Methamphetamine use and dental problems among adults enrolled in a program to increase access to oral health services for people living with HIV/AIDS.

OBJECTIVE: We examined the association between methamphetamine (meth) use and dental problems in a large sample of HIV-positive adults. METHODS: We gathered data from 2,178 interviews across 14 sites of the U.S. Health Resources and Services Administration HIV/AIDS Bureau's Special Projects of National Significance Innovations in Oral Health Care Initiative from May 2007 to August 2010. We used multivariate generalized estimating equations to test the association between meth use and dental problems, adjusting for potential confounders. RESULTS: Past and current meth use was significantly associated with more dental problems. The study also found that poor self-reported mental health status, fewer years since testing positive for HIV, a history of forgoing dental care, less frequent teeth brushing, poor self-reported oral health status, oral pain, grinding or clenching teeth, some alcohol use, more years of education, and self-reported men-who-have-sex-with-men HIV risk exposure (compared with other exposure routes) were significantly associated with dental problems. CONCLUSION: Individuals who are HIV-positive with a history of meth use experience access barriers to oral health care and more dental problems. Our study demonstrated that it is possible to recruit this population into dental care. Findings suggest that predisposing, enabling, and need factors can serve as demographic, clinical, and behavioral markers for recruiting people living with HIV/AIDS into oral health programs that can mitigate dental problems.

Preoperative autologous blood donation for oral and maxillofacial surgery: an analysis of 913 patients.

PURPOSE: Autologous transfusions are frequently used with elective surgical procedures and are a mandated choice under California law. Because unused units cannot be transfused to other patients, it is important to assess utilization and minimize waste. METHODS: The transfusion needs of 913 consecutive patients scheduled for major oral and maxillofacial surgery at the University of California San Francisco were evaluated in 3 categories: oncologic and reconstructive surgery (563), orthognathic surgery (260), and temporomandibular joint surgery (90). RESULTS: 24.9% of patients chose to undergo preoperative autologous blood donation. 24.2%, 20.6%, and 11.4% of oncologic and reconstructive surgery, orthognathic surgery, and temporomandibular joint surgery patients, respectively, who made an autologous donation preoperatively, subsequently received a transfusion postoperatively. CONCLUSION: Transfusion needs for most oral surgery procedures are clearly overestimated; the relatively low risk of blood loss associated with these procedures today should be taken into account when asking patients to participate in preoperative autologous blood donation.