Breaking the Cycle of Addiction and Poor Dental Care in Worcester

Usually, when you hear of treatments for substance abuse, you think of rehab, therapy, and support groups, and you don't think of the dentist. However, many people who are struggling with addiction are also dealing with a major hurdle to recovery: poor dental health that's caused by the use of substances like drugs or alcohol. Dr. Hugh Silk and his team at UMass Chan Medical School in Worcester just received a new grant to work directly with those battling addiction in the Worcester area, helping them restore their dental health and develop more self-confidence. Dr. Silk joins Nichole this week to talk about why oral health is so important and his plans for this new grant.

Episode Transcript

(00:07):
From WBZ News Radio in Boston.This is New England Weekend. Each week
we come together and talk about allthe topics important to you and the place
where you live. It's great tobe back here with you this week.
I'm Nicole Davis. When you thinkabout treatment for substance abuse, you often
think about therapy, rehab, dtalks, time at the gyms, support groups.

(00:28):
All of those are very important andthey work together to bring health and
hopefully happiness to people who are strugglingunder the hand of addiction. That being
said, many people who are navigatingrecovery find themselves eventually dealing with a pretty
big barrier that might stop them frommaking progress. We're talking about poor oral
health, something experts say happens frequentlybut really doesn't get the attention it deserves.

(00:50):
Doctor Hugh Silk at the UMAs ChanMedical School in Worcester is out there
in the streets working to change that. He just got a big new grant
to help make that happen. He'shere on the show now. Silk,
I do appreciate your time. I'dlove to know why oral health is not
a bigger focus when it comes tohelping people get out of addiction. And
into recovery. You know, Ithink what's happened with substance use disordered treatment

(01:12):
is we've really evolved to look atthe whole person. And so in the
past, where we might have said, all right, well, let's just
substitute your fentanyl your heroin with methadoneor suboxone and let's hope you get better,
we are. We've come a longway and we are looking at the
person. What else is going onfor you? What's going on with your

(01:34):
housing, what's going on with yournutrition, and what's going on with the
rest of your body, including yourmouth. What are these problems that we're
seeing pop up with people who arestruggling with substance abuse disorder. Yeah,
no, I'm glad you asked that. I'm glad you're covering this topic because
it really is profound how much oraldisease there is who use substances, and

(02:00):
it's a combination of things. Socertain substances, so we're talking about heroin
or fentanyl, can have an effecton the mouth themselves. They can dry
out the mouth, and a drymouth is poisoned. For the mouth,
saliva really helps heal the teeth,and when you don't have saliva. The
opposite is true. Will you takea medicine like crack or cocaine and it

(02:23):
affects the blood vessels in your gumsjust the way it affects the blood vessels
in your body like a person canhave a heart attack because the blood vessels
are shrinking. So now you're notgetting the blood supply you need to the
teeth. Your mouth is dried out. And then when you're using substances,
you don't always make good choices,and you start, you know, drinking

(02:45):
lots of red bull or sugary drinks. You start eating snacks that are high
in carbohydrates, and so this combinationis really hard on the teeth. And
then you're probably in a place whereyou're not brushing your teeth twice a day
and seeing the dentist. So itjust spins out of control. So many
many of our patients have cavities,have gum disease, and it's really sad.

(03:08):
It gets hard to eat properly,hard to take care of yourself,
and then obviously this leads to selfesteem issues. How are you going to
go out and try and get ajob when your teeth look that way?
Or you're in pain, and soit becomes all consuming. Well, and
you think about the fact that manypeople who are struggling with substance abuse disorder
already have self esteem issues. Theyhave other factors that are similar that led

(03:30):
them to go down that path inthe first place. So I'd imagine it
already compounds those issues that they're strugglingwith. Great society is not looking at
you favorably. You may have lostthe support of your family and friends,
You have people in my profession,in the health profession looking down on you.

(03:51):
It just gets compounded over and overand over again. And so yeah,
we've got to really sort of changethat cycle and start to get some
winds, start to get some positivity. They do say that oral health is
connected to overall health, and Iknow that there's an ongoing discussion about getting
more access to dental treatment because there'sobviously insurance issues and a lot of people

(04:15):
who are low income don't have accessto dental care. And then that impacts,
like you mentioned, not just thegums and the teeth and the tongue,
but then you know, in somecases it leads to infection, It
could lead to losing your teeth,which then means you can't nourish yourself properly.
So this is really a much biggerissue than just what you see in
the mouth. Absolutely. I meanI've spent twenty five years of my career

(04:35):
working on dental health issues, medicaldental integration because of that. So if
your mouth is inflamed, your bodygets inflamed. So if you have diabetes,
the diabetes gets worse. If youhave heart disease, it gets worse.
It can affect pregnancy, it canaffect Alzheimer's lung disease. I mean,
it's amazing this relationship, and soI think people are starting to understand

(05:00):
that even in our state, withsomething like mass Health, there are now
incentives for physicians to applied florid varnishedto the teeth of children or to do
dental referrals. And studies are veryclear. I mean, when someone gets
their mouth treated, their diabetes improves, literally the sugar comes down. So
yeah, we've got to take theseerusly. Okay, So then tell us

