Oral Diseases. 2018;24:482–488.
Received: 15 March 2017
Revised: 14 September 2017
Accepted: 15 September 2017
The use of crack and other illicit drugs impacts oral
health- related quality of life in Brazilians
| FB Zanatta
| TM Ardenghi
| CA Feldens
© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved
School of Dentistry, Master’s Degree in
Health and Life Sciences, Centro Universitário
Franciscano, Santa Maria, Brazil
Stomatology Department, School of
Dentistry, Universidade Federal de Santa
Maria (UFSM), Santa Maria, Brazil
Post-graduate Program in Dentistry,
Universidade Luterana do Brasil (ULBRA),
Raquel Pippi Antoniazzi, Centro Universitário
Franciscano, Santa Maria, RS, Brazil.
This study received funding from the Brazilian
fostering agency Fundação de Amparo à
Pesquisa do Rio Grande do Sul (FAPERGS).
Call 003/2012, case SPI 1655 12- 4.
Objective: The aim of this study was to investigate the impact of the use of crack and
other illicit drugs on oral health- related quality of life (OHRQoL) in young adults.
Methods: This cross- sectional study evaluated 106 crack users at a public treatment
center for drug addiction and 106 controls matched for gender, age, and use of to-
bacco. Clinical examinations were performed for dental caries and periodontal disease.
The outcome was OHRQoL, which was determined using the Oral Health Impact
Profile (OHIP- 14). The association between OHRQoL and illicit drugs was modeled
using conditional Poisson regression.
Results: Users of crack and other illicit drugs had a poorer OHRQoL than the controls
(p < .001). Among the crack users, the odds ratio to yield high OHIP- 14 was 3.40 (95%
confidence interval, 1.91–6.08). Adjustment for sex, age, schooling, income, smoking,
dental caries, and periodontal disease did not change such an estimate considerably.
The functional limitation and psychological discomfort domains were associated with
the use of illicit drugs.
Conclusion: Users of crack and other illicit drugs exerted a negative impact on
OHRQoL independently of socio- demographic characteristics and tobacco use, sug-
gesting the need for special attention regarding the specific oral health needs of this
population as well as drug prevention and treatment strategies.
crack cocaine, drug users, oral health, oral health-related quality of life, psychotropic drugs
1 | INTRODUCTION
Crack use is a public health problem, especially due to its systemic
(Ribeiro, Dunn, Laranjeira, & Sesso, 2004), behavioral (Morano, Gibson,
& Altice, 2013), and oral health- related consequences (Antoniazzi,
Zanatta, Rösing, & Feldens, 2016; Woyceichoski et al., 2008). The con-
sumption of the drug varies, depending on socioeconomic develop-
ment and access to crack in different countries (Bracken, Rodolico, &
Hill, 2013; Lozano et al., 2008; Roe, Beynon, Pickering, & Duffy, 2010).
The prevalence of illicit drug use in Brazil remains high, with approx-
imately 1% of the population having used crack (Abdalla et al., 2014;
Madruga et al., 2012). The profile of crack users in Brazil is character-
ized mainly by unemployed men less than 30 years of age, with low in-
come and schooling, greater involvement in prostitution, and a greater
probability of living on the street (Duailibi, Ribeiro, & Laranjeira, 2008).
The oral health status of drug addicts has been evaluated in in-
vestigations addressing objective or normative oral health condi-
tions (Antoniazzi et al., 2016; Cury, Oliveira, & Dos Santos, 2017;
Mitchell- Lewis, Phelan, Kelly, Bradley, & Lamster, 1994; Molendijk,
Ter Horst, Kasbergen, Truin, & Mulder, 1996; Woyceichoski et al.,
2008). However, normative oral health indicators traditionally used to
measure the consequences of adverse oral health conditions may not