Meth mouth is unlike any other drug, candy or vice in most dentists' memories. In short stretches of time, sometimes just months, a perfectly healthy set of teeth can turn a grayish-brown, twist and begin to fall out, and take on a peculiar texture less like that of hard enamel and more like a piece of over ripe fruit. The condition, known to some as "meth mouth," has been studied little in academic circles and is unknown to many urban and suburban dentists, whose patients are increasingly focused on cosmetic issues, the bleaching and perfect veneers of television's makeover shows. But other dentists, especially those in the open, empty swaths of land where methamphetamine is being manufactured in homemade laboratories, say they are seeing a growing number of such cases.
With the exception of a few formal studies, including one beginning in New Mexico, meth mouth has so far been less a topic of academic analysis in the dental industry than a matter for casual phone conversations and e-mail exchanges between dentists in small places. "The truth is, very little is known yet," said Dr. Stephen Wagner, who specializes in dentures and implants in his private practice and who will be studying 20 afflicted patients with Tatlock in the coming months at the University of New Mexico. "What I can tell you is what I have seen: It looks like someone has taken a hammer to these teeth and shattered them."
Dry mouth, one immediate cause of meth mouth, is the result of depleted saliva glands, easily exacerbated by the acidic nature of the drug when smoked or snorted. Meth is made from hydrochloric acid. When users smoke meth, the acid in the drug erodes their tooth enamel. The drug also leaves users dehydrated and craving sweets. Add up a loss of tooth enamel, a constant sweet tooth and a disregard for brushing, and you end up "meth mouth" with teeth that are little more than little black stubs.
Just how meth destroys the mouth so spectacularly is a matter of scientific debate. But Stein and others describe a "perfect storm" under way once users start smoking or snorting meth, a potent stimulant.
With meth vapors bathing the teeth in the acidic chemicals used to make the drug, the mouth dries up, stopping the flow of protective saliva. When that happens, oral bacteria explode - up to tenfold above normal levels, Stein said, setting the stage for severe, fast-moving decay. "To complicate all this, the meth user tends to crave sugary drinks, the perfect food source for the bacteria," he said.
" Making matters worse is the high anxiety and paranoia meth causes - people start grinding and clenching their teeth. When teeth literally begin to crumble, it's often too late to save them."
Meth cavities usually start between two teeth, moving from cuspid to cuspid across the network of enamel. Also, the desire to grind one's molars together can easily result in multiple teeth snapping right out of the meth user's mouth. The meth mouth epidemic is widespread in prisons as well, where clean, sharp teeth are not always valued. Prisons are now obligated to devote a growing portion of their health-care budgets to emergency dental care, which costs taxpayers in every state a small fortune each year.