Substance abuse & dental changes

[Elbrus]

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I am not a dentist, but in my practice I encounter quite a number of chemically dependent individuals, and often times my 'sense' for this is triggered by a wide variety of suspicious looking teeth. (Of course I will ask people directly, but 99.5% of the time they won't tell you immediately, I find out later on when reviewing someone else's note in the chart.)

Besides the blackened teeth from meth use, I'm hoping to recognize more subtle clues or characteristic dental features, to aide in identifying underlying problems. Photos or unique questions you might ask are much appreciated.

 

[PlaqueAttack]

When the pt asks for a specific drug (Vicodin etc..) and says nothing else will work that's a red flag, or when a pt refuses/delays treatment that would alleviate their reported pain and asks for meds instead. A big part of recognizing a drug seeker is their demeanor, the play the "sick person role" with their eyes downturned and anything will make them jump out of the seat in pain. And if you don't mention meds they get worse and worse but when you first mention meds their eyes light up.

 

[toofshucker]

I am not a dentist, but in my practice I encounter quite a number of chemically dependent individuals, and often times my 'sense' for this is triggered by a wide variety of suspicious looking teeth. (Of course I will ask people directly, but 99.5% of the time they won't tell you immediately, I find out later on when reviewing someone else's note in the chart.)

Besides the blackened teeth from meth use, I'm hoping to recognize more subtle clues or characteristic dental features, to aide in identifying underlying problems. Photos or unique questions you might ask are much appreciated.

www.dentaltown.com might be a better place to ask this question. You have to remember that this is a forum full of wanna-be dental students and dental students. Probably less than a quarter of the people posting here actually see patients.

 

[DrJeff]

Widespread erosive lesion on the lingual surface of maxillary anterior teeth is pretty indictative of a bulemic

 

[ChilliCheeseDog]

missing front teeth is indicative of a drunk douche bag who gets his face pounded in on a semi-regular to regular basis.....other indications include being a douche bag when sober as well.😀