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The perils of meth mouth

By: George Malkemus
February 9, 2018

Rampant tooth decay seen in methamphetamine users is commonly called meth mouth. The teeth look like they have been dipped in battery acid and, in a way, they have. Methamphetamine is extremely acidic and corrosive. Decay also results in meth users from dry mouth, poor oral hygiene, poor nutrition, drinking large amounts of soda and teeth clenching and grinding.

Often, there is no hope of treating the meth-damaged teeth and the teeth need extractions. The teeth often decay to the gum line, with abscesses and become non-restorable as no healthy tooth structure remains, but only a soft mushy substance. Often, the gums will grow over the remaining stumps of the roots and thus make extractions difficult.

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. Meth abusers are commonly called tweakers.  

Meth is an addictive drug that affects the nervous system by causing high levels of the neurotransmitters norepinephrine, dopamine and serotonin, to accumulate in the brain. This over stimulates brain cells and produces euphoria. Meth users become increasingly tolerant to the euphoric effect of the drug, so they have to increase frequency of use and take even larger doses. Due to this effect, users can become quickly addicted.

The use of methamphetamine is on the rise in the United States, even though it produces devastating effects on users’ health. Meth 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.

A person using crystal meth tweaks for days at a time and often stays awake and high for five to even 30 days. During this period, the acrid smoke, decreased saliva flow, poor hygiene, lack of dental care and extended periods without sleep take a toll on his/her teeth and health.

The causes of meth-related tooth decay:

Meth’s acidic nature: Lithium, muriatic acid, sulfuric acid, ether, red phosphorus and lye are key ingredients in meth manufacturing and traces of these corrosive, acidic agents are found in meth.  When a person smokes meth, these substances are heated, vaporized and swirled throughout the user’s mouth. They irritate and burn the sensitive tissues inside the mouth, create sores, gum disease and lead to rampant decay from the continuous corrosive effect of the vapors on tooth enamel.

Snorting meth also causes chemical damage to teeth. Snorting draws the caustic substances down the nasal passages, draining in the back of the throat and bathing the teeth with corrosive substances.

Dry mouth: 

Meth causes dry mouth by reducing saliva production. Saliva constantly washes the mouth, reducing bacteria levels that cause decay and gum disease. Saliva also acts as a buffer against acidic substances in the mouth, helping prevent decay. Without saliva, the acidic substances can eat away at the minerals in tooth enamel, quickly causing rampant decay. 

Soda consumption: 

With a drug-induced craving for high-calorie carbonated beverages, meth users are notorious for trying to treat cottonmouth [dry mouth] by consuming sugary sodas. Bacteria in the mouth feed on the sugars from the soda and secrete acid, causing tooth decay. Plus, most sodas are high acidic solutions, which adds to the dissolving of enamel and increased decay.

Grinding and clenching:  

Meth often makes users feel anxious and nervous, causing them to clench or grind their teeth. This leads to cracked, or broken teeth or teeth worn down to short nubs. Along with the weakness from rampant decay, the teeth are often broken at the gum line from clenching and grinding. 

Poor nutrition:  

Meth has an appetite suppressant effect. Drinking large quantities of soda, coupled with poor nutrition, the vomiting side effects of the drug and a decreased immune response, creates the perfect environment for decay to occur. Lack of good nutrition as well as lack of sleep reduces the meth user’s general health and natural defenses to infection including gum disease and decay.  

Oral hygiene neglect: 

Methamphetamine users often neglect oral hygiene, along with personal hygiene. Meth users aren’t likely to floss, brush and rinse when on a meth high. 

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 flow 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.

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 of 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 and his blood pressure was elevated to 165/89.  

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. A 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. A meth user will continue to have major dental issues without stopping his/her drug use and a change in life style.  This is usually only accomplished with social and psychological intervention, due to the extreme addictive nature of the drug. This problem can only be solved when the addict truly wants help. 


Enjoy Life and Keep Smiling!

George Malkemus has a Family and Cosmetic Dental Practice in Rohnert Park at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@  Visit Dr. Malkemus’ Web site at