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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE (Open Access)

Oral health status and oral health-related quality of life: a cross-sectional study of clients in an Australian opioid treatment program

Grace Wong https://orcid.org/0000-0003-1364-6866 A B C D * , Venkatesha Venkatesha E , Mark Enea Montebello F G H , Angela Masoe I , Kyle Cheng A B , Hannah Cook F , Bonny Puszka F and Anna Cheng A
+ Author Affiliations
- Author Affiliations

A Primary and Community Health, Oral Health Services, Northern Sydney Local Health District, NSW Health, St Leonards, NSW, Australia.

B Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, St Leonards, NSW, Australia.

C School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia.

D Oral Health, School of Health, Medical and Applied Science, CQUniversity, Rockhampton, Qld, Australia.

E Research Strategy, Northern Sydney Local Health District, NSW Health, St Leonards, NSW, Australia.

F Drug and Alcohol Services, Northern Sydney Local Health District, NSW Health, St Leonards, NSW, Australia.

G Specialty of Addiction Medicine, Northern Clinical School, The University of Sydney, St Leonards, NSW, Australia.

H National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.

I Centre for Oral Health Strategy, NSW Health, St Leonards, NSW, Australia.

* Correspondence to: grace.wong4@health.nsw.gov.au

Australian Journal of Primary Health 30, PY24021 https://doi.org/10.1071/PY24021
Submitted: 5 March 2024  Accepted: 12 August 2024  Published: 30 August 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

Individuals with opioid dependence often experience poor oral health, including dental decay, periodontal disease and mucosal infection, frequently exacerbated by factors such as smoking, alcohol consumption, inadequate oral hygiene and low utilisation of oral health services. This study aimed to assess oral health status and oral health-related quality of life (OHRQoL) among opioid-dependent individuals and explore their potential associations.

Methods

Participants enrolled in an opioid treatment program (OTP) at three Australian urban clinics were assessed using the validated Oral Health Assessment Tool (OHAT) and Oral Health Impact Profile (OHIP-14).

Results

The average age of the 75 participants was 44.7 years, with 45% receiving opioid treatment for over 5 years. Dental decay and inadequate oral hygiene were prevalent. Mean OHAT and OHIP-14 scores were 6.93 and 20.95 respectively, indicating moderate oral health severity and poor OHRQoL. Physical pain and psychological discomfort significantly impacted participants’ quality of life, with the effects being particularly pronounced for those aged 30 and above. An exploratory analysis revealed a strong correlation between OHAT and OHIP-14 severity scores, with a one-point increase in OHAT associated with 1.85 times higher odds of a lower OHRQoL (odds ratio = 1.85, 95% confidence interval: 1.38–2.49, P = <0.001).

Conclusions

These findings underscore the multifaceted impact of oral health on the well-being of OTP clients. Routine dental check-ups, education on oral hygiene practices and timely treatment for oral health problems are crucial recommendations based on this study. Such measures hold the potential to enhance the quality of life for individuals attending OTPs.

Keywords: dental caries, opioid dependence, opioid treatment program, opioid-related disorder, oral health, oral health assessment tool, oral health impact profile, oral health-related quality of life, periodontal disease.

References

Abdelsalam S, Van Den Boom W, Higgs P, Dietze P, Erbas B (2021) The association between depression and oral health related quality of life in people who inject drugs. Drug and Alcohol Dependence 229, 109121.
| Crossref | Google Scholar | PubMed |

Abdelsalam S, Livingston M, Quinn B, Agius PA, Ward B, Jamieson L, Dietze P (2023) Correlates of poor oral health related quality of life in a cohort of people who use methamphetamine in Australia. BMC Oral Health 23(1), 479.
| Crossref | Google Scholar | PubMed |

Baghaie H, Kisely S, Forbes M, Sawyer E, Siskind DJ (2017) A systematic review and meta-analysis of the association between poor oral health and substance abuse. Addiction 112(5), 765-779.
| Crossref | Google Scholar | PubMed |

Baiju RM, Peter E, Varghese NO, Sivaram R (2017) Oral health and quality of life: current concepts. Journal of Clinical and Diagnostic Research 11(6), Ze21-Ze26.
| Crossref | Google Scholar |

Bhat M, Bhat S, Brondani M, Mejia GC, Pradhan A, Roberts-Thomson K, Do LG (2021) Prevalence, extent, and severity of oral health impacts among adults in rural Karnataka, India. JDR Clinical & Translational Research 6(2), 242-250.
| Crossref | Google Scholar | PubMed |

Broadbent JM, Thomson WM (2005) For debate: problems with the DMF index pertinent to dental caries data analysis. Community Dentistry and Oral Epidemiology 33(6), 400-409.
| Crossref | Google Scholar | PubMed |

Cama E, Brener L, Wilson H, von Hippel C (2016) Internalized stigma among people who inject drugs. Substance Use & Misuse 51(12), 1664-1668.
| Crossref | Google Scholar | PubMed |

