A Comparison of Methamphetamine Users to a Matched NHANES Cohort: Propensity Score Analyses for Oral Health Care and Dental Service Need

  • Debra A. Murphy
  • Lauren Harrell
  • Rachel Fintzy
  • Thomas R. Belin
  • Alexis Gutierrez
  • Steven J. Vitero
  • Vivek Shetty


Dental problems are among the most frequently reported health issues of drug users. This study describes, among the largest population of methamphetamine (MA) users to date (N = 459, including both HIV-negative and HIV-positive participants) oral hygiene practice, dental care access, and dental quality of life. A matched control group from the Third National Health and Nutrition Examination Survey was utilized. Findings conclusively establish that MA users have severe oral health deficits compared to the general population: they are 3.5 times more likely to experience painful toothaches, 6.6 times to experience difficulty eating, and 8.6 times to be self-conscious due to dental appearance. HIV-positive users were more likely to have regular dental visits than HIV-negative users. Severity of use (both high-frequency use as well as injection as the method) was associated with poorer oral health care. Despite the magnitude of the need, few MA users receive the needed care.


Oral Health Dental Care Oral Health Care Dental Disease Dental Problem 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number 5RO1DA025680 (P.I., Dr. V. Shetty). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to acknowledge the study participants and the facilitative efforts of Mr. Peter Cabezas.

Conflict of Interest

Authors report no conflict of interest with the reported study.


