Podcast
Questions and Answers
What is the primary route of elimination for MDMA?
What is the primary route of elimination for MDMA?
- Sweat
- Fecal excretion
- Respiratory
- Urinary excretion (correct)
What enzyme primarily metabolizes MDMA?
What enzyme primarily metabolizes MDMA?
- Monoamine oxidase
- Catechol-O-methyltransferase
- Acetylcholinesterase
- Cytochrome P450 (correct)
Which of these is NOT a commonly used name for MDMA?
Which of these is NOT a commonly used name for MDMA?
- E
- Love Drug
- Speed (correct)
- XTC
Which of the following is NOT a systemic effect of MDMA use?
Which of the following is NOT a systemic effect of MDMA use?
What is the chemical structure of MDMA?
What is the chemical structure of MDMA?
What is MDMA's classification under the 1971 Misuse of Drugs Act?
What is MDMA's classification under the 1971 Misuse of Drugs Act?
What is the primary reason MDMA was first synthesized?
What is the primary reason MDMA was first synthesized?
What is the most common way to consume MDMA?
What is the most common way to consume MDMA?
What is the medication being discussed, that is easily obtainable, and potentially fashionable?
What is the medication being discussed, that is easily obtainable, and potentially fashionable?
What is the name of the effect that resembles a tyramine reaction?
What is the name of the effect that resembles a tyramine reaction?
Which of these is NOT a potential cardiovascular complication of this medication?
Which of these is NOT a potential cardiovascular complication of this medication?
Which of the following is a potential neurological effect of this medication?
Which of the following is a potential neurological effect of this medication?
Which of these metabolic effects could be caused by this medication?
Which of these metabolic effects could be caused by this medication?
Which of the following is NOT a stated potential gastrointestinal effect of this medication?
Which of the following is NOT a stated potential gastrointestinal effect of this medication?
Which of these can be a side effect of this drug?
Which of these can be a side effect of this drug?
Which of the following complications is NOT mentioned as potentially being caused by the medication?
Which of the following complications is NOT mentioned as potentially being caused by the medication?
What was the patient's primary complaint?
What was the patient's primary complaint?
What type of drug was the patient suspected of using?
What type of drug was the patient suspected of using?
What was the primary finding on the upper anterior occlusal radiograph?
What was the primary finding on the upper anterior occlusal radiograph?
What was the diagnosis made for the patient?
What was the diagnosis made for the patient?
What was the primary treatment for the patient's condition?
What was the primary treatment for the patient's condition?
What was the primary reason for the use of fluoride varnish on exposed roots?
What was the primary reason for the use of fluoride varnish on exposed roots?
What was the significance of the orthodontic retainer used in this case?
What was the significance of the orthodontic retainer used in this case?
What was the outcome of the treatment for the patient at the 4-month follow-up?
What was the outcome of the treatment for the patient at the 4-month follow-up?
What type of dental treatment had the patient recently completed?
What type of dental treatment had the patient recently completed?
What recreational drug did the patient disclose using?
What recreational drug did the patient disclose using?
What is the primary mechanism by which SSRIs may worsen the effects of Ecstasy?
What is the primary mechanism by which SSRIs may worsen the effects of Ecstasy?
What was the patient's oral hygiene status described as?
What was the patient's oral hygiene status described as?
What is a common acute oral manifestation of MDMA use?
What is a common acute oral manifestation of MDMA use?
What was a possible contributing factor to the patient's lip swelling?
What was a possible contributing factor to the patient's lip swelling?
What periodontitis was found in the patient's oral examination?
What periodontitis was found in the patient's oral examination?
Which of the following factors contributes to tooth surface loss (TSL) in MDMA users?
Which of the following factors contributes to tooth surface loss (TSL) in MDMA users?
What aspect of the patient's case highlights the need for suspicion of drug abuse?
What aspect of the patient's case highlights the need for suspicion of drug abuse?
What is the primary reason behind the elevation of AST and GGT levels in the case study described?
What is the primary reason behind the elevation of AST and GGT levels in the case study described?
Why is MDMA described as potentially dangerous despite being widely accepted?
Why is MDMA described as potentially dangerous despite being widely accepted?
What is the likely reason for the increased white blood cell count (WCC), particularly eosinophils, in the case study?
What is the likely reason for the increased white blood cell count (WCC), particularly eosinophils, in the case study?
Why might drug abusers require higher doses of local anesthetics for dental treatment?
Why might drug abusers require higher doses of local anesthetics for dental treatment?
Which of the following oral manifestations of MDMA use can lead to tooth decay?
Which of the following oral manifestations of MDMA use can lead to tooth decay?
What is the enzyme involved in the metabolism of MDMA that is inhibited by SSRIs?
What is the enzyme involved in the metabolism of MDMA that is inhibited by SSRIs?
What is a common oral manifestation associated with MDMA use?
What is a common oral manifestation associated with MDMA use?
What is the primary reason for the gingival damage associated with MDMA use?
What is the primary reason for the gingival damage associated with MDMA use?
Which of the following is NOT mentioned as a possible explanation for the gingival lesions observed in the patient described in the text?
Which of the following is NOT mentioned as a possible explanation for the gingival lesions observed in the patient described in the text?
What is the primary reason MDMA is typically ingested orally?
What is the primary reason MDMA is typically ingested orally?
Which of the following drugs, when used in a similar way as MDMA, has been linked to oral lesions?
Which of the following drugs, when used in a similar way as MDMA, has been linked to oral lesions?
How does the text describe the presentation of necrotizing gingivitis in the patient?
How does the text describe the presentation of necrotizing gingivitis in the patient?
