Oral Health Status of Methadone Clients in Dublin, Ireland

There are estimated 13,460 intravenous drug misusers in Ireland of which 5,076 are registered in methadone substitution programmes. At present there are no available data on the oral health status of substance misusers in Ireland. Objective: to provide information for development of oral health services for adults attending methadone clinics. Methods: 220 subjects aged 16-24 (n=104) and 25-34 (n=116) were selected from a random sample of 5 of the 55 methadone clinics in Dublin for a cross sectional survey. Each client underwent a clinical examination and structured interview questionnaire investigating their oral health status, knowledge and behaviours and their perceived access to oral health services. Results: a higher level of caries was found amongst the methadone clients (mean DMFT was 12.2 and 15.7 for 16-24 and 35-44-year-olds) than among the same age group of deprived adults in the general population examined for the Irish National Survey of Adult Oral Health in 1989/90 (mean DMFT 7.5 and 15.4 for 16-24 and 35-44-year-olds). Restorative treatment was needed for 98 and 100% of the methadone clients in the younger and older groups compared with 65 and 76% of deprived adults in the general population. There was a higher level of untreated trauma in the methadone group for example 37% of female methadone clients in the 16-24-year-old group compared with 8% of the general population of deprived adults in the same age group had untreated incisor trauma. Attendance for oral health services was low. Conclusion: Methadone clients have poor oral health and high treatment needs. This study highlights the special requirement of an available, accessible and acceptable dental service, which should be integrated with the existing methadone programme service.