University of Oulu

Shekarchizadeh, H., Khami, M. R., Mohebbi, S. Z., Ekhtiari, H., & Virtanen, J. I. (2019). Oral health status and its determinants among opiate dependents: a cross-sectional study. BMC Oral Health, 19(1).

Oral health status and its determinants among opiate dependents : a cross-sectional study

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Author: Shekarchizadeh, Hajar1; Khami, Mohammad R.2,3; Mohebbi, Simin Z.2,3;
Organizations: 1Department of Community Oral Health, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, University Blvd, Arqavanieh, Jey Street, P.O.Box: 81595-158, Isfahan, Iran
2Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Postal code 1417614411, Iran
3Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Postal code 1439955934, Iran
4Neurocognitive Laboratory, Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Postal code 1336616357, Iran
5Department of Clinical Dentistry, University of Bergen, N-5020, Bergen, Norway
6Medical Research Center, Oulu University Hospital, FI-90029, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link:
Language: English
Published: Springer Nature, 2019
Publish Date: 2019-10-02


Background: In addition to numerous general health problems, drug dependents manifest various oral health disorders. Our aim was to investigate the oral health status and its determinants among in-treatment opiate dependents.

Methods: As part of a comprehensive cross-sectional survey on opiate dependents admitted to methadone maintenance centers in Tehran, Iran, we conducted a clinical study in two centers from different socioeconomic areas. A trained dentist conducted face to face interviews and clinical oral examinations based on World Health Organization (WHO) criteria for Decayed, Missing, Filled Teeth (DMFT) index and Community Periodontal Index (CPI) on volunteer patients. Student’s t-test, Mann-Whitney U, Kruskal Wallis, and Chi2 tests, in addition to linear and logistic regression models served for statistical analysis (p < 0.05).

Results: A total of 217 patients (98% men), with a mean age of 43.6 years (SD 12.3) participated in the study. Opium was the main drug of abuse reported by 70% of the participants followed by crystalline heroin (22%). Of the participants, 24.4% were totally edentulous. The mean DMFT score of participants was 20.3 (SD 7.8). Missing teeth comprised the main part of the index followed by decayed and filled teeth. Older patients (p < 0.001) and the patients with a lower socioeconomic status (p = 0.01) had higher DMFT scores. None of the dentate patients had a healthy periodontium. Maximum CPI mostly consisted of shallow pockets (66%) followed by calculus in 15%, deep pockets in 11%, and bleeding in 8% of the participants. Older participants (p = 0.02) and those who started drug abuse at a younger age (p = 0.01) were more likely to develop periodontal pockets.

Conclusions: Opiate dependents had a poor oral health status in terms of the dentition status and periodontal health. Missing teeth comprised the main part of their dental caries history and none had a healthy periodontium. Oral health care should be integrated into the package of general health services available in treatment centers.

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Series: BMC oral health
ISSN: 1472-6831
ISSN-E: 1472-6831
ISSN-L: 1472-6831
Volume: 19
Article number: 5
DOI: 10.1186/s12903-018-0691-3
Type of Publication: A1 Journal article – refereed
Field of Science: 313 Dentistry
Funding: Data collection was funded by Tehran University of Medical Sciences and Health Services Grant number 12900.
Copyright information: © The Author(s). 2019. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.