A not for profit organization in Germantown, Tennessee.
Mission
Our mission is to organize a clinical study to see if dental treatment during court-ordered drug rehabilitation helps an addict maintain sobriety. The information from this study may support increased funding of dental treatment for patients in drug rehabilitation programs.
The Specific Aims of our organization are :
Find funding sources and coordinate local stakeholders to establish a pilot program in the Memphis/Shelby County area to test study design, protocol and standards. Once the initial pilot protocol is tested, seek acceptance of our study design by the National Dental Practice-Based Research Network (NDPBRN) for replication nationwide.
Under the guidance of the National Dental PBRN, reproduce this study in 25 court-ordered drug rehabilitation programs throughout the country to obtain a large unbiased sample size.
Provide follow up dental care for two years of post-drug rehabilitation treatment to collect data on oral health status, relapse, recidivism, and re-arrest data of patients who received comprehensive dental care during drug rehabilitation treatment.
Produce an analytical analysis of the collected data from this study on the recidivism rates of court-ordered rehabilitation.
Learn how you can participate in organizing this study
Send your contact information to SMILES4SOBRIETY@hotmail.com.
We need people from different backgrounds to help guide this project to completion.
Most of our interaction will be online.
Background and Scientific Rationale
Substance abuse is a disorder characterized by repetitive drug use that results in social or economic distress. Drug addiction is a chronic, relapsing disorder characterized by the compulsion to take a drug and loss of self-control in limiting drug intake. Both disorders are often associated with medical and psychiatric issues that are regularly treated during court-ordered drug rehabilitation programs.
Studies show drug abuse can induce rampant dental cavities, gum disease and pre-malignant conditions. Unlike medical and psychiatric issues, the oral health of drug abusers is given little attention during current drug rehabilitation treatment protocols. Only limited emergency dental care to treat pain from an acute dental infection is available. Most dental care involves dental extractions with little or no follow-up.
The psychological and physiological problems resulting from an addict's dental disease can be profound and may affect long-term sobriety. But there are no investigations to study the effects of dental treatment on rates of relapse or quality of life post-treatment. Evidence-based research is needed to prove dental treatment during drug rehabilitation reduces recidivism rates. With this outcome, medical insurance and government drug intervention programs would fund dental care in drug rehabilitation treatment protocols.
Potential Risks
There is no risk of integrating comprehensive dental care to drug addicts in court directed drug treatment programs. Providing comprehensive dental care as a component of drug rehabilitation treatment reduces emergency dental needs during active substance abuse treatment by eliminating a common drug abuse trigger, toothache. Properly managed and tailored dental care restores oral aesthetics and improves oral functionality reducing future cavity and periodontal disease risk.
Benefits
Reduces demand for public dental emergency services
Most drug abuse programs refer to emergency dental needs to charity dental providers. These clinics are commonly overwhelmed by community demand. Emergency dental treatment is usually dental extraction or antibiotic prescription with no follow-up. If charity dental services are unavailable, patients access medical providers or hospital emergency rooms where only palliative treatment is available. Many suffer great pain and infection with no treatment.
Manages medical problems reducing demand on public health network
Restoring the ability to chew a healthy diet helps a recovering addict manage co-morbid health conditions such as diabetes, high blood pressure, obesity, eating disorders, and sleep apnea. Oral cancer screening and recommendations for HPV vaccination reduces the risk of oropharyngeal cancer. Patients have a greater chance of staying healthy and avoid acute medical problems that overburden community medical systems.
Encourages social integration, good interpersonal relationships to reduced relapse.
The ability to smile and chew food is fundamental to human communication. Restoring and addict's smile with restorations, functional complete or partial dentures encourages interpersonal interactions, supports self-confidence, and increases employment opportunities. It reduces the recovering addict's isolation. Social integration can reduce depression leading to relapse.
Lowers future dental health care cost for the recovering addict
Comprehensive dental treatment includes dental health education, dietary counseling, and Silver Diamine Fluoride (SDF) treatment. These preventative measures reduce the risk of future dental disease. Lowered dental disease risk translates into decreased costs to maintain oral health and lowers the demand for community charity dental health systems. Overall preventative measures help maintain the dental health of the recovering addict far into the future.
Potential to change clinical practice
Dental treatment standards for court-ordered drug treatment programs would incorporate dental treatment into the treatment standards for drug rehabilitation treatment programs and justify funding for these services by insurance companies and other funding sources. Drug rehabilitation programs do not consider dental disease treatment in their drug rehabilitation treatment standards of care. Medical insurance coverage does not consider dental disease medical sequel to drug addiction and dental treatment is not covered by medical insurance or government funded drug intervention grants.
This study hope to establish working relationships between local Dental offices, local Courts, State Dental Boards and local drug rehabilitation programs. Establishing these working relationships may outlast this study and encourage the continued inclusion of dental services in local drug rehabilitation programs.
Funding for dental treatment provided by this study may support Dental offices within the network recovering from the negative financial impact of Covid-19. For a well-designed study, several funding sources could be utilized-various foundations, NIH grants, USDA, SAMHSA, BOP, MAT as well as SBA Disaster Grants
Dentist treat active and recovering addicts and see the impact of drug addiction every day in their dental offices and their communities. Dentists are interested in developing evidenced-based dental treatment guidelines to support addiction recovery.
Impact on the oral health of the public
Evidenced-based research supporting the efficacy of comprehensive dental in drug rehabilitation therapy allows the design and ultimate inclusion of dental treatment in the standards of care for drug rehabilitation programs.
Justification for why the National Dental PBRN is the best setting for the study as compared to an academic health center or similar setting.
The goals of the National Dental PBRN are to support national oral health research studies in dental practices on topics of importance to practitioners and their patients, to provide evidence useful in daily patient care, and to facilitate the translation of research findings into clinical practice.
The goals of this study align directly with those of the National Dental PBRN. The impact of dental disease on recovering addicts has never been scientifically evaluated. This lack of research excludes limit policymakers from including dental treatment as a part of drug rehabilitation treatment.
Unlike academic health centers, many PBRN Dental offices are near court-ordered drug rehabilitation clinics in both rural and metropolitan settings. Obtaining participants from both rural and municipal communities with varied approaches to drug rehabilitation reduces bias and improves the reliability of the study.
Feasibility to conduct a high-quality study and recruitment potential
According to a PBRN Poll, there is much interest in dental offices participating in this study. The study's protocol will be tested in a Pilot program in Memphis/ Shelby County Tennessee before roll out nationwide.