Chronic users of Methamphetamine (MA) are not hard to spot. They have been described as the “walking dead” due to their emaciated appearance, ashen skin color and severe dental disease, including the notable premature loss of teeth.
As a sympathomimetic amine, methamphetamine stimulates the sympathetic nervous system, acting on adrenergic receptors and causing decreased salivary flow, leading to xerostomia and increased propensity for tooth decay.
Rampant caries associated with use of methamphetamine is colloquially known as “meth mouth” or “crank decay.” The American Dental Association (ADA) has described a distinct and often severe pattern of decay most notably on the buccal smooth surface of the teeth at the cementoenamel junction and the interproximal surfaces of the anterior teeth.
Gingival inflammation, receding gingival tissue, mucosal lesions, decreased salivary output (dry mouth), severe dental caries and bruxism are common sequela among MA addicts. Disorders of the temporomandibular joint, myofacial pain and trismus are less common but very debilitating conditions associated with the chronic use of MA.
Why Does This Matter?
Clearly, among the vast and varied manifestations of SUD, those chronically addicted to MA are too often viewed and treated as hopeless pariahs. Their distinctly gaunt and haggard appearance and telltale dental disease is reflective of how sick they are and devastating to their self-esteem. This is where a collaborative, interdisciplinary approach between dentists, addiction and mental health providers can improve outcomes.
Moreover, dental professionals are in a unique position to identify MA users and facilitate referral to substance abuse treatment. Likewise, addiction and mental health providers should show more concern and haste for severe co-occurring dental disease and arrange for timely dental intervention. As the TV commercial says, your smile says a lot about you.