after taking E are also more prone to erosion. Others to consider This list is by no means exhaus- tive; indeed there are many new substances on the pharmaceuti- cal block including ketamine and GHD. Also, the scale of poly-drug use is escalating; 15 years ago users would have made do with one ec- stasy tablet, these days they’re tak- ing a whole cocktail of drugs with- out being aware of their impact. Any drug dependence or drug use that causes the person to ne- glect their personal hygiene, diet and dental care can significantly increase the risk of dental (and many other) problems. Forget the image of the dropout on the park bench though – most people who use drugs are ordinary people who lead perfectly normal lives. This was highlighted by a paper pub- lished in the British Dental Jour- nal last month relating to drug use among dental undergraduates and vocational trainees. Not only that, but a recent study indicates that, thousands of apparently success- ful, healthy and affluent people in their 20s, 30s and 40s choose to be heavy recreational drug users at the weekend. Indeed, in many areas, the main clubbing night has moved from Saturday to Friday to allow people to recover in time for work or lectures on a Monday morning. Looking for signs As dental professionals we have a major role to play in helping patients with their addictive beh- aviour and we need to look out for any signs and symptoms present in their mouths. Questions regard- ing drug use must be handled in a sensitive, non-judgemental and confidential manner. If drugs are causing problems, it may be neces- sary to discuss adjusting the meth- od of delivery. Prevention is certainly better than cure especially as restorative dental treatment can be expensive and time consuming. If patients are open about drug use, we can help them to manage the situation. Pro- fessional treatment depends on the particular drug and its effect on the teeth and gums but may include: • Referral to an appropriate cessation service • Application of topical fluoride and use of fluoride mouthwash to re- duce sensitivity and prevent decay • Recommending products aimed at limiting the damage caused by erosion, such as Pronamel tooth- paste and mouthwash • Diet advice, for example, sugar- free lollies and diet drinks (preferably non carbonated) for ecstasy users • Wearing a night guard to ease the symptoms of bruxism. It seems that we need to become more competent at diagnosing and managing drug-related problems because it’s possible that for many of our patients, gone are the days of getting high naturally. DT With Britain described as a drug-taking society, it’s essential that we become more competent at diagnosing and managing drug-related problems, says Alison Lowe Just say no to drugs About the author Alison Lowe is a dental hygienist based in Cardiff at The Orthodontic Centre, a private practice (specialising in implants, cosmetic work and perio) and Cardiff Den- tal School. She has won several awards including Hygienist of the Year 2008 and is a columnist for the Western Mail. She thoroughly enjoys what she does and is delighted to be contributing to Dental Trib- une UK.