{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:26:02Z","timestamp":1792603562474,"version":"4.5.0"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T00:00:00Z","timestamp":1580688000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cocaine is the second most abused illicit drug in the United States. To date, no study has examined the association between cocaine use and oral health with a nationally representative sample. Our study examined the association between cocaine use\u2014singly and with other substances\u2014and oral health outcomes, including periodontitis and untreated caries, among US adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data for 11,753 individuals, aged \u226530 years, who completed a periodontal examination, in the 2009 to 2014 National Health and Nutrition Examination Survey (NHANES) were analyzed. Descriptive analyses and multivariable binary logistic regression analyses were conducted on weighted data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 17% (20.5 million) of US adults aged \u226530 years had ever used cocaine, with higher likelihood seen among males, non\u2010Hispanic whites, and those living in poverty. Current cocaine use prevalence was 2.6% (3.2 million). By number of co\u2010used substances, the odds of having any periodontitis were higher among cocaine users who consumed \u22653 other substances (adjusted OR\u00a0=\u00a02.47; 95% CI\u00a0=\u00a01.15 to 5.30) when compared with solely cocaine users. By type of substance co\u2010used, odds of having untreated caries were greater among those reporting cigarettes (adjusted OR\u00a0=\u00a01.94; 95% CI\u00a0=\u00a01.21 to 3.11) or methamphetamine (adjusted OR\u00a0=\u00a05.40; 95% CI\u00a0=\u00a01.92 to 15.14) usage. Odds of any periodontitis were higher among those reported ancillary cigarette use (adjusted OR\u00a0=\u00a02.84; 95% CI\u00a0=\u00a01.60 to 5.04) compared with cocaine\u2010only users.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In addition to a positive association between periodontal disease, dental caries, and cocaine use, select co\u2010usage elevated the risk of oral disease. Patients should be screened for and counseled regarding substance abuse to facilitate a successful quit.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jper.19-0509","type":"journal-article","created":{"date-parts":[[2020,1,10]],"date-time":"2020-01-10T04:59:03Z","timestamp":1578632343000},"page":"1039-1048","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Cocaine, polysubstance abuse, and oral health outcomes, NHANES 2009 to 2014"],"prefix":"10.1002","volume":"91","author":[{"given":"Dania","family":"Bahdila","sequence":"first","affiliation":[{"name":"Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine  Boston MA USA"},{"name":"Department of Preventive Dental Sciences Faculty of Dentistry King Abdulaziz University  Jeddah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2200-2408","authenticated-orcid":false,"given":"Muath","family":"Aldosari","sequence":"additional","affiliation":[{"name":"Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine  Boston MA USA"},{"name":"Department of Periodontics and Community Dentistry College of Dentistry King Saud University  Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abeer","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine  Boston MA USA"},{"name":"Department of Preventive Dental Sciences Faculty of Dentistry King Abdulaziz University  Jeddah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jevae L.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Hegazi","sequence":"additional","affiliation":[{"name":"Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine  Boston MA USA"},{"name":"Department of Preventive Dental Sciences College of Dentistry Imam Abdulrahman Bin Faisal University  Dammam Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riddhi","family":"Badamia","sequence":"additional","affiliation":[{"name":"Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hesham","family":"Alhazmi","sequence":"additional","affiliation":[{"name":"Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine  Boston MA USA"},{"name":"Department of Preventive Dentistry Faculty of Dentistry Umm Al\u2010Qura University  Makkah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tejasvita","family":"Chandel","sequence":"additional","affiliation":[{"name":"Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satomi","family":"Odani","sequence":"additional","affiliation":[{"name":"The National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantine I.","family":"Vardavas","sequence":"additional","affiliation":[{"name":"Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Israel T.","family":"Agaku","sequence":"additional","affiliation":[{"name":"Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,3]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Substance Abuse and Mental Health Services Administration (SAMHSA).Key substance use and mental health indicators in the United States: results from the 2018 National Syrvey on Drug Use and Health. 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