Recommendations for the Dental Team

Many medical and dental practices utilize Screening, Brief Intervention, and Referral to Treatment (SBIRT) to identify and assist patients with suspected substance use disorders. SBIRT is an evidence-based public health approach designed to facilitate early identification of unhealthy substance use, provide brief motivational interventions, and connect patients with appropriate treatment resources when indicated.^1,7,31

Screening assesses the severity of substance use and helps determine the appropriate level of intervention.

Brief Intervention uses patient-centered, motivational communication techniques to increase awareness of substance use and encourage positive behavioral change.

Referral to Treatment connects individuals requiring more extensive care with specialized addiction treatment services.^1,7,31

When discussing suspected substance use, dental professionals should employ respectful, nonjudgmental, and trauma-informed communication that encourages honest disclosure while preserving patient dignity and strengthening the therapeutic relationship.^1,28

No other illicit drug has produced oral manifestations as dramatic—or received as much attention in the dental literature—as methamphetamine.

Many individuals with methamphetamine use disorder do not receive routine preventive dental care. The oral manifestations of methamphetamine use may continue to evolve for months following cessation of drug use, and comprehensive dental rehabilitation is often required. Successful preventive, restorative, periodontal, prosthodontic, and surgical treatment is frequently possible when patients are medically stable, engaged in recovery, and able to maintain appropriate oral hygiene.^13,28

Each patient should be evaluated individually. The extent of tooth wear, microfractures associated with bruxism, periodontal destruction, salivary dysfunction, caries risk, medical status, and the patient's readiness to participate in care should all be considered when developing a comprehensive treatment plan. Depending on the clinical presentation, treatment may include preventive therapy, direct restorations, crowns, periodontal therapy, endodontic treatment, extractions, removable prostheses, implant-supported prostheses, or comprehensive oral rehabilitation.^13,28

Treatment decisions should be based primarily on the patient's current medical condition, physiologic status, decision-making capacity, and ability to provide informed consent, rather than solely on a history of methamphetamine use.^1,28

When appropriate, collaboration with the patient's physician, behavioral health provider, addiction specialist, primary care clinician, and other members of the healthcare team may improve both oral and overall health outcomes.^1,28