Are traumatic dental injuries greater in alcohol or illicit drugs consumers? A systematic review and meta-analysis

Drug Alcohol Depend. 2019 Apr 1:197:236-249. doi: 10.1016/j.drugalcdep.2018.12.028. Epub 2019 Feb 20.

Abstract

Introduction and aims: Traumatic dental injuries (TDI), alcohol and illicit drugs consumption are highly-prevalent public health concerns. The aim of this study was to evaluate the association between alcohol and/or illicit drugs consumption and the presence of TDI.

Design and methods: This review was performed in accordance with MOOSE and PRISMA guidelines. Electronic searches were performed to found observational studies that investigated subjects that consumed alcohol and/or illicit drugs associated with TDI. Data extraction and a risk of bias assessment were performed. Three meta-analyses (MA) were performed to evaluate the association between TDI and alcohol consumption (1stMA), subgrouping the studies into alcohol intake and binge-drinking, alcohol-related problems (2ndMA), and drugs (3rdMA). The odds ratio (OR) were calculated (p ≤ 0.05) for all analyses. The evidence was certainty-tested using the GRADE approach.

Results: Twelve articles met the eligibility criteria. Nine studies were methodologically sound, while three had some confounding factors. In the pooled MA, an association between alcohol consumption and TDI (OR 1.57[1.33,1.85],p = 0.00001) was determined with moderate certainty of evidence, confirmed in the subgroups of alcohol intake (OR 1.49[1.17,1.90],p = 0.001) and binge-drinking (OR 1.68[1.30,2.18],p = 0.0001). No associations were found between TDI and risk for alcohol-related problems and drug use (OR 0.75[0.50,1.14],p = 0.18, and OR 1.20[0.82,1.75],p = 0.27, respectively), with both analyses having a very low certainty of evidence.

Discussion and conclusions: There is moderate evidence concerning the association between alcohol use and TDI. Despite the absence of an association between illicit drugs use, alcohol-related problems and the presence of TDI, these results should be viewed with caution, since they had very low-certainly-evidence.

Keywords: Alcohol drinking; Literature review; Street drugs; Tooth injuries.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adult
  • Alcohol Drinking / adverse effects*
  • Female
  • Humans
  • Illicit Drugs*
  • Male
  • Observational Studies as Topic
  • Odds Ratio
  • Prevalence
  • Substance-Related Disorders / complications*
  • Tooth Injuries / epidemiology*
  • Tooth Injuries / etiology*

Substances

  • Illicit Drugs