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ObjectiveThe aim of this study was to investigate the impact of the use of crack and other illicit drugs on oral health‐related quality of life (OHRQoL) in young adults.MethodsThis cross‐sectional study evaluated 106 crack users at a public treatment center for drug addiction and 106 controls matched for gender, age, and use of tobacco. Clinical examinations were performed for dental caries and periodontal disease. The outcome was OHRQoL, which was determined using the Oral Health Impact Profile (OHIP‐14). The association between OHRQoL and illicit drugs was modeled using conditional Poisson regression.ResultsUsers of crack and other illicit drugs had a poorer OHRQoL than the controls (p < .001). Among the crack users, the odds ratio to yield high OHIP‐14 was 3.40 (95% confidence interval, 1.91–6.08). Adjustment for sex, age, schooling, income, smoking, dental caries, and periodontal disease did not change such an estimate considerably. The functional limitation and psychological discomfort domains were associated with the use of illicit drugs.ConclusionUsers of crack and other illicit drugs exerted a negative impact on OHRQoL independently of socio‐demographic characteristics and tobacco use, suggesting the need for special attention regarding the specific oral health needs of this population as well as drug prevention and treatment strategies.