Substance-Related Disorders – Dental Hygiene Lecture

Vocabulary flashcards summarizing key terms and definitions related to substance-related disorders and their dental-hygiene implications.

Substance Addiction

Excessive, compulsive use of drugs or alcohol that elevates dopamine and endorphins and persists despite harm.

Blood Alcohol Concentration (BAC)

Percentage of alcohol in the blood; 0.08 g/dL is the U.S. legal intoxication level.

Standard Drink

Approximate amount of beverage that delivers ~14 g of pure alcohol (e.g., 12 oz beer, 5 oz wine, 1.5 oz 80-proof spirit).

Alcohol Tolerance

Need for higher doses of alcohol to obtain the previously achieved effect.

Clinical Pattern of Alcohol Use

Frequent heavy or binge drinking, loss of control, and continued use despite harm.

Alcohol Use Disorder (AUD)

Medical diagnosis for problematic drinking that impairs health or functioning.

Alcohol Overdose

Toxic level of alcohol causing vomiting, confusion, slow breathing, coma, or death; medical emergency.

Alcohol Metabolism

Liver converts ethanol → acetaldehyde → acetate at ~0.015 % BAC per hour (≈1 drink/hr).

Acetaldehyde

Toxic intermediate produced during hepatic alcohol metabolism before conversion to acetate.

Health Hazards of Alcohol

Damage to nervous, cardiovascular, hepatic, GI, immune, reproductive systems and ↑ cancer risk.

Fetal Alcohol Spectrum Disorders (FASDs)

Range of birth defects from prenatal alcohol exposure including growth, CNS, and facial anomalies.

Fetal Alcohol Syndrome (FAS)

Most severe FASD form with characteristic facial features, growth deficiency, and neurodevelopmental deficits.

Alcohol Withdrawal Syndrome

Signs (anxiety, tremor, hypertension) appearing 6–24 h after cessation in dependent drinkers.

Delirium Tremens (DTs)

Severe, life-threatening alcohol withdrawal with confusion, agitation, hallucinations, autonomic instability.

Behavioral Treatments (AUD)

Counseling modalities (CBT, motivational interviewing, family therapy) that build skills to stop drinking.

Naltrexone (ReVia)

Opioid antagonist medication that reduces alcohol cravings and relapse risk.

Acamprosate (Campral)

Glutamate modulator used to maintain abstinence in moderate-to-severe AUD.

Disulfiram (Antabuse)

Alcohol-aversive drug; causes flushing, headache, nausea if alcohol consumed within ~2 weeks.

Mutual-Support Groups

Peer programs (e.g., Alcoholics Anonymous 12-step) offering support for sobriety and relapse prevention.

Drug Abuse Screening Test-10 (DAST-10)

Brief questionnaire used in healthcare to identify problematic drug use.

Prescription Drug Monitoring Program (PDMP)

State database dentists consult to track controlled-substance prescriptions and curb opioid misuse.

Methamphetamine "Meth Mouth"

Rampant cervical caries, severe xerostomia, bruxism, cracked teeth linked to meth abuse.

Trismus

Limited jaw opening; common in methamphetamine users.

Cocaine-Induced Palatal Perforation

Oronasal fistula from chronic intranasal cocaine use; causes speech and swallowing issues.

Xerostomia

Dry mouth due to reduced salivary flow; prevalent with many substances (alcohol, cannabis, opioids, stimulants).

Naloxone (Narcan, Evzio)

Opioid antagonist that reverses overdose; available OTC and should be in dental emergency kits.

Endorphins

Endogenous peptides producing analgesia and euphoria; levels rise during substance use.

Intra-Oral Signs of Drug Abuse

Findings such as rampant caries, mucosal necrosis, gingival recession, oronasal perforations.

Extra-Oral Signs of Drug Abuse

Appearance: jaundice, long sleeves to hide needle marks, weight loss, poor hygiene, skin lesions.

DAST-10 Interpretation

Scores categorize risk to guide brief intervention, referral, or treatment for substance misuse.

Dental Documentation for Substance Abuse

Record alerts, early oral signs, contraindications (e.g., avoid alcohol rinses, epinephrine) and patient behavior.

Motivational Interviewing

Patient-centered communication style to enhance intrinsic motivation for behavior change, including substance cessation.

Prescription Opioid Risk Education

Patient counseling on safe use, storage, and disposal of opioid analgesics to prevent misuse.