(05:21):
about this new grant. You gotit from Rise Massachusetts. I've actually had
Rise on the show before. They'redoing great work to try to stop the
overdose crisis. Talk to us aboutthis new grant that you got. Well,
we have a lot of individuals whocome to see us in the community.
We have taken our care outside ofthe office and we have a care

(05:42):
mobile. Our organization is called Roadto Care through UMass Memorial Health, and
we see patients at various sites aroundthe city where people tend to congregate,
whether that is a shelter or afood pantry or main south And when we
see patients there, we try tooffer them full spectrum care, so we

(06:03):
deal with all of their health issues. We have on their snacks, water,
hats, and warmers, whatever peopleneed. And so what we're trying
to add is some better access todental care. So we'll be giving people
toothbrushes and toothpaste, We'll be askingthem about their mouth, and then we'll
be working with a case worker totry to help them get to the dentist.

(06:29):
So in the past we gave thema list of dentists that accept their
insurance, but life is hard,and so we want to take that a
little bit further and help them makethe call, help remind them to go
to the appointment. If they needtransportation help to get them there. It
really doesn't take that much. Whensomebody is really feeling at their lowest point,

(06:49):
it doesn't take much from others justto hold out a hand and say,
look, I've got you. It'sokay that you're struggling to get these
basic things done. It's okay thatyou're struggle just to get up in the
morning toothbrush and toothpaste. Might notseem like a lot of people listening,
but it really can open the doorto somebody caring about themselves enough to want
to get out of that situation.Yeah, I mean for you or we

(07:13):
might we might turn to a siblingor a friend or someone. You know.
Again, people have burned some bridges. That happens, people have become
isolated. People do not have thesame resources that you or I have access
to. So yeah, you knowthis is this is not a huge grain,
but this little bit of money tohave somebody just give someone a little

(07:33):
bit of support to take that firststep and to get things rolling in the
right direction. You know, wewe work with many other organizations in the
city that are helping people around thehousing, that are helping people around finding
work. And yeah, I meanif this helps as well, that's going
to be huge And just imagine,you know, I say this to people,

(07:55):
and I don't mean for it tobe offensive, but if you are
hiring a secretary for the front ofyour office, you wouldn't hire someone who
is missing their forefront teeth. Youjust wouldn't. You'd say, I don't
want that to be literally the faceof my organization. So we can get
someone dentures and suddenly they look,you know, just like the next person,
and they've already got intelligence and hardwork and all that. Then they're

(08:18):
going to get their foot in thedoor and things will go in the right
direction, I hope. Considering thatwe still have a long way to go
when it comes to fighting the opioidcrisis and the overdose crisis, because it's
not just opioids anymore. The overdosecrisis here in Massachusetts. It seems like
one little step, but it's reallynot. It could open the door to
so much more, No for sure, for sure, And I mean we
are seeing these efforts pay off.I haven't seen the numbers for the whole

(08:43):
year in Worcester where we are yet, but the first half of the year
our overdose deaths were down, SoI think this sort of harm reduction comprehensive
approach is helping, We'll see,and we can't grade ourselves just on deaths
or deaths obviously, right, it'swhat kind of lives are people having?

(09:03):
And so I think all this addsup. A lot of people thank us
when we respect them, and Ithink I can see in their eyes when
there's a team approach, when wehave a peer counselor or recovery coach,
and we have a case worker andwe have a nurse and everyone is sort

(09:24):
of helping in their own way andmoving them in the right direction. I
think that's how we're going to getthere. And personally, for you,
i' mean getting this grant from Rise, this is ninety three thousand dollars and
that's a pretty substantial amount of moneyto go toward this. But you have
been doing this research and doing thiswork in the community for a long time.
How does it feel for you tobe able to get out there into

(09:46):
the streets and help these people outdirectly? Yeah, you know, I
took a tiny bit of money,talking like a few thousand dollars, and
we did a survey of people whohave substance use disorder in Worcester, and
you know, This was with themedical student and we just asked, like,
what are the barriers, and itwas transportation, it was finding a
dentist who will accept my insurance.It was these little things. We need

(10:09):
more toothbrushes whenever. And so thestudents said, well, what are we
going to do with this information?And I said, well, we've got
to find a grant and so youknow, we saw the need, now
we have the money to address it. I think this will be huge.
I mean some of the work I'vedone in the past with trying to get
doctor's offices, applying florid varnish becausewaiting to see the dentist is just not

(10:31):
not okay. We saw a changein children's cavities being improved. So yes,
these these little bits of money,with very well intentioned efforts that are
practical and doable, I think,you know, make a big difference in
the lives of If this is goingto affect hundreds to one thousand people in

(10:54):
Worcester and their lives will change,I'm good with that. Thank you so
much for your time, Thank youfor all the work and all the best
as you start this new program.Yeah, well thanks for having me on
here, and thanks not everyone takestime to think about those who are our
last fortunate, so I really appreciateyou you taking time to address this topic.
All right, have a safe andhealthy and warm weekend. Please join

(11:16):
me again next week for another editionof the show. I'm Nicole Davis from
WBZ News Radio on iHeartRadio