Assessing oral health of crack users in Brazil: Perceptions and associated factors, findings from a mixed methods study

ABSTRACT

This study explores associated factors and perceptions of oral health among crack users recruited in open drug scenes in Brazil. A mixed methods approach was used. The quantitative component analysed findings from a large (N = 7381), population-based survey. The outcomes under analysis were ‘self-perception of oral health’ and ‘self-reporting of problems affecting the mouth, teeth and gingiva (gums)’. The qualitative component comprised a focus group, with 12 individuals recruited from a drug treatment clinic. Lower self-perception of oral health problems vis-à-vis a higher prevalence of problems affecting the mouth, teeth, and gingiva were found in users who had a lower level of education, used substances daily, had worse self-perception of physical health, did not receive health care and regularly used alcohol and/or tobacco. The results show an association between substance use and decline in oral health, as well as the lack of health services focusing on such issues. Oral health services should be emphasised as a gateway to the health system. So far, the putative cross-referral between services and professionals working in oral health and other health professionals working in the field of drug dependence has not been observed.

KEYWORDS:

• Crack cocaine
• crack users
• oral health
• vulnerability
• inequalities

Acknowledgements

The authors are grateful to the volunteers who participated in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Disclaimer

The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of any agency of the Brazilian government.

Additional information

Funding

This study was funded by different Brazilian government agencies: The original survey was funded by a contract with BRAZIL SENAD (in the context of the Federal decree 7.179, May 10 2010), the Development agency ‘Coordenação de Aperfeiçoamento de Pessoal de Nível Superior’ (CAPES), who supported all work carried out in the context of postgraduated studies in Brazil and overseas. The additional information and the corresponding brand deeply reworked version of the original manuscript was coordinated by Francisco I. Bastos, as part of FAPERJ ‘Health Network program’ (E-26/010.002428/2019), profiting from its component: ‘analysis/reanalysis of Brazilian major databases on substance use’.