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A COCAINE ADDICTION
By: Moriah Wallace, Christen Kennon, & Cecily Fontenot
INTRODUCTION
There are 2.4 million cocaine abusers in the U.S.
Most commonly used illicit drug
Cocaine is extracted from the leaf of Erythoxlum coca bush.
Our goal is to educate dental professionals on how to recognize the signs and
symptoms of cocaine use and how to give proper treatment to a patient with a
cocaine addiction.
Topics include: how cocaine effects the brain, the signs and symptoms of
cocaine use, and how to apply the dental hygiene process of care.
BEHAVIORAL SYMPTOMS
Anxiety
Irritation
Extremely talkative
Increased energy
Bizarre behaviors
Violence
Changes in habits, attitudes, and
efficiency
Irregular attendance at appointments by
one who was previously responsible.
Cause vasoconstriction
Liver Damage
Gastrointestinal Effects
Cardiovascular Effects
Gastrointestinal
complications
Abdominal pain
Nausea
Vomiting
INTERVIEWING THE
PATIENT
Effective Communication
Keep the lines of communication open
the dental hygienist should remain empathetic, respectful, and nonjudgmental
Discuss the effects of drug use on the patients well being
DRUG
INTERACTIONS
Epinephrine- response is enhanced by the vasoconstrictor activities of cocaine
Administration of local anesthetic after recent use of cocaine may cause an acute rise in
blood pressure.
Convulsions are associated with the combination of lidocaine and cocaine potentiates
Dental treatment should be postponed 6 to 24 hours after the ingestion of cocaine.
Opioid analgesics should be avoided in patients recovering from substance abuse.
Vasoconstrictors should not be used in patients who are actively using cocaine.
CLINICAL
EXAMINATION
EXTRAORAL
Vital Signs- Increase in blood pressure, cardiac arrhythmias, and increase in body temperature
Personal Appearance- Lack of interest in proper dress and personal hygiene, small blood stains on
clothes from previous injections, dramatic weight loss.
Eyes- Wears sunglasses to conceal dilated or constricted pupils and eye redness, or to avoid bright
light due to eye sensitivity.
Nose- Perforated nasal septum
Lips- Angular cheilitis
Arms- Needle marks may be noted when determining blood pressure. Patient may wear long sleeves
TMJ- Limitations or deviations of movement, limitation of opening, tenderness, sensitivity, noises,
discomfort, TMD
CLINICAL EXAMINATION
INTRAORAL
Mucosa, Lips, and Tongue- Xerostomia, soft tissue abnormalities, glossodynia, halitosis
Gingiva- Poor oral hygiene, heavy biofilm, generalized calculus deposits, moderate to
severe gingival inflammation, spontaneous bleeding or bleeding on probing, gingival
lesions, periodontal disease
Palate- Perforation of palate due to chronic cocaine snorting.
Teeth- Chipped and fractured from falls and injuries, abrasion, attrition, erosion, occlusal
wear, corrosion of gold restorations
Dental Caries- Diet high in cariogenic substances, root caries, rampant carious lesions,
tooth loss, increased risk factors: poor diet, lack of dental care, accumulation of biofilm, and
xerostomia.
Oral Manifestations- Saddlenose deformity, rapid gingival recession, mucosal
ulcerations, trismus, excessive hemorrhage after tooth extraction
Perforated Septum
Rampant Caries
Attrition
Cleft Palate
Saddlenose
Angular Cheilitis
TREATMENT
SUMMARY
Review and confirm the dental hygiene care plan with the patient
Modify as necessary and obtain consent
Implement the plan
Monitor patient comfort
Provide post-treatment instruction
Implement self-care intervention
Confirm the plan for continuing care or maintenance
Maintain patient privacy and confidentiality
Follow up with the patient as necessary
HOW TO GET
HELP
www.drugabuse.gov
www.samhsa.gov
1-800-662HELP (4357)
REFERENCES
Bassiouny, Mohamed. (2013). Dental Erosion Due to Abuse of Illicit Drugs and Acidic Carbonated Beverages. General Dentistry, 61(2),
38-44.
Cocaine Abuse & Addiction Signs, Effects & Symptoms. (n.d.). Retrieved August 02, 2016, from
http://www.acadianaaddiction.com/addiction/cocaine/symptoms-signs -effects#Signs-and-Symptoms
Hamilton, J. S., M.D. (2014). What Effect Does Cocaine Have on the Nose? Retrieved August 03, 2016, from http://www.ohniww.org/cocaine-nose-collapse-treatment/
Hofstede, Theresa M. & Jacob, Rhonda F. (2010). Diagnostic Considerations and Prosthetic Rehabilitation of a Cocaine-induced Midline
Destructive Lesion: A Clinical Report. The Journal of Prosthetic Dentistry, 103(1), 1-5. doi:10.1016/S0022-3913(09)00153-X
How does cocaine produce its effects? (n.d.). Retrieved August 02, 2016, from
https://www.drugabuse.gov/publications/research-reports/cocaine/how-does-cocaine -produce-its-effects
Maloney, William, J. (2010). The Significance of Cocaine Use to Dental Practice. New York State Dental Journal, 76(6), 36-39.
Shekarchizadeh, Hajar, Khami, Mohammad R., Mohebbi, Simon Z., Ekhtiari, Hamed, & Virtanen, Jorma I. (2013). Oral Health of Drug
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Standards for Clinical Dental Hygiene Practice - adha.org. (n.d.). Retrieved August 2, 2016, from
https://www.adha.org/resources-docs/2016-Revised-Standards-for-Clinical-Dental -Hygiene-Practice.pdf
Wilkins, E. M. (2009). Clinical practice of the dental hygienist (11th ed.). Philadelphia: Wolters Kluwer Health/Lippincott
Williams & Wilkins.