Spotting substance abusers

Aug. 1, 2005
A recent discussion on one of the dental hygiene e-mail groups addressed the topic of carious lesions associated with “meth mouth.

A recent discussion on one of the dental hygiene e-mail groups addressed the topic of carious lesions associated with “meth mouth.” Many hygienists in the discussion were unfamiliar with the signs and symptoms of crystal methamphetamine use. Michelle Klassen, RDH, is trying to change that and educate hygienists and other dental professionals about the oral manifestations of addictions in a continuing education program of the same name. Her program is an ever-evolving seminar designed to enlighten the dental professional regarding current research on tobacco, cocaine, marijuana, heroin, and crystal meth. Specific characteristics of tissue changes, periodontal disease locations, and dental erosion can encourage clinicians to ask patients specific questions regarding substance abuse. A dental professional taking this course will be educated about these various components, and yet will be laughing and interacting with fellow participants.

As a result of attending “Oral Manifestations of Addictions,” the participant will:

• Identify the characteristics that a person must display in order to be considered “addicted”

• Identify signs and symptoms of an individual misusing CNS depressants, stimulants, and psychedelics

• Recognize the dental implications if a patient is misusing CNS depressants, stimulants, and psychedelics

• Identify oral manifestations of cocaine and marijuana on the oral cavity through the use of case studies

In addition, Michelle offers a program that coincides with the Oral Manifestations program titled, “Pharmacology Made Easy.” This program updates basic pharmacological principles and discusses commonly used street drugs and how they also can affect dental patients. Objectives for the pharmacology program include: explaining the concept of dose response via mathematical calculations, and discussing the pharmacokinetics of drugs. She also offers other programs for dental professionals on topics such as motivation and communication, dentin hypersensitivity, dental product updates, and a new program on the controversy between tobacco cessation and obesity.

Dental hygienists, as well as other dental professionals, would benefit from the “Oral Manifestations of Addictions” program because it allows the entire team to broaden its knowledge about street drugs and signs and symptoms associated with abuse. Many addicts “shop” dental offices looking for prescription drugs. If the dental team is on the same page, problems can be spotted before they occur. They will also have the peace of mind that comes from knowing how to react if a dental emergency occurs involving a patient who has been abusing.

Michelle became involved in educating dental professionals about drugs because she wanted to further her own education in dentistry. She also wanted to provide a field of research from which dental hygiene could grow. At the University of Alberta where she was studying, Michelle enrolled in an addiction studies certificate program from which she graduated in 2001. She recently completed another addiction program at the Harvard Medical School in 2004. She ultimately would like to pursue a doctorate in oral biology with a focus on how various drugs affect the oral cavity. Her original addiction certificate developed after a professor told her that there needed to be more research on how topically applied cocaine affected gingival tissues. From there, she was “hooked.” This research focus gave her the motivation she was looking for to develop her programs.

Michelle’s programs are presented in PowerPoint, and her handouts include highlights of the programs. In addition, at the beginning of each course, Michelle likes to challenge participants by offering a pretest. Prizes are awarded to the highest scorers. She involves a lot of communication skills and role plays throughout her programs. She can often be found telling a joke, throwing chocolates, or doing a tap dance or two to lighten up the often-serious topics. She believes strongly in pairing education with fun! After being a dental assistant and receptionist for a number of years, she received her dental hygiene degree from the University of Alberta in Edmonton, Canada, and currently is employed in private practice. She began presenting CE programs in 1998 and now has her own company, Unique Dental Seminars. She is a member of the Canadian Dental Hygienists Association, as well as a member of the ADHA. She is concerned about the lack of educational recognition that dental hygienists receive and the limitations of practice. She believes hygienists need to further their education, even to the PhD level, to promote the profession.

Michelle is passionate about her children, ages six and four, and maintaining a healthy lifestyle. She would love to continue to be proactive in creating new and interesting CE programs, paying special attention to the wants and needs of dental professionals around the world. The one piece of advice she would offer dental professionals is to “follow your passion in life. It is a great, uplifting feeling to know that you are making a difference in your profession and your world. Reach for the stars!” By creating an understanding that approximately 98 percent of the population is affected directly or indirectly by substance abuse of minor or major proportions, she empowers dental professionals to reach for the stars in providing comprehensive dental and health education to their patients.

For information regarding Michelle’s programs: [email protected].


Ann-Marie C. DePalma, RDH, BS, is currently a faculty member at Mt. Ida College’s dental hygiene program after spending more than 25 years in private practice. She is also pursuing a master’s degree in education in instructional design. A member of several professional dental hygiene associations, Ann-Marie has written numerous articles and provides continuing education programs for dental hygienists and dental team members. She can be reached at [email protected].