Oral and Dental Consequences of Methamphetamine Use.

描述（由申请人提供）：我们的研究提案来自甲基苯丙胺（MA）滥用与猖獗的龋齿和牙齿表面的参与的新兴关联，否则，被认为是在低风险的腐烂。MA使用的这些口腔并发症通常被称为“甲基口腔”，可能会在龋齿和牙周病风险增加的免疫受损个体中加剧。尽管有明显的个人和社会影响，但缺乏生态研究和甲基口腔的操作定义，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，并允许牙科社区整合到一个合作护理模式中，以治疗MA使用的健康后果。我们的前期调查，根据医生进行的评估301 MA用户，已经建立了广泛的牙科疾病是一个独特的合并症MA用户。通过详细的口腔评估，由训练有素的和校准的牙科检查员，我们现在试图验证我们的医生评估员的初步结果，并评估口腔/牙科表现的判别效用，用于检测和管理未披露的MA用户提交给牙科诊所。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与来自国家健康和营养检查调查（NHANES）的个人倾向评分匹配队列有显著差异，并反映了MA使用行为的严重程度。通过对500名成人甲基苯丙胺使用者的横断面调查，我们将：1）验证甲基苯丙胺（MA）使用者与非MA使用者的龋齿经历和口腔疾病的发生率和模式存在实质性差异; 2）描述牙齿后果、MA使用模式和其他个体特征之间的关系; 3）根据龋齿经历的详细模式，开发一种牙科疾病的综合指数，可以帮助牙医可靠地区分隐蔽MA使用者和非使用者;以及4）调查MA使用者中负面的“牙科自我形象”与寻求治疗的意愿之间的关联程度。一个关键的目标是总结和传播我们的研究成果，通过基于网络的，可查询的，索引的数字图像存储库记录的范围内的口腔表现及其与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用户的医疗保健。

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.