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Oral Manifestations Caused by Methamphetamine



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    “The mouth is the mirror of one’s body. ” Depending how an individual may take care of their overall health will eventually reflect on how he/she takes care of their oral region; it does consist of the body as well. If an individual, works out, eats proper nutrition, gets enough sleep and has daily responsibilities, would you look at that person to be put into a healthy bracket, correct? Well what if this person happened to recreationally take drugs on the weekends, would their lifestyle still be considered him/her as a healthy person?

    What people do not realize is that they may not see themselves as a drug addict but they are a drug abuser. One may not be completely addicted but they are forming a pattern of becoming dependent on a drug to fulfill that “wanting” feeling they have in their head. Drug abuse is a very serious issue in today’s society and what people do not know is that even doing a little here and there can lead to a serious issue. For example if someone with a regular lifestyle happened to come across the drug called Methamphetamine, an addictive stimulant that affects the central nervous system, it could take one time of use to get addicted (NIH 2006).

    Extended and extensive abuse of methamphetamine has damaging and devastating effects on the orofacial region. This oral manifestation presents itself through a myriad of visible interruptions to oral health such as: Xerostomia, gingival enlargement, dental caries, and periodontal disease. Methamphetamine also known as “crystal meth” is credited to be one of the most highly addictive drugs. It is a drug that affects your appearance, wellbeing, brain chemistry, and overall health. Meth releases a surge of dopamine, causing an intense rush of pleasure or prolonged sense of euphoria.

    Over time, meth destroys dopamine receptors, making it impossible to feel pleasure. Although these pleasure centers can heal over time, research suggests that damage to users’ cognitive abilities may be permanent (Heringlake2006). Prolonged abuse can lead to psychotic behavior, including paranoia, insomnia, anxiety, extreme aggression, delusions and hallucinations, and even death. Methamphetamine has been around for a very long time and although it appears to be more prevalent now as opposed to back then.

    “Amphetamine was first made in 1887 in Germany and methamphetamine, more potent and easy to make, was developed in Japan in 1919. ”(Drug-FreeWorld2006) The crystalline powder was soluble in water, making it a perfect candidate for injection”(Drug-FreeWorld2006) Methamphetamine went into wide use during World War II, when both sides used it to keep troops awake”( Drug-FreeWorld2006) “High doses were given to Japanese Kamikaze pilots before their suicide missions.

    And after the war, methamphetamine abuse by injection reached epidemic proportions when supplies stored for military use became available to the Japanese public” (Drug-FreeWorld2006). The Chemical structures of Methamphetamine can affect a person’s memory, motor skills, and behavior. With all of these drastic changes to an individual, it can cause harm for themselves and others around them. Methamphetamine’s chemical structure is similar to that of amphetamine, but it has more pronounced effects on the central nervous system.

    Like amphetamine, it causes “increased activity, decreased appetite, and a general sense of well-being” (Narconon2010) the effects of methamphetamine can last 6 to 8 hours. After the initial “rush,” there is typically a state of high agitation that in some individuals can lead to violent behavior” (Narconon 2010). When a person is using meth multiple times, the drug destroys the wiring of the pleasure centers of the brain making it harder to experience pleasure at all. Studies have shown that these tissues can regrow over time, the process can take years, and the repair may never be complete (Heringlake 2006).

    If an individual happens to come across a stranger, friend, or family member, who they may think might be a “meth user”, here are some things he/she may want to look for around the house, in their car, or any personal living space; these things include; small bags of white looking powder, syringes, random pens that can be used to snort, aluminum foil, or even soda cans with a hole in the side of it. Also some things you can look out for from a face to face interaction are; dilated pupils, He or she may become sexually excited, large amounts of weight lost and gaunt looking, thin and undernourished.

    He or she will probably appear unusually active but may also act nervous and anxious. (Spiller2000) “Heavy usage can weaken and destroy blood vessels, causing tissues to become prone to damage and inhibiting the body’s ability to repair itself. Acne may appear, causing sores to take longer to heal. Some users are covered in small sores, the result of obsessive skin-picking brought on by the hallucination of having bugs crawling beneath the skin, a disorder known as formication” (Heringlake).

    Some problems that can occur internally consist of, increased heart rate, disorganized life-style, and lowered resistance to illness, liver damage, convulsions, and extreme rise in body temperature, which can cause brain damage, stroke and death. The most difficult transformation of a meth user in the orofacial region, which is commonly termed as “meth mouth”, is both painful for the user and clinician that are willing to help if the user is seeking it. Some of the signs of meth mouth are visible in the photograph above, while others are not visible in the image.

    The objective signs include: “Rampant tooth decay, which is located around the gum line in most cases. Then there is a severe gum disease called, recurrent ANUG (Acute Necrotizing Ulcerative Gingivitis), ANUG may resolve itself without treatment, but can eventually return again later on as time passes. The most common issue a meth user has is broken teeth. This happens due to weakening of the tooth because of the tooth decay. This is caused by “grinding” of the teeth, and the methamphetamine to chip and break the fragile teeth.

    Attrition of the teeth is the wearing of enamel of the teeth due to grinding as well. Another sign is, very bad breath, this occurs during periods of ANUG, which progressively gets worse, due to poor hygiene, tooth decay and dry mouth. Abscessed teeth, this happens when the decay kills the nerve in the tooth. ” (spiller2000) An oral manifestation is the “disorders of the mouth attendant upon non-oral disease or injury. ” Although there are numerous oral manifestations of “meth mouth”, there are specific oral manifestations that make “meth mouth” what it is.

