Oral Health Disparities among Illicit Drug Users in the US: Secondary Analysis using Data from NHANES 2017–2018

Purpose This study used data from the National Health and Nutrition Examination Survey (NHANES) to examine associations between the use of four illicit drugs (cocaine, heroin, marijuana, and methamphetamine) and the dental caries experience among adults in the US using the Decayed, Missing and Filled Teeth (DMFT) index. Materials and Methods Data from NHANES 2017–2018, a cross-sectional study that included adults aged 18–69 years, was used in this study. A self-reported questionnaire was used to collect data related to drug use, and a calibrated dental examination was performed to diagnose caries. The associations among the illicit drug use, DMFT score, and score of each component were analyzed using zero-inflated negative binomial regression. Results Marijuana was the most commonly used drug among the participants (60.9%). In adjusted zero-inflated negative binomial models, current heroin was associated with fewer missing teeth (IRR = 0.50, 95% CI: 0.25 – 0.82) and former heroin use with fewer decayed teeth (IR R= 0.61, 95% CI: 0.41 – 0.97). The associations for marijuana and cocaine were not statistically significant after adjustment. Conclusion Illicit drug use shows heterogenous associations with the development of caries; however, the impact differs according to the type of drug. The findings of this study emphasize the requirement for comprehensive dental management and integration of substance-abuse screening within oral healthcare services.