27 Mar Recovering From Meth Mouth
“Meth mouth” is a condition that develops in people with short- or long-term addictions to methamphetamine. It involves several factors, including the effect of methamphetamine on saliva glands in the mouth; poor oral hygiene and dietary habits in meth addicts; tooth decay associated with these habits; frequent meth-related grinding of the teeth; and cracking of the tooth surfaces related to physical stress caused by this grinding. Left untreated, meth mouth can lead to a severe degradation of tooth and gum health and the need for extensive tooth removal. Dentists can take a number of steps to help affected individuals recover from the condition.
Meth Mouth Basics
In addition to its many other effects on the brain and body, methamphetamine damages the saliva glands in the mouth and seriously reduces the output of saliva from these glands. In turn, lack of proper saliva output creates a condition known as xerostomia, or dry mouth. Unlike the temporary dry mouth that everyone experiences from time to time, xerostomia happens persistently over longer periods. Normally, the saliva in your mouth helps stop cavity-causing bacteria from damaging your teeth; however, in people with persistent dry mouth, harmful bacteria populations can increase as much as 10 times above normal. Bacteria levels in the mouths of meth users also commonly rise because of poor oral hygiene and a tendency to consume a lot of sugar.
Tooth decay in meth addicts is also linked to chronic, unconscious tooth clenching or grinding, a habit known as bruxism. In advanced cases associated with chronic meth use, bruxism can lead to cracks that give bacteria a direct route into the interiors of affected teeth. Consequences of this situation and other meth-related mouth changes include rampant cavity formation and the onset of a gum inflammation called gingivitis. In some cases, meth addicts develop an advanced, medically serious form of gum inflammation called acute necrotizing ulcerative gingivitis (ANUG), an infection that produces gum tissue death; they can also develop a related tissue-destroying infection called necrotizing ulcerative periodontitis (NUP), in the deeper structures that directly support the teeth. Infections associated with ANUG or NUP can spread to other parts of the body.
Effective treatment of meth mouth typically only occurs when a meth addict stops using the drug and enters some form of supervised addiction recovery. In people with relatively little decay-related damage, dentists can usually restore proper dental function by treating and filling cavities. In people with advanced tooth decay, recovery may require a root canal, a procedure that involves removal of damaged nerves and tissue in a tooth’s interior.
Dentists can address mild or moderate gingivitis by prescribing antibiotics that kill off harmful bacteria, as well as by freeing the gum line from a substance called plaque, which builds up on teeth and creates an environment that promotes gingivitis. In people with ANUG or NUP, recovery typically requires surgery to remove dead tissue. To relieve chronic dry mouth stemming from meth-related saliva gland damage, recovering addicts must usually find a way to artificially increase the moisture in their mouths. Saliva-increasing medications such as cevimeline (Evoxac) or pilocarpine (Salagen) may be the solution.
Meth-mouth recovery also relies on improved dietary habits (i.e., reduced sugar consumption), improved education on all matters related to oral hygiene, and the establishment of regular tooth brushing and regular visits to a dentist.
In severe cases, the combined effects of meth mouth produce an advanced, profound degree of tooth destruction. People in these circumstances typically must have teeth removed and replaced with dentures or implanted dental prosthetics. In long-term addicts, extraction of all teeth is sometimes required.
In addition to improved education and hygiene, continued improvement in the aftermath of meth mouth typically relies on the avoidance of drug relapses. While any methamphetamine addict can develop the condition, a study published in 2000 in the Journal of Periodontology indicates that addicts who inhale (snort) meth have considerably higher chances of developing meth mouth than those who smoke or inject the drug.
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