Improving the Oral Health of People Seeking Substance Use Treatment

People who experience substance use disorder (SUD) also face barriers to accessing oral health care, including those related to social determinants of health: living with low incomes, reduced access to transportation, and lack of adequate insurance coverage. These challenges, especially when taken together, can make it difficult to prioritize oral health until it becomes urgent. When it does, it may be difficult to find a dentist, get to appointments, and carry through with the recommended care plans and follow up visits.

These challenges and barriers are compounded by the direct effects of substance use, including dry mouth and vascular changes, which worsen oral health. Some medications for opioid use disorder, including suboxone and methadone, can also have side effects that affect oral health including dry mouth and mouth acidity. Meanwhile, periodontitis is associated with heart disease, uncontrolled diabetes, substance use, and other systemic conditions.

In partnership with Dr. Hugh Silk at UMass Chan Medical School, RIZE is developing a scalable oral health intervention for people experiencing SUD that can be offered in SUD provider outreach settings. The model will be offered in three tiers of progressively in-depth interventions based on clinician expertise, training, and local internal and external resources.

During year one of the project, UMass Chan Medical School will pilot, evaluate, and strengthen the model with its patients. The team will engage patients with initial oral health screenings, oral hygiene supplies, and advice, of which we anticipate approximately 20 percent will be interested in case management support for dental visits. Once the intervention is piloted and strengthened based on learnings from year one, in year two, RIZE aims to provide UMass with funding to continue the program and offer trainings to other SUD providers in Massachusetts. We also will seek opportunities to replicate the program at other substance use outreach sites.