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Background: Researchers have reported rampant caries among methamphetamine users. The authors investigated the prevalence of dental disease and associated risk behaviors in methamphetamine users compared with those in heroin users., Methods: This pilot project was a cross-sectional study of an ongoing cohort of young adult injection-drug users (IDUs) in San Francisco. Participants completed an oral health questionnaire administered by a research assistant, and dentists performed clinical examinations to record the participants' data in terms of scores on the decayed-missing-filled surfaces (DMFS) index, presence of residual roots, scores on an oral hygiene index and whether any salivary hypofunction was observed., Results: The prevalence of dental disease among 58 young adult IDUs was strikingly high compared with that in the U.S. general population; however, the authors found no difference in the level of dental disease between users of methamphetamine and users of heroin. The mean DMFS score and number of decayed surfaces exceeded 28 in both groups., Conclusions: Although the authors detected no difference in dental disease between methamphetamine and heroin users, they found a high prevalence of caries and caries-associated behaviors in the sample of young adult IDUs., Clinical Implications: Given the high level of dental disease observed in this population of young adult IDUs, one next step may be to explore the feasibility and effectiveness of providing low-intensity preventive measures (such as distribution of chlorhexidine rinses or xylitol gum or application of fluoride varnishes) through outreach workers.

Background: Dentists experience more neck, shoulder and lower back pain than do practitioners in other occupational groups. The authors examined the prevalence of musculoskeletal pain in dental students, by sex., Methods: The authors investigated the body distribution and severity of reported musculoskeletal pain in a population of dental students, considering increased exposure to clinical experience with years in dental school. A total of 271 dental students in all four school years completed a questionnaire focusing on pain reported in five general body regions., Results: Forty-six to 71 percent of students reported body pain, with the percentage generally increasing with years in dental school. Women reported having the worst pain in their neck/shoulder region (chi2, P = .004); men reported having the worst pain in their mid- to lower back regions (chi2, P = .015). Frequency and daily duration of the worst pain were higher in the third year of dental school than in the first year (Bonferroni test, P = .014 and P = .001, respectively), as was the persistence (in months) of the most symptomatic body pain (P = .001). Pain intensity was higher for women than for men (two-way analysis of variance, P < .05). The perception of how performance of dental procedures affects pain increased significantly with number of years in dental school (P = .001)., Conclusions: Chronic musculoskeletal pain appears early in dental careers, with more than 70 percent of dental students of both sexes reporting pain by their third year., Clinical Implications: Musculoskeletal pain is a common complaint of dental professionals that may lead to serious physical disability. Since this type of pain occurs early in dental training, dentistry is obligated to further examine the mental, physical and ergonomic factors that may be contributory.