“Meth mouth” is one of the most notorious physical effects found among meth users. Poor hygiene and the consumption of sugary food and drinks can rapidly turn pearly-whites into a yellow, decaying, stomach-turning mess that often leaves meth users with enormous dental bills and gaping holes in their mouths.

To fully investigate this phenomenon, the Partnership interviewed Dr. Robert Brandjord, former President of the American Dental Association (ADA).

What exactly is meth mouth?
DR. ROBERT BRANDJORD: “Meth mouth” occurs when a person has a rapid onset of dental decay. Often, their teeth become blackened and stained and appear to be rotting away and falling apart. What makes it different from normal dental decay is the rapid rate at which it occurs.

The difference between meth mouth and other types of decay can be pretty clear. Most of the time when people have tooth decay, it happens in the back of the mouth, in the grooves of the teeth because that area is the hardest to clean. When a person has tooth decay as a result of meth use, the decay occurs on the front teeth, along the surfaces of the gumline - which, ironically, is the easiest area to get clean.

Can someone get meth mouth even if they don’t smoke meth — but, say, uses the drug intravenously?
You can get any of the effects of meth mouth without actually smoking meth. Contrary to popular belief, meth mouth is not a result of the toxic chemicals of the drug itself.

Meth mouth can occur for a number of reasons. First, meth users often become less and less concerned with their personal hygiene and sometimes stop taking care of their teeth altogether. Second, meth users crave sugary drinks, like sodas, when they’re high on meth. Having a high intake of these beverages can help to cause tooth decay. The sugar combined with poor oral hygiene is a terrible combination for the mouth. Third, the use of meth slows down saliva production in the mouth - which is a natural cleanser of the oral cavity. Also, meth stimulates the grinding and clenching of teeth - this is how the teeth break apart while they are decaying.

So, do all meth users get meth mouth?
No, not all meth users get meth mouth, since it’s brought on more by personal hygiene than the actual drug itself. If a meth user can still remember to brush his or her teeth and refrains from drinking sugary beverages, the risk of getting meth mouth will decrease. However, as stated before, chronic methamphetamine use can cause dry mouth (xerostomia), which significantly increases the risk of dental decay, enamel erosion and periodontal disease.

How many dental treatments can it take to cure meth mouth?
This can vary - some teeth can be restored quickly, but so many people come in to see dentists in such a severe state that their teeth can’t be saved. Many people have no choice but to have dentures and partial dentures put in. Meth mouth robs people, especially young people, of their teeth.

What are typical treatments for meth mouth?
Frequent professional dental hygiene visits with the application of concentrated fluoride to prevent rapid progression of the tooth decay. After this, the teeth would be restored or removed (depending on the damage). The appropriate treatment is dependent on the extent of damage done to the teeth.

Are these treatments expensive? Up to how much can they cost?
The cost of the treatments depends on the amount of damage to the teeth that has occurred and the treatment needed to restore the teeth. If the damage is to the extent you have seen in some of the pictures the costs can be in the thousands of dollars.

What have you done to prepare American dentists to fix this type of tooth decay?
We’ve put together brochures and information that’s available on our website and we encourage all dentists to share any experience they have had treating meth mouth with the ADA and their colleagues.

What do you suggest for a meth user who is concerned about the condition of his or her mouth?
First, I would hope that if they are concerned about the condition of their mouth, they would seek professional help to treat the overall methamphetamine addiction. Cessation of the meth use would be the most desirable first step to stop the progression of meth mouth.

If a person is still using, the dry mouth (xerostomia) induced by meth will cause an individual to want to drink plenty of liquids - I would recommend drinking water and not sugary carbonated beverages. As stated earlier, the rate of progression of meth mouth can be reduced by practicing good oral hygiene, which includes brushing, flossing and rinsing with fluoridated mouthwash and getting frequent professional dental cleanings.