Recommendations for the Dental Team

Many medical and dental facilities are being trained and utilizing the Screening, Brief Intervention, and Referral for Treatment (SBIRT) tool to address those suspected of substance abuse. SBIRT is a comprehensive public health approach for the delivery of early identification, intervention and treatment services to patients with substance abuse or those at risk. This program provides methods of early intervention to approach the patient.

• Screening assesses the severity of substance abuse and identifies the appropriate level of treatment.

• Brief intervention focuses on increasing insight and awareness regarding substance abuse and motivation toward behavioral change.

• Referral for treatment provides those identified as needing more extensive treatment access to specialty care.^7,79,91

No other illicit drug’s oral effects have been so pronounced or have received so much attention as methamphetamine.

Many meth users fail to adequately care for their teeth or regularly visit the dental office. Conventional dental treatment is frequently of little value. The results of methamphetamine abuse may take up to two years after the patient has stopped using meth to manifest in the oral cavity.^13,28

Each case must be evaluated individually. The amount of wear and micro-fractures on the teeth from grinding, the degree of periodontal involvement, and severity of tooth decay has to be taken into consideration before determining treatment. At some point dental restorative care may include, as appropriate, extractions, amalgam/composite restorations, veneers/crowns, and/or partial/complete dentures.²⁸