Comprehensive Oral Care Improves Treatment Outcomes in Male and Female Patients with High-Severity and Chronic Substance Use Disorders
The University of Utah School of Dentistry has demonstrated an important role for oral health in managing SUD patients by identifying dramatic increases in treatment length of stay for these patients and their ability to obtain employment, as well as a decrease in their homelessness and drug use, by providing comprehensive dental care as an integrated part of their care.
Background. Using data from a workforce training program funded by the Health Resources and Services Administration, the authors de-identified pre- and post-treatment assessments of high-severity and chronic substance use disorders (SUDs) to test the effect of integrated comprehensive oral health care for patients with SUDs on SUD therapeutic outcomes.
Methods. After 1 through 2 months of treatment at a SUD treatment facility, 158 male self-selected (First Step House) or 128 randomly selected sex-mixed (Odyssey House) patients aged 20 through 50 years with major dental needs received integrated comprehensive dental treatment. The SUD treatment outcomes for these groups were compared with those of matched 862 male or 142 sex-mixed patients, respectively, similarly treated for SUDs, but with no comprehensive oral health care (dental controls). Effects of age, primary drug of abuse, sex, and SUD treatment facility-influenced outcomes were determined with multivariate analyses.
Results. The dental treatment versus dental control significant outcomes were hazard ratio (95% confidence interval [CI]) 3.24 (2.35 to 4.46) increase for completion of SUD treatment, and odds ratios (95% CI) at discharge were 2.44 (1.66 to 3.59) increase for employment, 2.19 (1.44 to 3.33) increase in drug abstinence, and 0.27 (0.11 to 0.68) reduction in homelessness. Identified variables did not contribute to the outcomes.
Conclusions and Practical Implications. Improvement in SUD treatment outcomes at discharge suggests that complementary comprehensive oral health care improves SUD therapeutic results in patients with SUDs. Integrated comprehensive oral health care of major dental problems significantly improves treatment of outcomes in patients whose disorders are particularly difficult to manage, such as patients with SUDs.
Authors. Glen R. Hanson, DDS, PhD; Shawn McMillan, MPA; Kali Mower, BS; Carter T. Bruett, BS; Llely Duarte, BS; Sri Koduri, MS, MPA; Lilliam Pinzon, DDS, MS, MPH; Matt Warthen, BS; Ken Smith, PhD; Huong Meeks, PhD; Bryan Trump, DDS, MS