What is Meth Mouth?
Meth mouth is a dental condition characterized by severe decay and loss of teeth, as well as fracture, enamel erosion, and other oral problems symptomatic of extended use of the drug methamphetamine (meth). The specific cause of the condition is unknown, although drug-induced xerostomia (dry mouth) and bruxism (grinding of the teeth) are thought to be involved. Other frequently cited factors are poor nutrition and lack of dental hygiene, common among long-term users of the drug. The legitimacy of meth mouth as a unique condition has been questioned because of the similar effects of some other drugs on teeth. Advocates of its status as a unique condition cite the pattern and scope of the decay as distinguishing factors.
Methamphetamine (meth), a highly addictive drug that produces a dramatic increase in energy and euphoria, can have negative health effects that include serious dental problems. As of 2012, it is the most discussed illegal drug in dental literature.
The most notable effect of long-term use of methamphetamine on dental health is the development of caries (tooth decay); the teeth of some drug users appear to be dark and in the process of disintegrating. Caries often occurs in the cervical regions of teeth, where the tooth surface narrows at the junction of the crown and the root. It is usually found on the buccal (cheek) side of the teeth and on tooth surfaces that are adjacent to incisors and canines; eventually, the coronal tooth area, near the crown, can be affected by the decay. The dental caries of meth mouth often progresses slowly, perhaps because its advancement is hindered by intermittent hygienic practices. The decay can lead to tooth fractures and severe pain.In some cases, teeth are permanently damaged and must be removed. Along with malnutrition and weight loss, the dental effects of methamphetamine use contribute to the appearance of premature aging seen in some users.The effects of meth mouth are similar to those of Sjögren’s syndrome, an autoimmune disease that causes a lack of saliva, which results in tooth decay.
Methamphetamine users sometimes experience soreness in the joint of the jaw and dental attrition (tooth wear), owing to bruxism (grinding of the teeth) caused by the drug. This bruxism can occur continuously. Chronic use of the drug might also cause trismus, the inability to open the jaw. Long-term users often experience xerostomia (dry mouth).
The dental effects of long-term methamphetamine use are often attributed to its effects on saliva. The reduction in saliva increases the likelihood of dental caries, enamel erosion, and periodontal disease. Although it is clear that use of the drug decreases saliva, the mechanism by which it does so is unclear. One theory is that the drug causes vasoconstriction (narrowing of the blood vessels) in salivary glands, decreasing salivary flow. This constriction is thought to be due to the activation of alpha-adrenergic receptors by norepinephrine, the levels of which are dramatically increased by methamphetamine use. These factors can be compounded by dehydration, which occurs in many methamphetamine users after drug-induced increases in metabolism.The characteristics of the saliva produced during use of the drug, which includes high protein content, may also contribute to the sensation of dry mouth.
Long-term methamphetamine use can cause parafunctional habits, routine actions of a body part that are different than their common use, which can result in tooth wear and exacerbate periodontal diseases. One such habit that may affect the development of meth mouth is bruxism, particularly as the drug’s effects wane and stereotypy occurs, a phase that is often referred to as “tweaking”.This bruxism may be due to a drug-induced increase in monoamines. Other behaviors of long-term methamphetamine users that may cause or accelerate the symptoms of meth mouth are the failure to pay attention to oral hygiene and excessive food intake during binges, especially sugary foods; the drug’s users often report strong cravings for sugar and consume large amounts of high-sugar beverages. The altered mental state that accompanies methamphetamine use lasts longer than that of some other common drugs, increasing the amount of time the user engages in drug-induced behavior.
No academic reviews have supported the idea that the use of hydrochloric acid in methamphetamine’s manufacturing process contributes to dental decay.Speculation that oral consumption of the drug causes tooth decay by raising the acidity of users’ mouths is also unsupported. Meth mouth is generally most severe in users who inject the drug, rather than those who smoke, ingest or inhale it.
How Meth Can Damage Your Mouth
Methamphetamine use damages dental health in several ways:
- During the “high” produced by this drug, users usually experience cravings for sugary carbonated beverages, which is bad for teeth.
- The “high” from this drug lasts about 12 hours, during which time users will probably not brush or floss,therefore leaving the sugary substances on their teeth for long periods of time.
- The acidic contents of this drug can damage teeth. Ingredients can include battery acid, lantern fuel, antifreeze, hydrochloric acid, drain cleaner, lye and over-the-counter cold medications containing ephedrine.
- Users of methamphetamines usually tend to clench and / or grind their teeth.
- Methamphetamines dry up protective saliva around the teeth.
Meth mouth is very difficult to treat unless the patient ceases using methamphetamine; persistent drug use makes changes in hygiene or nutrition practices unlikely. Many drug users lack access to dental treatment, and few are willing to participate in such a course of action, often because of poverty.Those who are willing to seek dental treatment often resist discussing their drug use. Providing dental treatment to individuals who use methamphetamine can also be dangerous, because the potential combination of local anesthetic and methamphetamine can cause serious cardiac problems. There is also an increased risk of serious side effects if opioid medications are used in the patient’s treatment.
Treatment of meth mouth usually consists of attempts to increase salivary flow, halt tooth decay, and encourage behavioral changes. Toothpaste with fluoride is very important to the restoration of dental health. Only prescription fluoride rinses can adequately treat the condition. Sialogogues, drugs that increase the amount of saliva in the mouth, can be used to treat xerostomia and protect against dental health problems. Pilocarpine and cevimeline, sialogogues that are Food and Drug Administration (FDA) approved to treat hyposalivation caused by Sjogren’s syndrome, may have the potential to effectively treat methamphetamine-caused xerostomia.
Education about oral hygiene for long-term methamphetamine users is sometimes required. Changes in diet are often necessary for recovering drug users that are receiving dental treatment, and the use of sugar-free gum may be beneficial. The consumption of water and the avoidance of beverages with a diuretic (dehydrating) effect can also help patients with meth mouth.
Source : Wikipedia