Cohort study of HIV-positive and -negative methamphetamine users

Abstract

Background: The effects of methamphetamine (MA) on caries have been well documented. Little, however, is known about its effects on the periodontium. The authors conducted this study to determine the prevalence and severity of periodontal disease in an urban population of HIV-positive MA users.

Methods: This cross-sectional survey was conducted in one of the most populous urban areas of Los Angeles County, California, beset with high rates of MA use. Participants were recruited by a combination of street outreach methods, referral from drug treatment centers, and word of mouth. Participants were eligible if they were older than 18 years, spoke English or Spanish, used MA in the past 30 days, were willing to undergo a dental examination and psychosocial assessments, and were willing to provide a urine sample. Periodontal assessments were completed for 541 participants by 3 trained and calibrated dentists.

Results: The prevalence and severity of periodontal disease were high in this population of HIV-positive and -negative MA users. Cigarette smoking and age were identified as risk factors.

Conclusions: The HIV-positive and -negative cohorts were remarkably similar, suggesting that their lifestyles contributed more to their destructive periodontal disease than their MA use.

Practical implications: MA users are at high risk of developing destructive periodontal disease and badly broken-down teeth. Clinicians should plan accordingly for timely management of the patients' care, knowing that MA users have extensive periodontal and restorative treatment needs.

Keywords: Attachment loss; HIV; epidemiology; methamphetamine use; periodontal disease; pocket depth.