What is the primary reason for the patient's gingival lesions being initially attributed to MDMA?
What is the primary reason for the patient's gingival lesions being initially attributed to MDMA?
Which of the following is NOT a possible reason why the patient's lesions were not initially attributed to cocaine use?
Which of the following is NOT a possible reason why the patient's lesions were not initially attributed to cocaine use?
Flashcards
MDMA
MDMA
Methylenedioxymethamphetamine, also known as Ecstasy, a recreational drug.
Systemic effects of MDMA
Systemic effects of MDMA
Various health impacts affecting the entire body, potentially including death.
Tooth clenching
Tooth clenching
Involuntary grinding or clenching of teeth often due to MDMA use.
Periodontitis
Periodontitis
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Oral implications of MDMA
Oral implications of MDMA
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Psychoactive properties
Psychoactive properties
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MDMA metabolism
MDMA metabolism
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Long-term effects of MDMA
Long-term effects of MDMA
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Sympathomimetic
Sympathomimetic
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Effects of Sympathomimetics
Effects of Sympathomimetics
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Neurological Sequelae
Neurological Sequelae
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Cardiovascular Risks
Cardiovascular Risks
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Respiratory Complications
Respiratory Complications
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Hepatorenal Effects
Hepatorenal Effects
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Metabolic Issues
Metabolic Issues
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Gastrointestinal Reactions
Gastrointestinal Reactions
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SSRI
SSRI
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CYP2D6
CYP2D6
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Bruxism
Bruxism
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Dry Mouth
Dry Mouth
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Tooth Surface Loss (TSL)
Tooth Surface Loss (TSL)
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Acute Dentoalveolar Abscess
Acute Dentoalveolar Abscess
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Eosinophils
Eosinophils
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Elevated Liver Enzymes
Elevated Liver Enzymes
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Ischaemic vasoconstriction
Ischaemic vasoconstriction
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Cervical abrasions
Cervical abrasions
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Necrotising gingivitis
Necrotising gingivitis
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Gingival ulceration
Gingival ulceration
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Oral mucosa reaction
Oral mucosa reaction
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Local drug reaction
Local drug reaction
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Cocaine-related injuries
Cocaine-related injuries
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MDMA and oral health
MDMA and oral health
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General Malaise
General Malaise
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Pyrexia
Pyrexia
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MDMA (Ecstasy)
MDMA (Ecstasy)
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periodontal pockets
periodontal pockets
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Salivary flow
Salivary flow
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Localised defect in alveolar gingiva
Localised defect in alveolar gingiva
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Recreational drug use
Recreational drug use
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Symptoms of drug use
Symptoms of drug use
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Viridans Streptococci
Viridans Streptococci
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TMJ Arthromyalgia
TMJ Arthromyalgia
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Dental Attrition
Dental Attrition
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Xerostomia
Xerostomia
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Mucosal Ulceration
Mucosal Ulceration
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Cessation of MDMA Use
Cessation of MDMA Use
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Sub-gingival Debridement
Sub-gingival Debridement
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Fluoride Application
Fluoride Application
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Study Notes
Ecstasy-Related Periodontitis and Mucosal Ulceration
-
Methylenedioxymethamphetamine (MDMA), commonly known as ecstasy, is a recreational drug with oral and systemic effects.
-
MDMA use has been linked to a previously unreported oral manifestation: periodontitis.
-
Systemic effects of MDMA use include:
- Psychiatric: agitation, delirium, panic, paranoia, depression, psychosis, suicidal thoughts.
- Neurological: ataxia, seizures, tremor, tics, nystagmus, cerebral hemorrhage.
- Cardiovascular: tachycardia, hypertension, myocardial ischemia/infarction, ventricular ectopy.
- Respiratory: pulmonary hypertension and edema.
- Hepatorenal: renal failure, urinary retention, myoglobinuria, jaundice, hepatitis, hepatic failure.
- Metabolic: metabolic acidosis, hyponatremia, hypoglycemia, rhabdomyolysis, hyperthermia.
- Gastrointestinal: nausea, vomiting, anorexia, diarrhea, ischemic colitis.
- Other: disseminated intravascular coagulation (DIC), vasculitis, sexual dysfunction, serotonin syndrome, aplastic anemia, death.
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Oral effects of MDMA include
- Bruxism and tooth clenching
- Temporomandibular joint (TMJ) arthromyalgia
- Dental attrition
- Xerostomia (dry mouth)
- Mucosal ulceration
- Periodontitis
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A 15-year-old boy presented with upper lip swelling, malaise, and fever.
- He had just finished orthodontic treatment and had good oral hygiene.
- He reported using MDMA recreationally the day prior.
- MDMA was found in the labial vestibule adjacent to periodontal destruction.
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A mucosal fenestration defect was found on the upper lip, with exposed alveolar bone and roots.
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Mild root blunting and no significant bone loss were observed on radiographs.
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White blood cell count was elevated with an increase in eosinophils.
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Erythrocyte sedimentation rate (ESR) and liver enzymes were elevated.
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The culture of the fluid from the abscess showed normal oral flora.
-
Topical application of MDMA was suspected as the cause.
-
Treatment included:
- Oral antibiotics (Penicillin V and Metronidazole)
- Oral hygiene instruction, scaling, and polishing
- Scaling and sub-gingival debridement
- Fluoride application to exposed roots
- Orthodontic retainer for mobile teeth
-
The mucosal ulcer healed in one week, and the patient was discharged for routine periodontal care after 4 months.
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MDMA is frequently used, though it can be dangerous.
-
Dentists should be aware of potential complications of MDMA use.
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