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The Iranian Ministry of Health and Medical Education ranked
addiction as the fourth most important health problem in the country. The
direct and indirect side-effects of illegal drug abuse on the dental and oral
health has rarely been surveyed, probably due to the difficulties in recruiting
the appropriate individuals. This challenge can be overcome by concentrating on
those who are presently in the drug rehabilitation clinics, as previous studies
have done 13,14. The present study is in accordance with Shekarchizadeh et al, McKenna
et al and Manarte et al regarding the advantages of
this method of recruitment of the subjects 13-15.A1 A2 

The results of this investigation revealed poor oral self-care
among the addicts. Similar to the other reports, approximately, only 10 % of
the participants regularly brushed their teeth at least twice in a day, and 88 %
snacked on sugary products daily, either once or more. In the previous studies
conducted in Iran, Brazil, and the USA, the addicts undergoing rehabilitation
showed similar habits regarding cleaning the teeth, eating, and dental flossing
13. These results are comparable to the study, though some investigations in China, England,
and Netherlands have reported more favorable self-cleaning behaviors among the
addicts 15-17. Since most participants had an adequate level of knowledge
towards dental and oral healthcare, these results can be attributed to
addiction and the influence of drug abuse on the patient’s behavior, type of
drug and its abuse, age, and the duration of addiction.

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The dental and oral health status among the
methamphetamine abusers (Tables 1 and 2) was much worse than that among the
non-methamphetamine drug abusers, as reported for the general Iranian
population in the previous studies 18-20 as well as some other investigations
around the world 21,22.

The present study shows a high predominance of
TMJ
disorders A3 A4 in the methamphetamine abusers as compared to
the non-methamphetamine addicts. TMJ disorders can be attributed to the effect of methamphetamine on
saliva (decreasing salivary flow), which results to enamel erosion, periodontal
disease, and temporomandibular disorders 8-10.

The DMFT of the examined addicts showed a
significant difference between the methamphetamine and non-methamphetamine
abusers. The low DMFT score was associated with toothpaste use and the
frequency of brushing the teeth. In addition, based on the previous local
investigations, the DMFT score among our subjects (22.6) was much higher than that
among the general Iranian population 23-25. These results can be attributed
to the acidic and corrosive properties of methamphetamine that affect the teeth
10, and the impurities in the drugs from the production processes 26.

 LIMITATIONS OF THE STUDY    A5 

Though the survey has
reached its purposes, there were unavoidable limitations. First, we derived
some data about oral health experiences from
participants self-reports and brief oral assessments. In addition, it is
possible that individuals have a history of alcohol or multidrug use without a
corresponding diagnosis in the participant’s data.

CONCLUSION

This study reveals the poor dental and oral
health status in the addicts, especially methamphetamine abusers in Iran. Thus,
there is a need to design and implement oral health improvement programs for
drug addicts in Iran.

DECLARATIONS

Acknowledgement

The authors are grateful to the people who
worked in all Hospitals in Tehran for helpful assistance during the experiment.
No sources of funding was received for this study.

 A1Only
2 references cited

 A2Done

 A3The
authors should profer a possible reason for this.

 A4Done
(highlighted as yellow)

 A5State the limitations
of the study under a subheading (titled ‘Limitations of the study’) at the end
of the ‘Discussion’ section

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