{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T10:12:01Z","timestamp":1763719921864,"version":"3.45.0"},"reference-count":36,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Objectives: This study aims to explore the relationship between dental caries and unemployment among U.S. adults who have engaged in illicit drug use, such as cocaine, heroin, and methamphetamine. Methods: The National Health and Nutrition Examination Survey (2015\u20132018) data were analyzed. The independent variable was severe dental caries (defined as DMFT &gt; 13.99), and the dependent variable was employment status. The sample was categorized into non-users, current users (used in the past year), and former users (used prior to the past year). Covariates included age, education, race, gender, smoking status, family income-to-federal poverty level ratio, and health insurance status. Logistic regression with survey weights was applied to assess associations between severe dental caries and employment status. Results: The total sample (n = 5476) represented 131,848,604 U.S. adults aged 18\u201359 years, with 4% current users and 12% former users of the specified drugs. Among current users, those with severe caries had higher odds of unemployment (OR = 2.6, p = 0.025) compared to those without severe caries. No significant association was found between severe caries and employment status among former users after controlling for covariates. Conclusions: The study underscores a significant association between severe dental caries and unemployment among U.S. adults who have used illicit drugs in the past year. These findings suggest a potential need for targeted oral health interventions in this population to improve economic well-being. Future research should focus on longitudinal studies to establish causality and explore mechanisms through which dental health may impact employment prospects.<\/jats:p>","DOI":"10.3390\/dj13120548","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T09:50:26Z","timestamp":1763718626000},"page":"548","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Dental Caries and Unemployment Among U.S. Adults with a History of Illicit Drugs"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1053-6522","authenticated-orcid":false,"given":"Sucharu","family":"Ghosh","sequence":"first","affiliation":[{"name":"Department of Community Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY 14642, USA"},{"name":"Department of Oral and Maxillofacial Surgery, NYCHHC\/Lincoln Medical Center, Bronx, NY 10451, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samarpita","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Arthur A. Dugoni School of Dentistry, University of the Pacific, Sacramento, CA 95817, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4432-1565","authenticated-orcid":false,"given":"Changyong","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY 14642, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janine","family":"Burkhardt","sequence":"additional","affiliation":[{"name":"Project Home, Philadelphia, PA 19130, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sangeeta","family":"Gajendra","sequence":"additional","affiliation":[{"name":"Department of Community Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY 14642, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"ref_1","first-page":"189","article-title":"Etiology of xerostomia and dental caries among methamphetamine abusers","volume":"3","author":"Saini","year":"2005","journal-title":"Oral Health Prev. Dent."},{"key":"ref_2","unstructured":"Juergens, J. (2022, February 05). Illicit Drug Addiction and Abuse. Addiction Center. Available online: https:\/\/www.addictioncenter.com\/drugs\/illicit-drugs\/."},{"key":"ref_3","unstructured":"Healthy People 2020 (2020). Social Determinants of Health, U.S. Department of Health and Human Services."},{"key":"ref_4","unstructured":"Centers for Disease Control and Prevention (2022, April 09). The Social-Ecological Model: A Famework for Prevention Atlanta (GA): Centers for Disease Control and Prevention, Available online: http:\/\/www.cdc.gov\/ncipc\/dvp\/social-ecological-model_DVPhtm."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1146\/annurev-publhealth-040119-094318","article-title":"Disparities in access to oral health care","volume":"41","author":"Northridge","year":"2020","journal-title":"Annu. Rev. Public Health"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Chen, W.L., and Chen, J.H. (2020). College fields of study and substance use. BMC Public Health, 20.","DOI":"10.1186\/s12889-020-09722-1"},{"key":"ref_7","unstructured":"National Institute of Dental and Craniofacial Research (US) (2022, September 15). Section 1, effect of oral health on the community, overall well-being, and the economy, Oral Health in America: Advances and Challenges [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK578297\/."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1111\/add.14892","article-title":"Frequency of health-care utilization by adults who use illicit drugs: A systematic review and meta-analysis","volume":"115","author":"Lewer","year":"2020","journal-title":"Addiction"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1016\/S0140-6736(13)61530-5","article-title":"Global burden of disease attributable to illicit drug use and dependence: Findings from the Global Burden of Disease Study 2010","volume":"382","author":"Degenhardt","year":"2013","journal-title":"Lancet"},{"key":"ref_10","unstructured":"National Drug Intelligence Center (2011). The Economic Impact of Illicit Drug Use on American Society, United States Department of Justice."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3235","DOI":"10.1111\/add.15360","article-title":"Illicit drug use and oral health","volume":"116","author":"Rossow","year":"2021","journal-title":"Addiction"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.jsat.2011.02.005","article-title":"Oral health of substance-dependent individuals: Impact of specific substances","volume":"41","author":"Cheng","year":"2011","journal-title":"J. Subst. Abuse Treat."