Psychoactive drugs are those drugs that affect ones feeling of mental awareness affecting their emotions, perceptions and feelings.
Although such type of illegal drugs may vary upon the country. But some common misused drugs are :
- Heroine
- Hashish
- Marijuana
- Cocaine
- Opiates
- Cannabis
- LSD (Hallucinogen)
Continous use of such drugs not only affect the essential organs of our body but also the oral cavity. Also, the respective dental surgeon should be aware of such habit of the patient as drug consumption is usually associated by other habits like alcohol and tobacco also.
A small proportion of the population are in a continous use of such psychoactive drugs.
Affect of Certain Drugs on the Procedure
- Erosion of enamel
- Ulceration and inflammation of gingival
- Pre-malignant lesion of oral cavity
- Increased level of osteoporosis
- Increased plaque and Calculus deposition
- Decrease in Salivary flow
- Altering oral microbial flora
- Mucosal inflammation, oedema, ulcers
Affect of Certain Drugs on the Procedure
As of now not much is known about the effects of these drugs on the success of dental implants and osseointegration. But they are thought to be altering bone repair and bone healing, in turn, alter successful osseointegration and ultimately lead to premature implant loss or peri-implant complications.
These drugs directly affects the functioning of brain of an individual which may result their ability to maintain oral hygiene, carelessness and aggression towards the dental treatment.
- Opiates may lead to suppression of pain responses causing patient to ignore the signs of tooth decay, periodontal diseases and limited access to dental care depleting the chances of a successful dental implant.
- Opiates and amphetamines cause reduction in the saliva production that is essential to protect against dental decay and periodontal diseases.
- Regular use of Cocaine through may lead to perforation of nasal septum, palate, gingival lesion and erosion of the tooth surface. Cocaine do tends to decrease the salivary pH and that I not a suitable factor after a dental imlant placement.
- Hashish and Marijuana do possess a significant risk of developing pre-malignant lesions plus it do affects the vasculature of the patient thereby affecting the wound healing.
- Methamphetamine users have decreased salivary production, increased risk of caries and high sugar intake all of which affects the prognosis of dental implants.
- LSD– It has a prominent anorexic affect on patient which will relate to may problems associated with malnutrition. Also, the efficacy for high sugar intake increases in such patients.
- Not only there are only after procedure affects but use of these psycho-active drugs do increases the risk of a medical emergency especially the cardiovascular system may be affected during dental procedure when adrenaline containing local anesthetic or retraction cord is used.
- Cocaine and vasoconstrictors interaction can lead to cardiac arrest.
Considerations During the Treatment
- Behaviour Modification– these patients have a special tendency to miss appointments causing a delay in the treatment. Signs of alcohol abused to be observed before the procedure and rescheduling the appointment to be done on that basis.
- Habit Cessation Consultation– Patients need to be told about the negative implications of the habit and the adverse outcome on the procedure. Therefore adviced to quit and cease the abuse of substances.
- Monitor all the vital signs during the procedure- Take special care of the pain tolerance that may be decreased, resulting in failure of local analgesic agents to relieve pain.
- Special implications for oral hygiene- The foremost thing is that the patient should be made to realize that the maximum efforts to maintain his oral hygiene, for a successful dental implant procedure is to be made by him only.
- Mediactions- Opiod user need to be prescribed only NSAIDs for pain relief. Patients who are alcoholic along with drug abuse should never be prescribed aspirin and non-steroidal anti-inflammatory drugs as alcohol tends to decrease salivary pH as they are acidic drugs.
- Liver of patients consuming alcohol and psychoactive drugs is usually affected leading to depletion of clotting factors, thereby, prolonging chances of bleeding during or after the procedure.
