Meth Mouth—A Growing Epidemic in Dentistry?

Abstract

In the past two decades, the synthetic style and fashion drug “crystal meth” (“crystal”, “meth”), chemically representing the crystalline form of the methamphetamine hydrochloride, has become more and more popular in the United States, in Eastern Europe, and just recently in Central and Western Europe. “Meth” is cheap, easy to synthesize and to market, and has an extremely high potential for abuse and dependence. As a strong sympathomimetic, “meth” has the potency to switch off hunger, fatigue and, pain while simultaneously increasing physical and mental performance. The most relevant side effects are heart and circulatory complaints, severe psychotic attacks, personality changes, and progressive neurodegeneration. Another effect is “meth mouth”, defined as serious tooth and oral health damage after long-standing “meth” abuse; this condition may become increasingly relevant in dentistry and oral- and maxillofacial surgery. There might be an association between general methamphetamine abuse and the development of osteonecrosis, similar to the medication-related osteonecrosis of the jaws (MRONJ). Several case reports concerning “meth” patients after tooth extractions or oral surgery have presented clinical pictures similar to MRONJ. This overview summarizes the most relevant aspect concerning “crystal meth” abuse and “meth mouth”.

Crystal methamphetamine and its effects on mental and oral health: A narrative review

“…Available evidence also shows that persistent caries lesions and oral tissue inflammation can spread to other body parts and cause further lesions as well as diseases such as endocarditis ( Rommel et al, 2015 ). These observations have led to the view that methamphetamine's impact on soft tissues and vascularization is what ultimately causes or initiates methamphetamine-induced osteonecrosis of the jaws ( Pabst et al, 2017 , Ristow et al, 2015 , Rommel et al, 2015 , Rustemeyer et al, 2014 ). Long-term MA usage has also been found to contribute to sinusitis and mucoceles of the maxillary sinus ( Faucett et al, 2015 ).…”

“…Thus, even though several approaches are available, the most effective mode of MA addiction treatment will depend on the individual needs and circumstances ( Brown & DeFulio, 2020 ). Some common treatment options include behavioral therapies, such as cognitive-behavioral therapy (CBT) and contingency management, which can help individuals identify and change negative patterns of thinking and behavior associated with drug abuse ( Pabst et al, 2017 ). In clinical practice, medication-assisted treatments based on bupropion and naltrexone have also been shown to help reduce cravings and withdrawal symptoms ( Skeer et al, 2022 ), while some addicts benefit from antidepressants, antipsychotics, and substitution/replacement therapy ( Panenka et al, 2013 ).…”

“…Meth mouth is a term that describes an oral condition frequently found in MA users, and includes the characteristics such as xerostomia, extensive carious lesions, enamel erosion, bruxism, and muscle trismus ( Pabst et al, 2017 ). While xerostomia is attributed to the reduction in the salivary flow due to MA use ( Skeer et al, 2022 ), increased consumption of sugary beverages and food, combined with reduced oral hygiene ( Shiao et al, 2021 ), would lead to severe dental problems.…”

Back With a Vengeance: The Reappearance of Methamphetamine and its Implications for Health Care Providers

“…33 The profound dental and oral damage ("meth mouth") associated with METH dependence has been well documented and is reaching epidemic proportions. 34 This condition may be caused by a variety of different factors, including reduced saliva production, cravings for high-calorie drinks, and the acidity of the drug. 35 Serious adverse effects from "meth mouth" are possible and may include osteonecrosis of the jaw and severe infections.…”

“(Meth) Will Hurt You and Hurt Your Teeth”: Teen, Parent, and Dental Practitioner Perspectives on Implementing Crystal Meth Use Prevention Messaging in the Dental Office Setting

“…Frequent and regular use of crystal methamphetamine (“meth”) via smoking, injecting, snorting, or ingesting can cause extreme deterioration of the mouth and skin [ 1 ]. Considered a growing epidemic in the dental field [ 2 ], “meth mouth” is the result of an array of dental diseases caused by meth use, including dental caries, breakage, cracking, deep discoloring, rotting [ 3 , 4 ], and ultimately intense oral pain [ 5 ]. In one study of 571 people who use meth, 96% had caries, 58% had untreated dental decay, and 67% did not have all of their natural teeth [ 3 ].…”