Beyond Health Services: The Persistent Impact of Early Substance Abuse on Oral Health-related Quality of Life

A bstract Aim: To investigate the impact of self-reported oral health morbidity and the use of health services on the quality of life of adults, users of a drug addiction treatment service, verifying the moderating effect of chemical dependence. Methods: The research instrument covered socioeconomic characteristics, severity of chemical dependency, morbidity in oral health, use of health services, and oral health-related quality of life. The analysis was performed through the decision tree using the chi-squared automatic interaction detector algorithm and regression analysis with moderation. Results: The results suggested an association between the high impact on quality of life and the self-perceived need for extraction at the time of self-assessment. In addition, an association was found between the intensity of orofacial pain felt in the last 6 months and quality of life. The moderated regression model, including health service use, age at first substance abuse, and their interaction term, explained 66.15% of the variance in quality of life impact ( R 2 = 0.6615, P = 0.0101). The significant interaction term shows that the association between health service use and quality of life impact varies according to the age at first substance abuse, highlighting a meaningful moderating effect. Conclusion: Self-reported oral morbidity is associated with a greater impact on quality of life. For individuals with substance dependence, early initiation of substance use alone is sufficient to negatively affect oral health-related quality of life, regardless of health service utilization.