Kratom use categories and their associations with co-occurring substance use and mental health disorder symptoms during the COVID-19 pandemic.

BACKGROUND: Kratom, a psychoactive substance, use is an evolving research area that needs more studies to augment the limited literature. Our study examines the association between kratom use categories and mental health and substance use disorders in the U.S. METHODS: We used the 2020 National Survey on Drug Use and Health data (N = 32,893), a cross-sectional survey data, on the U.S. population aged 12 years or older. We used STATA/SE version 16 to perform a multinomial logistic regression analysis to assess our study aims. RESULTS: Bisexuals, compared to heterosexuals, had higher risks of kratom use within the past 30 days (relative risk ratio [RRR]= 2.47, 95% CI= 1.07, 5.71). Major depressive episode was positively associated with kratom use more than 30 days ago (RRR= 2.04, 95% CI= 1.24, 3.34). This association was also observed for mild (RRR= 2.04, 95% CI= 1.38, 3.02), moderate (RRR= 2.25, 95% CI= 1.13, 4.51), or severe alcohol use disorder (RRR= 1.88, 95% CI= 1.05, 3.36); and mild (RRR= 1.98, 95% CI= 1.27, 3.11), moderate (RRR= 2.38, 95% CI= 1.27, 4.45), or severe marijuana use disorder (RRR= 2.13, 95% CI= 1.02, 4.47). Illicit drug other than marijuana use disorder was associated positively with kratom use more than 30 days ago (RRR= 2.81, 95% CI= 1.85, 4.26) and kratom use within the past 30 days (RRR= 5.48, 95% CI= 1.50, 20.02). CONCLUSIONS: Our findings suggested that identifying as bisexual, experiencing depression, alcohol use disorder, or illicit drug use disorder increased the risks of kratom use. There is a need to consider mental health and substance use disorders and sexual identity in kratom use interventions and policies geared toward reducing or preventing kratom use.

Prophylactic extraction of non-impacted third molars: is it necessary?

BACKGROUND: The decision of removing a non-impacted 3rd molar, unlike extraction of an impacted 3rd molar, is challenging for dentists as well as patients. This study investigates the pathologies affecting second molars situated adjacent to asymptomatic non-impacted 3rd molars. METHODS: This retrospective study included digital radiographs of 749 patients taken between April to October 2015. Panoramic radiographs were evaluated for the presence of erupted asymptomatic non-impacted 3rd molars and pathologies on adjacent second molars. The patients were reviewed according to age and gender. RESULTS: A total of 2342 asymptomatic 3rd molars were assessed in the study based on the inclusion and exclusion criteria, and 2112 of them were found to be non-impacted. The second molars adjacent to non-impacted 3rd molars were shown to be significantly associated with distal caries (25.2%), mesial bone loss (10.5%) and total bone loss (37.2%), i.e., mesial as well as distal bone loss. CONCLUSIONS: Pathologies of the 3rd molars and teeth adjacent to 3rd molars can occur as a result of multiple factors. Caries and periodontal disease may also occur due to the inaccessibility to maintain oral hygiene. With a regular follow-up schedule, reinforced by the dentist and good oral hygiene, several pathologies that are significantly associated with non-impacted 3rd molars can be prevented and may not require prophylactic extraction.