Oral and Dental Consequences of Methamphetamine Use.

描述（由申请人提供）：我们的研究计划源于甲基苯丙胺（MA）滥用与猖獗的龋齿和牙齿表面的侵害之间的新联系，否则，这些牙齿表面被认为是低龋病风险的。通常被称为“冰毒嘴”，使用甲基安非他明的这些口腔合并症可能在免疫功能低下的个体中加剧，这些个体患龋齿和牙周病的风险增加。尽管有明显的个人和社会影响，但缺乏生态学研究和对冰毒嘴的操作定义，阻碍了知识库的培养，以帮助牙科专业人员在早期阶段区分病情，制定最佳临床实践，并允许将牙科社区整合到一个合作护理模式中，以治疗使用甲基苯丙胺的健康后果。我们的前体调查，基于医生对301名MA使用者的评估，已经确定广泛的牙齿疾病是MA使用者的显著合并症。通过经过培训和校准的牙科检查人员的详细口腔评估，我们现在试图验证我们的医师评估人员的初步发现，并评估口腔/牙科表现的鉴别效用，以检测和管理牙科诊所未披露的MA使用者。我们假设MA使用者的龋齿经历和口腔疾病的发生率和模式将与来自国家健康和营养检查调查（NHANES）的倾向得分匹配的个体队列显著不同，并反映了MA使用行为的严重程度。通过对500名甲基苯丙胺成年服用者的横断面调查，我们将：1)验证甲基苯丙胺服用者与非服用者患龋齿和口腔疾病的比率和模式有很大不同；2)描述口腔后果、ma使用模式和其他个体特征之间的关系；3)基于龋齿经历的详细模式，开发一种牙科疾病的综合指数，帮助牙医可靠地区分隐蔽的MA用户和非用户；4)调查ma使用者的负面“牙齿自我形象”与寻求治疗意愿的关联程度。一个关键的目标是通过一个基于网络的、可查询的、索引的数字图像存储库来总结和传播我们的研究成果，这些图像记录了口腔表现的范围及其与MA使用水平的关联。了解MA使用的口腔后果和相关的社会行为决定因素将有助于牙科专业人员在早期阶段区分病情，制定管理后果的最佳实践，并为有针对性的预防和干预策略奠定基础，使牙科社区有意义地参与MA使用者的医疗保健。

DESCRIPTION (provided by applicant): Our research proposal derives from the emerging association of methamphetamine (MA) abuse with rampant dental caries and involvement of tooth surfaces that are considered, otherwise, to be at low risk for decay. Commonly identified by the moniker "meth mouth", these oral co-morbidities of MA use may be exacerbated in immune-compromised individuals who are at increased risk for caries and periodontal disease. Despite the manifest personal and societal impact, the lack of ecological studies and operational definitions of meth mouth have prevented the cultivation of a knowledge base to help dental professionals distinguish the condition in its early stages, formulate best clinical practices and, allow integration of the dental community in a collaborative care model for treating the health consequences of MA use. Our precursor investigation, based on physician-conducted assessments of 301 MA users, has established that extensive dental disease is a distinguishing comorbidity in MA users. Through detailed oral assessments by trained and calibrated dental examiners we now seek to validate the initial findings of our physician assessors and evaluate the discriminant utility of oral/dental manifestations for detecting and managing undisclosed MA users presenting to the dental office. We hypothesize that the rates and patterns of dental caries experience and oral disease in MA users will be significantly different than a propensity-score matched cohort of individuals from the National Health and Nutrition Examination Survey (NHANES) and reflect the severity of the MA use behavior. Using a cross-sectional survey of 500 adult MA users, we will: 1) validate that the rates and patterns of dental caries experience and oral disease are substantially different in methamphetamine (MA) users than non-MA users; 2) characterize the relationship between dental consequences, patterns of MA-use and other individual characteristics; 3) develop a composite index of dental disease, based on a detailed pattern of dental caries experience, that can help dentists reliably distinguish covert MA users from non-users; and 4) investigate the extent to which negative "dental self-image" among MA-users is associated with a willingness to seek treatment. A key goal is to summarize and disseminate our research findings through a web based, queriable, repository of indexed digital images documenting the range of oral manifestations and their association with the levels of MA use. Understanding the oral consequences of MA use and the contextual sociobehavioral determinants will help dental professionals distinguish the condition at an early stage, develop best practices for managing the consequences, and set the stage for targeted prevention and intervention strategies that meaningfully involve the dental community in the healthcare of MA users.