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DELTA REGION AIDS EDUCATION AND TRAINING CENTER • deltaaetc.org

Meth MouthDental Issues in Methamphetamine Abusers

Medical Case Management Clinical Conference Christina Eaton, MPH

Delta AETC


The Relationship Between Methamphetamine Use and Increased Dental Disease

• J Am Dent Assoc, Vol 141, No 3, 307-318

• Vivek Shetty, DDS, DrMedDent• Larissa J. Mooney, MD• Corwin M. Zigler, MA• Thomas R. Belin, PhD• Debra Murphy, PhD and Richard Rawson, Ph


Name That Famous Mouth


What is “Meth Mouth”?

• Destruction of the teeth and gums directly resulting from methamphetamine abuse

• Indirect consequence of methamphetamine abuse– Neglected or forgotten brushing & flossing while

high or when coming down


• Forms on teeth when starches & sugars interact with bacteria present in mouth

• Plaque is removed with brushing BUT re-forms within 24 hours

• If stays longer than 2-3 days can harden into tartar

7

1. PLAQUE : “ Soft, sticky, fussy deposits on tooth”


2. Calculus/Tartar/Stone : “ Hard deposits on tooth”

DELTA REGION AIDS EDUCATION AND TRAINING CENTER • deltaaetc.org9

1. PLAQUE : “ Soft, sticky, fussy deposits on tooth”

2. Calculus/Tartar/Stone : “ Hard deposits on tooth”

3. Periodontal Pocket: “ Due to bone & Ligaments destruction”


PERIODONTAL POCKET: When Periodontitis cause bone destruction.

P. Pocket

Healthy gum & Bone


How Does MA Use Cause Tooth Decay?

• MA use causes blood vessels to constrict (shrink)

• Blood vessels in mouth can not feed teeth and gums

• Repeated shrinking causes vessels to die– Inhibits body’s ability to repair itself

• Dental tissue starves and breaks down


How Does MA Use Cause Tooth Decay?What is xerostomia?

1 2 3 4 5

20% 20% 20%20%20%1. Calcium breakdown2. Dryness in the mouth3. Small cracks in the teeth4. Bad breath5. Gum recession


Xerostomia

• Saliva breaks down acids in the mouth

• MA use blocks the brain mechanism causing salivation

• Acids build up and eat away at tooth enamel

• MA can stay in the body for 8+ hours

– Sustained reduction in saliva = rapid bacterial growth


How Does MA Use Cause Tooth Decay?Self Treatment for Xerostomia

• Carbonated drinks are often craved to counteract the effects of “dry mouth”

– Provides food for bacteria, creating more acid

– Insufficient saliva to counter decreased pH

– Acid eats away at tooth enamel


Which method of MA use results in the highest rates of dental disease?

1 2 3

33% 33%33%1. Smoking2. Snorting3. Injecting


How Does MA Use Cause Tooth Decay?• Prevailing belief

– Smoking > IV or snorting

• 2000 report in Peridontology – Snorting > IV

• 2010 Study– IV > Smoking or Snorting

• Why?– IV MA users have higher level of addiction


How Does MA Use Cause Tooth Decay?

• Bruxism (Teeth grinding & clenching)

– Caused by drug-induced hyperactivity

– Puts large amounts of unnatural pressure on tooth

– Creates small fractures in enamel, exposing dentin layer or pulp of the tooth

– Exacerbates TMJ disorders


Which subset of MA users more often reports having TMJ problems?

1 2

50%50%

1. Males2. Females


•Mike Myers (Austin Powers), Austin Powers in Goldmember



Counseling Your Clients

• Plan for dental care before getting high

• Reminder notes to brush and floss

• Keep extra toothbrush and travel sized toothpaste in backpack, car, etc if will not return home



• Brush daily

• Use soft bristle brush and toothpaste that contains fluoride

• Fluoride best defense against tooth decay


Moment of Truth: I floss…..

1 2 3 4 5

20% 20% 20%20%20%1. Everyday2. A few times a week3. Sporadically4. With my fingernails5. What is flossing?


Counseling Your Clients: Flossing

• Floss on a regular basis – once a day

• Don’t floss right before or after oral sex

• Check teeth and gums often for early signs of decay and gum disease



• Drink water not soda to keep mouth moist

• When high try to drink 64 oz (8 glasses) a day



• Suck on sugar-free candy like lemon drops to help produce saliva

• See dentist every six months for a routine cleaning and check-up


Summary• Dental disease is a distinguishing marker of MA use

• MA users often have current dental problems & unmet oral health needs

• MA contributes to dental problems by causing xerostomia and bruxism

• Counsel clients to keep up with dental health and drink plenty of water if continuing MA use

delta region aids education and training center deltaaetc.org meth mouth dental issues in...

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