ORAL EFFECTS OF METHAMPHETAMINE USE: A STUDY OF "METH MOUTH"

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 冰毒是一种强有力的中枢神经系统兴奋剂，在美国，滥用甲基苯丙胺的情况正在增加。它价格低廉，易于制造，并能产生持续的兴奋(12小时，而可卡因为1小时)。它可以口服、吸入、注射或烟熏。2003年全国毒品使用与健康调查报告称，有1230万美国人至少尝试过一次甲基苯丙胺。在南卡罗来纳州，在过去4年中，在公共诊所寻求治疗的冰毒成瘾者人数增加了7倍(加州酒精和其他药物滥用服务部，2006年)。 最近，少数报告描述了与使用甲基苯丙胺有关的重大口腔疾病。它的特点是加速的、猖獗的龋齿，累及牙齿的口腔光滑表面和前牙的近中表面。此外，一些甲基苯丙胺成瘾者出现了釉质侵蚀和磨损方面。 不幸的是，目前的报告有限，没有证明甲基苯丙胺是牙病的罪魁祸首，也没有阐明口腔发现的潜在机制。为了达到这些目标，我们计划进行口腔检查，并收集有关甲基苯丙胺成瘾者的口腔健康知识和口腔卫生习惯的资料。这些信息可用于制定管理甲基苯丙胺使用者口腔疾病的方案。这些研究将提供甲基苯丙胺成瘾者口腔健康的基线特征，洞察甲基苯丙胺对口腔结构的可能致病机制，并确定这一人群中的护理障碍。 该项目的具体目标是： 具体目标1：描述慢性甲基苯丙胺依赖者的龋齿类型、口腔细菌负荷、牙周病变、磨损模式和唾液流动。 假设：长期使用甲基苯丙胺与一种特定的牙科疾病模式有关，包括猖獗的龋齿、牙周病、灰色斑块、临床牙冠的斜裂和口干症。 具体目标2：调查口腔健康与(1)冰毒的用量、频率和持续时间以及(2)摄入冰毒的方法(即口服、鼻吸、注射或吸烟)的关系。 假设：口腔疾病将与冰毒的使用数量、频率和持续时间呈正相关，并将更多地出现在吸食、吸食或口服冰毒的吸毒者中。 具体目标3：调查冰毒成瘾者的口腔健康与(1)口腔健康习惯(即定期刷牙和使用牙线；定期看牙医)、(2)非饮食软饮料的消费量和(3)磨牙/咬牙频率的关系。 假设：与那些没有这些行为的人相比，那些表现出不良的口腔健康习惯、过量饮用非减肥软饮料、经常磨牙和咬牙的吸毒者会表现出更明显的牙病。 具体目标4：调查冰毒成瘾者对冰毒使用与牙病关系的了解 假设：冰毒成瘾者对冰毒使用和牙病之间的关系知之甚少。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Abuse of methamphetamine (meth), a potent central nervous system stimulant, is increasing in the United States. It is inexpensive, easy to make and produces an extended high (12 hours versus one hour for cocaine). It can be taken orally, snorted, injected or smoked. The 2003 National Survey on Drug Use and Health reported 12.3 million Americans had tried methamphetamine at least once. In South Carolina, the number of meth addicts seeking treatment in public clinics has increased 7-fold in the past 4 years (SC Department of Alcohol and Other Drug Abuse Services, 2006). Recently a small number of reports have described significant oral disease associated with the use of methamphetamine. "Meth mouth," as it is called, is characterized by accelerated, rampant caries involving the buccal smooth surfaces of the teeth and the interproximal surfaces of the anterior teeth. Additionally some methamphetamine addicts have developed enamel erosion and wear facets. Unfortunately current reports are limited and have not proven that methamphetamine is responsible for dental disease nor do they illuminate potential mechanisms for oral findings. To accomplish these aims we plan to conduct oral screening examinations and collect information on oral health knowledge and the oral hygiene practices of subjects addicted to methamphetamine. This information could serve to generate protocols for the management of oral disease in methamphetamine users. These studies will provide a baseline characterization of the oral health of individuals addicted to methamphetamine, insight into possible pathogenic mechanisms of methamphetamine on oral structures, and identify barriers to care in this population. The specific aims of this project are: Specific Aim 1: To describe patterns of dental caries, oral bacterial burden, periodontal involvement, wear patterns and salivary flow in chronic methamphetamine addicts Hypothesis: Chronic methamphetamine use is associated with a specific pattern of dental conditions including rampant caries, periodontal disease, grey-stained plaque, cracked teeth an oblique cleaving of clinical crowns, and xerostomia. Specific Aim 2: To investigate the relationship between oral health and (1) quantity, frequency and duration of meth use and (2) method of ingestion (i.e., orally, snorted, injected or smoked) of meth. Hypothesis: Oral disease will be positively correlated with quantity, frequenc and duration of meth use and will be found more frequently in addicts, who snort, smoke or orally consume meth. Specific Aim 3: To investigate the relationship between oral health in meth addicts and (1) oral health habits (i.e., regular tooth brushing and flossing; regular visits to dentist), (2) quantity of non-diet soft drinks consumed, and (3) frequency of grinding/clenching of the teeth. Hypothesis: Meth addicts who exhibit poor oral health habits, excessive consumption of non-diet soft drinks, and frequent grinding and clenching of teeth will show more pronounced dental disease than those without these behaviors. Specific Aim 4: To investigate meth addicts' knowledge of the relationship between meth use and dental disease Hypothesis: Meth addicts will have little knowledge of the relationship between meth use and dental disease.