Meth Mouth
A common sign of meth abuse is extreme tooth decay, a condition that has become known in the media as "meth mouth." Users with "meth mouth" have blackened, stained, or rotting teeth, which often can't be saved, even among young or short-term users. The exact causes of "meth mouth" are not fully understood. Various reports have attributed the decay to the corrosive effects of the chemicals found in the drug, such as anhydrous ammonia (found in fertilizers), red phosphorus (found on matchboxes) and lithium (found in batteries), which when smoked or snorted might erode the tooth's protective enamel coating; however, it's more likely that this degree of tooth decay is brought on by a combination of side effects from a meth high.
When meth is ingested, it causes the user's blood vessels to shrink, limiting the steady blood supply that the mouth needs in order to stay healthy. With repeated shrinking, these vessels die and the oral tissues decay. Similarly, meth use leads to "dry mouth" (xerostomia), and without enough saliva to neutralize the mouth's harsh acids, those acids eat away at the tooth and gums, causing weak spots that are susceptible to cavities. The cavities are then exacerbated by behavior common in users on a meth high: a strong desire for sugary foods and drinks, compulsive tooth grinding, and the general neglect of regular brushing and flossing.
The extent of a tooth decay varies widely among meth users. A 2000 report in the Journal of Periodontology found that users who snorted the drug had significantly worse tooth decay than users who smoked or injected it, although all types of users suffered from dental problems. Anecdotal evidence also suggests that the degree of tooth decay is not necessarily dependent on the length of drug use. "[O]ne gentleman I saw said he used it for four months and there was nothing except for root tips left in his mouth," said Dr. Athena Bettger, a dentist who practices two days a week at the Multnomah County Jail in Portland, Ore. "Whereas another gentleman I saw said he was using it for four years, and … I think three teeth needed to come out and he needed a couple of fillings because of the cavities."
Dentists like Dr. Bettger, who practice in America's prisons and jails, have seen some of the worst cases of "meth mouth," and state correctional facilities are feeling the impact on their budgets. In August 2005, National Public Radio reported that dental costs in the Minnesota Department of Corrections had doubled in the past five years, mostly due to the extensive dental work performed on former meth addicts. Although there are no quantitative studies to document this phenomenon, anecdotal evidence supports this trend. Dr. Chris Heringlake, a dentist in at St. Cloud Correctional Facility in Minnesota, told NPR that he first saw "meth mouth" eight years ago, and now he sees it every day. Dr. Bettger has also noticed this trend in Oregon: "The general trend that I am seeing is that there is a definite increase. … There are more and more teeth that need assistance and there are more and more [inmates] needing assistance."
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