Chalmers JM, King PL, Spencer AJ, Wright FAC, Carter KD (2005) The oral health assessment tool — validity and reliability. Australian Dental Journal 50(3), 191-199.
| Crossref | Google Scholar | PubMed |

Cossa F, Piastra A, Sarrion-Pérez MG, Bagán L (2020) Oral manifestations in drug users: a review. Journal of Clinical and Experimental Dentistry 12(2), e193-e200.
| Crossref | Google Scholar | PubMed |

Degenhardt L, Grebely J, Stone J, Hickman M, Vickerman P, Marshall BDL, Bruneau J, Altice FL, Henderson G, Rahimi-Movaghar A, Larney S (2019) Global patterns of opioid use and dependence: harms to populations, interventions, and future action. The Lancet 394(10208), 1560-1579.
| Crossref | Google Scholar | PubMed |

González-Aragón Pineda AE, García Pérez A, García-Godoy F (2020) Salivary parameters and oral health status amongst adolescents in Mexico. BMC Oral Health 20(1), 190.
| Crossref | Google Scholar | PubMed |

Hajek A, Brettschneider C, Mallon T, Ernst A, Mamone S, Wiese B, Weyerer S, Werle J, Pentzek M, Fuchs A, Stein J, Luck T, Bickel H, Weeg D, Wagner M, Heser K, Maier W, Scherer M, Riedel-Heller SG, König HH (2017) The impact of social engagement on health-related quality of life and depressive symptoms in old age – evidence from a multicenter prospective cohort study in Germany. Health and Quality of Life Outcomes 15(1), 140.
| Crossref | Google Scholar | PubMed |

John MT, Reißmann DR, Feuerstahler L, Waller N, Baba K, Larsson P, Čelebić A, Szabo G, Rener-Sitar K (2014) Factor analyses of the Oral Health Impact Profile – overview and studied population. Journal of Prosthodontic Research 58(1), 26-34.
| Crossref | Google Scholar | PubMed |

Kingston REF, Marel C, Mills KL (2017) A systematic review of the prevalence of comorbid mental health disorders in people presenting for substance use treatment in Australia. Drug and Alcohol Review 36(4), 527-539.
| Crossref | Google Scholar | PubMed |

Kupper LL, Hafner KB (1989) How appropriate are popular sample size formulas? The American Statistician 43(2), 101-105.
| Crossref | Google Scholar |

McIntosh J, McKeganey N (2000) Addicts’ narratives of recovery from drug use: constructing a non-addict identity. Social Science & Medicine 50(10), 1501-1510.
| Crossref | Google Scholar | PubMed |

McLaughlin MF, Li R, Carrero ND, Bain PA, Chatterjee A (2021) Opioid use disorder treatment for people experiencing homelessness: a scoping review. Drug and Alcohol Dependence 224, 108717.
| Crossref | Google Scholar | PubMed |

Poudel P, Kong A, Hocking S, Whitton G, Srinivas R, Borgnakke WS, George A (2023) Oral health-care needs among clients receiving alcohol and other drugs treatment – a scoping review. Drug and Alcohol Review 42(2), 346-366.
| Crossref | Google Scholar | PubMed |

Robinson PG, Acquah S, Gibson B (2005) Drug users: oral health-related attitudes and behaviours. British Dental Journal 198(4), 219-224 discussion 214.
| Crossref | Google Scholar | PubMed |

Roe B, Beynon C, Pickering L, Duffy P (2010) Experiences of drug use and ageing: health, quality of life, relationship and service implications. Journal of Advanced Nursing 66(9), 1968-1979.
| Crossref | Google Scholar | PubMed |

Rosenblum A, Marsch LA, Joseph H, Portenoy RK (2008) Opioids and the treatment of chronic pain: controversies, current status, and future directions. Experimental and Clinical Psychopharmacology 16(5), 405-416.
| Crossref | Google Scholar | PubMed |

Sordo L, Barrio G, Bravo MJ, Indave BI, Degenhardt L, Wiessing L, Ferri M, Pastor-Barriuso R (2017) Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies. The BMJ 357, j1550.
| Crossref | Google Scholar | PubMed |

Truong A, Higgs P, Cogger S, Jamieson L, Burns L, Dietze P (2015) Oral health-related quality of life among an Australian sample of people who inject drugs. Journal of Public Health Dentistry 75(3), 218-224.
| Crossref | Google Scholar | PubMed |

WHO (2003) The world oral health report 2003: continuous improvement of oral health in the 21st century – the approach of the WHO Global Oral Health Programme. World Health Organization, Geneva, Switzerland.

United Nations Office on Drugs and Crimes (2018) World Drug Report (Sales No.E.18.XI.9). (United Nations)

Yazdanian M, Armoon B, Noroozi A, Mohammadi R, Bayat A-H, Ahounbar E, Higgs P, Nasab HS, Bayani A, Hemmat M (2020) Dental caries and periodontal disease among people who use drugs: a systematic review and meta-analysis. BMC Oral Health 20(1), 44.
| Crossref | Google Scholar | PubMed |