​Neil Sikka, a Bupa Dental Care dentist, shares his years of experience in handling patients facing addiction issues and provides insights into this crucial aspect of dental care.

In the world of dentistry, clinicians often find themselves in a unique position to identify and assist patients who are battling with challenges such as substance and alcohol abuse. Clinicians who are trained to recognise the physical signs of such struggles and provide guidance on treatment can make a significant difference in these individuals' lives.

Recognising the signs

Understanding a patient's medical history is the first step in identifying signs of substance or alcohol abuse. This will help determine when the addiction began, what treatments have been sought, and whether any ongoing follow-up is necessary. Additionally, it's crucial to consider someone’s personal circumstances that may have triggered the addiction, such as divorce, job loss, or the loss of loved ones. Dental professionals that have been treating patients for some time will be better placed to understand if a patient is going through a difficult time, having had more time to build trust and rapport with them.

Key signs and symptoms

Neil stresses the need for dental professionals to be vigilant about specific oral signs that can be indicative of substance abuse:

  • Dry Mouth: Many drugs can cause dry mouth, disrupting the natural protective coating that saliva provides to teeth. This condition can lead to increased vulnerability to dental issues.
  • Tooth Decay: Many substances, when mixed with saliva, become acidic. This acidity can erode tooth enamel, leading to tooth decay and weakened teeth.
  • Teeth Grinding: A common side effect of substances can cause users to grind their teeth, resulting in significant dental damage over time.

In addition to these signs, it's essential to be aware of signs related to alcohol abuse, such as gum disease, tooth erosion, and halitosis.

Advice, treatment, and referral

If you suspect a patient is struggling with substance or alcohol abuse, offering support and guidance becomes paramount. For example, encouraging patients to make small lifestyle changes that can positively impact their dental health. This includes reducing all sugar intake, brushing regularly with a fluoride toothpaste such as Duraphat 5000 and using an alcohol-free fluoride mouthwash. Clinicians should also provide dietary advice, oral hygiene instruction and recommend a fluoride varnish application to reduce potential tooth decay.

Dental professionals should also be prepared to refer patients to relevant charities, such as Dentaid, medical practices, or general practitioners who can help them address addiction issues.

Assisting at-risk patients

Clinicians must also be cognizant of the broader lifestyle issues affecting patients dealing with addiction. These individuals may struggle to keep appointments, and clinicians should be trained to deal with this and be prepared to take appropriate action in case of a safety concern.

In the dental chair, care extends beyond teeth and gums – it touches the lives of patients who may be facing some of their most challenging battles. Using compassion and empathy can make a real difference to the way people feel. Just a simple act of relieving pain, showing you care and taking the time to listen can have such a positive effect on their lives.

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