The aim of this study was to investigate the occurrence of oral lesions and micronuclei in crack cocaine users. A cross-sectional study was conducted involving 106 crack users and 106 non-users matched for age, sex, and tobacco use. Socio-demographic characteristics, the consumption of psychoactive substances, and the occurrence of fundamental lesions were investigated. Cellular changes in the oral mucosa (karyolysis, karyorrhexis, 'broken egg' events, and micronuclei) were determined by exfoliative cytology for 54 participants in each group. Crack users had a greater occurrence of fundamental lesions (P=0.001). Furthermore, they had higher mean occurrences of micronuclei (17.25 vs. 3.80), karyolysis (12.39 vs. 9.46), and karyorrhexis (30.39 vs. 10.11) (number per 1000 cells) than non-users (all P<0.05). No difference between the groups was found with regard to broken egg events (P>0.05). After controlling for confounding variables, fundamental lesions were 2.02-fold more frequent and micronuclei were 3.54-fold more frequent in crack users. Crack use was found to be associated with clinical and cellular changes in the oral mucosa. These findings can contribute to the planning of health care for individuals who are dependent on street drugs.
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