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1177\/0022034511399918","article-title":"Oral health-related quality of life: What, why, how, and future implications","volume":"90","author":"Sischo","year":"2011","journal-title":"J. Dent. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1111\/j.1834-7819.2010.01229.x","article-title":"Xerostomia: An update for clinicians","volume":"55","author":"Hopcraft","year":"2010","journal-title":"Aust. Dent. J."},{"key":"ref_15","first-page":"929","article-title":"Oral health of drug abusers: A review of health effects and care","volume":"42","author":"Shekarchizadeh","year":"2013","journal-title":"Iran. J. Public Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1002\/JPER.19-0509","article-title":"Cocaine, polysubstance abuse, and oral health outcomes, NHANES 2009 to 2014","volume":"91","author":"Bahdila","year":"2020","journal-title":"J. Periodontol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1111\/jphd.12389","article-title":"Prevalence of oral conditions among methamphetamine users: NHANES 2009\u20132014","volume":"81","author":"Hegazi","year":"2021","journal-title":"J. Public Health Dent."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1016\/S0140-6736(05)71146-6","article-title":"Social determinants of health inequalities","volume":"365","author":"Marmot","year":"2005","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1002\/hec.1052","article-title":"Measuring the effects of work loss on productivity with team production","volume":"15","author":"Nicholson","year":"2006","journal-title":"Health Econ."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1111\/cdoe.12157","article-title":"The association between current unemployment and clinically determined poor oral health","volume":"43","author":"Vehkalahti","year":"2015","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1111\/jphd.12317","article-title":"Broken smiles: The impact of untreated dental caries and missing anterior teeth on employment","volume":"79","author":"Tschampl","year":"2019","journal-title":"J. Public Health Dent."},{"key":"ref_22","unstructured":"Bush, D.M., and Lipari, R.N. (2023, December 10). Substance Use and Substance Use Disorder by Industry. The CBHSQ Report, Available online: https:\/\/datatools.samhsa.gov\/."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1111\/jphd.12092","article-title":"Oral health-related quality of life among an Australian sample of people who inject drugs","volume":"75","author":"Truong","year":"2015","journal-title":"J. Public Health Dent."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.adaj.2019.02.016","article-title":"Comprehensive oral care improves treatment outcomes in male and female patients with high-severity and chronic substance use disorders","volume":"150","author":"Hanson","year":"2019","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Supi\u0107, Z.T., Petrovi\u0107, R., Mili\u0107evi\u0107, M.S., Trajkovi\u0107, G., and Bukumiri\u0107, Z. (2013). The oral health of heroin drug users: Case study in Bosnia and Herzegovina. BMC Public Health, 13.","DOI":"10.1186\/1471-2458-13-1202"},{"key":"ref_26","unstructured":"Centers for Disease Control and Prevention (2022, August 22). National Health and Nutrition Examination Survey Data, Available online: https:\/\/www.cdc.gov\/nchs\/nhanes\/index.html."},{"key":"ref_27","unstructured":"Centers for Disease Control and Prevention (2017). NCHS Research Ethics Review Board (ERB) Approval, CDC."},{"key":"ref_28","first-page":"661","article-title":"The global burden of oral diseases and risks to oral health","volume":"83","author":"Petersen","year":"2005","journal-title":"Bull. World Health Organ."},{"key":"ref_29","unstructured":"CDC\/National Center for Health Statistics (2019). Module 3: Weighting, CDC."},{"key":"ref_30","unstructured":"SAS Institute Inc (2013). SAS\/ACCESS\u00ae 9.4 Interface to ADABAS, SAS Institute Inc."},{"key":"ref_31","unstructured":"Substance Abuse and Mental Health Services Administration (2021). Key substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health, SAMHSA. Report No.: HHS Publication No. PEP21-07-01-003, NSDUH Series H-56."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1080\/10550887.2012.694604","article-title":"Rate and predictors of employment among formerly polysubstance dependent urban individuals in recovery","volume":"31","author":"Laudet","year":"2012","journal-title":"J. Addict. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.jsat.2019.09.002","article-title":"Change in employment status and cocaine use treatment outcomes: A secondary analysis across six clinical trials","volume":"106","author":"Miguel","year":"2019","journal-title":"J. Subst. Abuse Treat."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"7585","DOI":"10.1007\/s11356-017-8404-z","article-title":"Dental health status in crack\/cocaine-addicted men: A cross-sectional study","volume":"24","author":"Cury","year":"2017","journal-title":"Environ. Sci. Pollut. Res. Int."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Rommel, N., Rohleder, N.H., Koerdt, S., Wagenpfeil, S., H\u00e4rtel-Petri, R., Wolff, K.D., and Kesting, M.R. (2016). Sympathomimetic effects of chronic methamphetamine abuse on oral health: A cross-sectional study. BMC Oral Health, 16.","DOI":"10.1186\/s12903-016-0218-8"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1177\/0022034516640478","article-title":"Methamphetamine users have increased dental disease: A propensity score analysis","volume":"95","author":"Shetty","year":"2016","journal-title":"J. Dent. Res."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/13\/12\/548\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T10:09:08Z","timestamp":1763719748000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/13\/12\/548"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,21]]},"references-count":36,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["dj13120548"],"URL":"https:\/\/doi.org\/10.3390\/dj13120548","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,21]]}}}