    Some of these manifestations consist of, Xerostomia (dry mouth), gingival enlargement, dental caries, and periodontal disease. These manifestations are severe to an individual because lack of saliva, causes lack of appetite and dehydration, gingival enlargement causing pain and swelling, dental caries that eventually decay causing the tooth to break down and the nerve to die, leading to bacteria into the bloodstream. Also periodontal disease, causing pain, inflammation, swelling, bone loss, intense surgeries, lack of appetite and so forth.

    Xerostomia is due to “excessive sweating and diarrhea, as well as the direct effect of the drug on the sympathetic nervous system. The lack of saliva and dry conditions in the mouth cause a shift in the bacterial flora (the mix of germ species in the mouth) toward bacteria that produce more acid from the sugar consumed in the ubiquitous soft drinks the addict is likely to consume. ”(spiller2000) This causes the tooth decay to advance much faster, than someone without dry mouth. ” (spiller2000). Gingival enlargement, also known as gingival hyperplasia has a great effect on an individual’s mouth.

    Gingival enlargement is the overgrowth of tissue of the mouth causing redness, pain, and easy bleeding upon touching. The most severe manifestation of all is dental caries, which is what starts the process of periodontal disease. Meth users have black or stained rotting teeth. Usually these teeth that are decayed cannot be saved. There are several factors in the use of meth causing destruction to the oral cavity. Some examples are; “the “buzz” from meth last’s about 12 hours, during the “buzz” the user will crave sugary substances, like soda and candy.

    Methamphetamine users usually will clench or grind their teeth. This will cause severe wear on the dentition. The user will not brush or floss their teeth for several days. This often leads to dental disease. The acidic content of the drug will damage the teeth. Ingredients include battery acid, fertilizers, and household cleaning agents. ” (MainGov) Periodontal disease is the most severe than any other manifestations itself. “Meth reduces blood flow to the teeth and periodontal structures thereby creating low oxygen tension which can lead to increased risk of infection and slow healing.

    This, coupled with poor hygiene and diet, may lead to very poor periodontal health in meth users and loss of teeth over time. ” (MedicineUtah) There are two different stages of periodontal disease, moderate and severe. Since periodontal disease is the worst of them all it is placed in the severe bracket. Periodontal disease can be reversed with improvement of oral hygiene, prescription drugs, periodontal surgeries, scheduled cleanings every few weeks, and most of all diminishing the use of methamphetamine.

    If a patient comes in looking for help to improve their oral hygiene, a dental professional can “encourage the patient to obtain the necessary help to address the underlying meth abuse habit. The dental healthcare provider will obtain a thorough medical history and perform a thorough dental examination to determine the extent of oral involvement. The provider will also counsel and instruct the patient on the importance of accomplishing proper oral hygiene, maintaining a well-balanced diet, and reducing the intake of carbonated beverages. A supplemental fluoride gel or rinse may be prescribed.

    Emergency or urgent dental care can generally be provided when needed, but more extensive definitive care will likely be deferred until the meth abuse habit is no longer present. ”(AAOM). When dealing with a meth user, a professional should take extra precautions when interacting with the person. They should make sure they have all the proper safety barriers: such as mask, eyewear, and gloves before entering a meth user’s mouth. The reason for this is because one does not know exactly what type of life-threating disease’s this person can transfer to them.

    Through this research, we see that being a meth user is a very difficult and devastating life-style to go through. The positive aspect of this research is that anyone can get help and improve their oral hygiene. Carrie Wright, a registered dental hygienist, (RDH) did an interview on five ex- meth addict users. She selected two men out of the five and asked them if they would be interested in coming into Lane Community College for intraoral photos and interviews. They both agreed. She kept their identity unknown and gave them two fake names, “Wells and Thompson”.

    Wright states “Wells and Thompson present with many missing teeth, and crowns fractured completely away at the gum line, where only root tips remain. They both have severe inflammation, and heavy supragingival and subgingival calculus deposits. ” According to Wells, seeking dental treatment is an important part of an addict’s recovery. He says, “Before I started doing meth, I didn’t have a cavity in my head. ” This interview shows already what type of person these men were, just normal regular guys trying to get through life and happened to turn to the wrong substance not realizing what long term harm it has done to them.

    Now Wells is missing almost half of his teeth, and the ones that remain are far from healthy. He sadly states, “It reminds me a lot of my addiction. ”(Wright) Thompson adds, “Recovery is a delicate process and becomes harder with constant reminders of addiction; my toothless grin is almost taunting, not to mention embarrassing. ”(Wright) Most people would not be pleased with a toothless or partially toothless smile, so we wonder why or how these people would still not seek dental care. The answer, however, is simple.

    Thompson explains “that heavy users are not integrated into mainstream society. They usually only associate themselves with other people who are also heavy users. Their friends and support groups are largely edentulous or partially edentulous (meaning no teeth). It is socially acceptable to have this sort of appearance. ”(Wright) Thompson states that he used meth the most while he was a truck driver. “When I was driving the truck, I didn’t want to stop just to do (snort) a line, so I would steer with my left hand and use my right hand to snort the meth, so I always used my right nostril.

    ”(Wright) Wright states that looking at his panorex radiograph, it became visible the damage he has done to his nasal passage. In our society, the view of beauty is not what it seems anymore. These men live in embarrassment of their smiles every day. It is a reminder of their mistakes and their long journey ahead of them. Wright states that “both Wells and Thompson are all currently saving money to have dentures fabricated as soon as possible. One man states, “It could never be soon enough. ”(Wright) Meth Mouth (dental caries, gingival enlargement)

    Oral Manifestations Caused by Methamphetamine. (2016, Aug 22). Retrieved from

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