  1. 1.
    Loesche WJ. Periodontal disease: Link to cardiovascular disease. Compendium of Continuing Education in Dentistry, 2000; 21: 463–470.PubMedGoogle Scholar
  2. 2.
    U.S. Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General—Executive Summary. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000.Google Scholar
  3. 3.
    Chen I. The Surgeon General’s report on oral health: Implications for research and education. The New York State Dental Journal, 2000; 66: 38–42.PubMedGoogle Scholar
  4. 4.
    Gelberg L, Linn LS, Rosenberg DJ. Dental health of homeless adults. Special Care in Dentistry, 1988; 8: 167–172.CrossRefPubMedGoogle Scholar
  5. 5.
    MacKay AP, Fingerhut LA, Duran CR. Adolescent Health Chartbook. Health, United States, 2000. Hyattsville, MD: National Center for Health Statistics, 2000.Google Scholar
  6. 6.
    Marcus M, Reifel NM, Nakazono TT. Clinical measures and treatment needs. Advances in Dental Research, 1997; 11: 263–271.CrossRefPubMedGoogle Scholar
  7. 7.
    Metsch LR, Crandall L, Wohler-Torres B, et al. Met and unmet need for dental services among active drug users in Miami, Florida. Journal of Behavioral Health Services & Research, 2002; 29: 176–188.CrossRefGoogle Scholar
  8. 8.
    McFarland KK, Fung EYK. The complexity of addiction. How to address the oral health needs of patients experiencing drug abuse and addiction problems. Dimensions of Dental Hygiene, 2011; 9: 76–81.Google Scholar
  9. 9.
    Dasanayake AP, Warnakulasuriya S, Harris CK, et al. Tooth decay in alcohol abusers compared to alcohol and drug abusers. International Journal of Dentistry, 2010: Article ID 786503.Google Scholar
  10. 10.
    Madinier I, Harrosch J, Dugourd M, et al. [The buccal-dental health of drug addicts treated in the University hospital centre in Nice]. Presse Médicale, 2003; 32: 919–923.Google Scholar
  11. 11.
    Robinson PG, Acquah S, Gibson B. Drug users: Oral health-related attitudes and behaviours. British Dental Journal, 2005; 198: 219–224.CrossRefPubMedGoogle Scholar
  12. 12.
    Du M, Bedi R, Guo L, et al. Oral health status of heroin users in a rehabilitation centre in Hubei province, China. Community Dental Health, 2001; 18: 94–98.PubMedGoogle Scholar
  13. 13.
    Sheedy JJ. Methadone and caries. Case reports. Australian Dental Journal, 1996; 41: 367–369.CrossRefPubMedGoogle Scholar
  14. 14.
    Scheutz F. Dental health in a group of drug addicts attending an addiction-clinic. Community Dentistry and Oral Epidemiology, 1984; 12: 23–28.CrossRefPubMedGoogle Scholar
  15. 15.
    American Dental Association. Methamphetamine use: meth mouth. Chicago, IL: 2007. Available online at Accessed April 2, 2007.
  16. 16.
    Cheng WS, Garfein RS, Semple SJ, et al. Binge use and sex and drug use behaviors among HIV(−), heterosexual methamphetamine users in San Diego. Substance Use & Misuse, 2010; 45(1–2): 116–133.CrossRefGoogle Scholar
  17. 17.
    Saini T, Edwards PC, Kimmes NS, et al. Etiology of xerostomia and dental caries among methamphetamine abusers. Oral Health & Preventive Dentistry, 2005; 3: 189–195.Google Scholar
  18. 18.
    Shetty V, Mooney LJ, Zigler CM, et al. The relationship between methamphetamine use and increased dental disease. Journal of the American Dental Association, 2010; 141: 307–318.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Ravenel MC, Salinas CF, Marlow NM, et al. Methamphetamine abuse and oral health: A pilot study of “meth mouth.” Quintessence International, 2012; 43: 229–237.PubMedGoogle Scholar
  20. 20.
    Morio KA, Marshall TA, Qian F, et al. Comparing diet, oral hygiene and caries status of adult methamphetamine users and nonusers: A pilot study. Journal of the American Dental Association, 2008; 139: 171–176.CrossRefPubMedGoogle Scholar
  21. 21.
    Greenspan D, Greenspan JS. HIV-related oral disease. Lancet, 1996; 348: 729–733.CrossRefPubMedGoogle Scholar
  22. 22.
    Hodgson TA, Greenspan D, Greenspan JS. Oral lesions of HIV disease and HAART in industrialized countries. Advances in Dental Research, 2006; 19: 57–62.CrossRefPubMedGoogle Scholar
  23. 23.
    Ramírez-Amador V, Esquivel-Pedraza L, Sierra-Madero J, et al. The changing clinical spectrum of Human Immunodeficiency Virus (HIV)-related oral lesions in 1,000 consecutive patients: A 12-year study in a referral center in Mexico. Medicine, 2003; 82: 39–50.CrossRefPubMedGoogle Scholar
  24. 24.
    Centers for Disease Control and Prevention. National Health and Nutrition Examination Survey. Atlanta, GA: 2012. Available online at Accessed April 4, 2012.
  25. 25.
    Heinzerling KG, Swanson A-N, Kim S, et al. Randomized, double-blind, placebo-controlled trial of modafinil for the treatment of methamphetamine dependence. Drug and Alcohol Dependence, 2010; 109(1–3): 20–29.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Hser Y-I, Huang D, Brecht M-L, Li L, et al. Contrasting trajectories of heroin, cocaine, and methamphetamine use. Journal of Addictive Diseases, 2008; 27: 13–21.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Pennell S, Rienick C, Grimes J. Meth Matters: Report on methamphetamine users in five western cities. Washington, DC: U.S. Department of Justice, 1999.Google Scholar
  28. 28.
    Semple SJ, Patterson TL, Grant I. The context of sexual risk behavior among heterosexual methamphetamine users. Addictive Behaviors, 2004; 29: 807–810.CrossRefPubMedGoogle Scholar
  29. 29.
    McGlothlin WH, Anglin MD, Wilson BD. An evaluation of the California civil addict program (DHEW Publication No. ADM 78-558). Washington, DC: U. S. Government Printing Office, 1977.Google Scholar
  30. 30.
    Slade GD. Measuring oral health and quality of life. University of North Carolina: Department of Dental Ecology, School of Dentistry, 1997.Google Scholar
  31. 31.
    Shoptaw S, Reback CJ. Associations between methamphetamine use and HIV among men who have sex with men: A model for guiding public policy. Journal of Urban Health, 2006; 83: 1151–1157.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Sears B, Cooper C, Younai FS, Donohoe T. HIV Discrimination in Dental Care: Results of a Discrimination Testing Study in Los Angeles County. Los Angeles, CA: The Williams Institute, UCLA School of Law, 2011.Google Scholar

Copyright information

© National Council for Behavioral Health 2014

Authors and Affiliations

  • Debra A. Murphy
    • 1
  • Lauren Harrell
    • 2
  • Rachel Fintzy
    • 5
  • Thomas R. Belin
    • 2
  • Alexis Gutierrez
    • 3
  • Steven J. Vitero
    • 4
  • Vivek Shetty
    • 5
  1. 1.Health Risk Reduction Projects, Integrated Substance Abuse Programs, Department of PsychiatryUniversity of California Los AngelesLos AngelesUSA
  2. 2.Department of BiostatisticsUniversity of California Los AngelesLos AngelesUSA
  3. 3.San Fernando Dental Clinic NEVHCSan FernandoUSA
  4. 4.AIDS Project Los Angeles Dental Services, Inc.Los AngelesUSA
  5. 5.Section of Oral and Maxillofacial SurgeryUniversity of California Los AngelesLos AngelesUSA

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