EVALUATING ORAL AND MAXILLOFACIAL HEALTH CHALLENGES IN INTRAVENOUS DRUG USERS: A CROSS-SECTIONAL STUDY OF DRUG REPLACEMENT THERAPY PARTICIPANTS AND NON-PARTICIPANTS.

Abstract

Introduction: Intravenous drug use has a significant impact on oral and maxillofacial health, often resulting in complications like tooth loss and osteomyelitis. This study investigates the differences in oral health between drug users enrolled in replacement therapy and those not yet participating, with the goal of assessing the impact of structured treatment programs.

Aim: to evaluate and compare the prevalence of oral and maxillofacial complications among drug users involved in replacement therapy and those newly registering for treatment.

Methods: This cross-sectional study was conducted in Tbilisi, Georgia, at the Center for Mental Health and Prevention of Addiction. Participants were divided into two groups: 135 individuals registering for replacement therapy for the first time and 115 participants who had been enrolled for over a year. Data collection involved questionnaires and intraoral examinations, focusing on inflammatory signs, functional impairments, and complications like retained roots and signs of toxic osteomyelitis. Statistical analysis was performed using IBM SPSS Statistics version 23.

Results: The findings revealed that individuals without prior replacement therapy had significantly more severe inflammatory symptoms, including draining fistulas (12.6% vs. 3.5%, χ²(2)=8.61, p=0.013), exposed bone (12.6% vs. 0.9%, χ²(1)=13.74, p=0.000), and visualized sequestra (8.9% vs. 1.7%, χ²(1)=6.01, p=0.014). Functional impairments, such as difficulties in mouth opening (31.1% vs. 12.2%, χ²(1)=12.81, p=0.000) and tooth loosening (51.1% vs. 35.7%, χ²(1)=6.02, p=0.014), were also more prevalent in this group. Retained dental roots were notably higher in the posterior lower jaw among untreated individuals (72.6% vs. 53.9%, χ²(1)=9.41, p=0.002).

Conclusion: The findings suggest that drug replacement therapy plays a significant role in reducing severe oral and maxillofacial complications. Integrating dental care into addiction programs is essential for addressing untreated oral health issues and preventing severe outcomes such as osteomyelitis. Longitudinal studies are recommended to further evaluate the long-term benefits of replacement therapy and refine intervention strategies.