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In January 2006, Dr. Malkemus began writing dental health articles for The Community
Voice newspaper. He wanted to give back to the community and share his passion for
health, as well as his observations of the remarkable planet around us. Current
and past articles are provided here. To view his articles as they appear, see the
Health, Beauty, and Fitness Section at www.thecommunityvoice.com.
Other Resources
Meth Mouth
METH MOUTH
by George A. Malkemus D.D.S.
Methamphetamine is an inexpensive, easy-to-make illicit drug. It is known by several street names: "meth," "speed," "ice," "chalk," "crank," "fire," "glass," "crystal" and "tina." It is made in tens of thousands of illegal laboratories across the country. According to the 2003 National Survey on Drug Use and Health, 12.3 million Americans aged 12 years and older (5.2 percent of the population) had tried methamphetamine at least once in their lifetimes, with the majority of past-year users between 18 and 34 years of age.
Methamphetamine is an addictive drug that affects the nervous system. It causes high levels of the neurotransmitters, norepinephrine, dopamine and serotonin, to accumulate in the brain, which stimulates brain cells and produces euphoria. Users may become addicted quickly and use the drug with increasing frequency and in ever-larger doses.
The use of methamphetamine is on the rise in the United States, even though it produces devastating effects on users’ health. Methamphetamine can cause shortness of breath, increased respiration, hyperthermia, nausea, vomiting, diarrhea, an irregular heartbeat, high blood pressure and permanent brain damage. Other effects include irritability, insomnia, confusion, hallucinations, tremors, convulsions, anxiety, paranoia and aggressiveness.
Persons using crystal meth, tweaking for days at a time, often stay awake and high for five to thirty days. During this period, the acrid smoke, decreased saliva flow, poor hygiene, lack of dental care, and extended periods without sleep takes a toll on their teeth.
Rampant Tooth Decay
Methamphetamine use causes rampant tooth decay. Often users describe their teeth as blackened, stained, rotting, crumbling or falling apart. This condition has become known, euphemistically, as Meth Mouth. Often, there is no hope of treating the methamphetamine-damaged teeth, and they are extracted. Teeth look as though they have been dipped in battery acid and, in a way, they have. The coronal (top) portion of the teeth will decay to the gum line, abscess, and become non-restorable as no tooth structure remains above the bone line. Often, the gums will grow over the remaining stumps of roots and extractions become extremely difficult, as teeth have been reduced to extremely soft mush.
In the early stages of Meth Mouth, gumline cavities appear. Teeth begin to decalcify due to the highly acidic, moist, environment, which is a perfect breeding ground for the bacteria causing dental decay. Gumline decay weakens tooth structure. Cleaving is often seen, with large vertical fractures of the enamel. Once decay has begun, it will continue to develop if the individual does not receive dental care, often leading to complete destruction of the tooth involved or, in many cases, all of the teeth.
The causes of methamphetamine-related tooth decay usually include the following:
– The drug’s acidic nature, which eats away the teeth.
– Its ability to dry the mouth, reducing the amount of protective saliva around the teeth.
– A drug-induced craving for high-calorie carbonated beverages.
- The tendency of users to grind and clench their teeth, wearing down the teeth to small nubs.
– Poor nutrition from the appetite suppressant effect.
Blood Vessel Constriction
Meth causes blood vessels to constrict or tighten, including blood vessels in the mouth. This in turn causes a lack of the blood that normally nourishes the gums and teeth properly. With repeated shrinking, the vessels will not recover, thus causing the dental tissue to starve and break down. The end result is tooth decay, gum disease and bone loss.
Another result of the constriction of blood vessels is the gaunt look and quick aging of the patients. Tissues of the face quickly die and sag from the lack of nutrients and blood supply. This aging effect causes intense itching from the constricting capillaries near the surface of the skin. Compulsive scratching often leads to infection and sores.
Dry Mouth
Dry mouth called xerostomia is caused by the blood vessel constriction and the reduction of salivary gland function. The tongue and lining of the mouth can become raw and irritated without the lubrication action of saliva. This can lead to secondary infections, limited ability to speak and eat. Without saliva , acids accumulate, lowering the pH of the mouth and causing the breakdown of the surface of the teeth. Meth also has a direct acidic effect on the teeth causing the dissolving of the protective surface enamel.
Many Meth users try to reduce the xerostomia by consuming sugary sodas. The soda, coupled with decreased home care, poor nutrition, vomiting side effects of the drug and decreased immune response, creates the perfect environment for decay to occur.
Case Study
A 27-year-old male complained of pain and a draining abscess on his upper right front tooth. Further investigation revealed that all his front teeth had rampant decay and most of his molars had been worn down to the gum line. His plaque level was extremely high and he reported he did not know when he had brushed last. His eyes were dilated, his blood pressure was elevated to 165/89 and his temperature was 104.5 degrees. While waiting for his appointment he was observed pacing back and forth while picking at his skin. He explained he was trying to remove the bugs he was sure were embedded beneath his skin. Review of his health history revealed he had been using meth in the oral form for eight months. His diet consisted of high sugar intake in the form of soda to moisturize his dry mouth. Rampant decay resulted from lack of care, dry mouth, increased acidity, and a lowered immune response. His skin was raw from constant scratching and his face was gaunt with deep lines in his sagging skin.
Dentists, parents and others should be concerned if they notice patients, family members or friends—especially teenagers and young adults—who have unaccounted-for and accelerated tooth decay. Dental treatment only slows down the problem in meth users without the stopping of drug use and a change in life style. This is usually only accomplished with social and psychological intervention, due to the addictive nature of the drug. This problem can only be solved when the addict truly wants help. Our awareness of the extreme consequences of this drug use can help our community as well.
Enjoy Life and Keep Smiling!
George Malkemus has had a Family and Cosmetic Dental Practice in Rohnert Park for over 22 years at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@ malkemusdds.com. Visit Dr. Malkemus’ Web site at http://www.malkemusdds.com
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