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Meth Mouth: Severe Decay of Teeth

Meth mouth, a severe dental condition in meth users, results from prolonged exposure to methamphetamine, leading to tooth decay, gum disease, and tooth loss. This condition, indicating long-term meth use, requires extensive dental treatment and addiction intervention.

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Seen in people who abuse meth regularly, meth mouth is a sign of long-term methamphetamine use. It refers to the decay, rotting, and loss of teeth in someone who uses meth. It is a serious health risk of meth addiction and requires medical intervention and addiction treatment to effectively treat. 

How Long Does It Take to Get Meth Mouth?

Meth mouth develops after long-term meth use, of which the exact length of time depends on the individual. It can take years for severe tooth decay to set in and for the harmful chemicals in meth to erode teeth. 

One study identified a young male who developed gum disease, tooth decay, and oral lesions after approximately four years of meth use. Another patient suffered osteonecrosis of the jaw, a serious condition in which bone cells in the jawbone die and the jawbone pokes through the gums, after attempting self-removal of decayed teeth following 20 years of meth abuse. 

People who smoke methamphetamine put themselves at a greater risk of developing meth mouth sooner, though anyone who consumes meth may develop the condition. Each time meth is smoked, toxic chemicals are inhaled into the mouth, settling on the gums and teeth. The more a person smokes meth, the sooner they are likely to develop meth mouth. 

The Causes of Meth Mouth

With meth mouth, teeth break and fall out of the mouth due to gum disease and tooth decay as a result of using meth. Meth mouth develops due to a combination of factors, including poor diet, minimal dental hygiene, dry mouth, and teeth grinding, and this happens to many people using meth. 

According to a study in the Journal of the American Dental Association of 571 meth users, the more people used meth, the more likely they were to develop related dental problems. Additionally, women, meth users over 30 years old, and people who also smoked cigarettes were at an increased risk of meth mouth. 

Additional causes of meth mouth may be more behavioral, suggests a 2015 study in the Journal of Dental Hygiene. The study found that while using meth, people were likely to consume sugary drinks like soda, and they were less likely to brush their teeth and seek regular dental care. Such behaviors led to dental visits for cavities, tooth surface stains, and lost teeth. 

Signs & Symptoms of Meth Mouth 

Meth mouth ranges in severity from minor cavities to severe tooth loss, discoloring, and decay. Individuals develop meth mouth differently. The impact of meth use on oral health depends on the individual’s response to meth, how well they care for their teeth while using, and what other foods, drinks, and substances they consume. 

Signs of meth mouth include the following: 

  • Blackened and stained teeth
  • Rotting teeth
  • Crumbling teeth
  • Teeth falling apart 
  • Missing teeth 
  • Lesions on the gums

Methamphetamine is an acidic substance that itself can lead to tooth decay. When combined with poor health and dental hygiene habits, methamphetamine can cause irreversible damage to teeth that requires extensive dental work to repair. 

Meth mouth can develop in all individuals who use meth, not just those who smoke it. Snorting, smoking, injecting, or orally consuming meth all expose users to the risks of meth mouth. 

The Stages of Meth Mouth

Meth mouth starts gradually and gets progressively worse with extended meth use. Cavities and gum disease take time to develop, but they are exacerbated by poor teeth cleaning, repeated exposure to toxic chemicals, and a lack of natural protective factors, such as saliva to protect tooth enamel. 

The three primary stages of meth mouth are as follows: 

  • Stage 1: Gums appear red and swollen, the user has bad breath, and teeth begin to show signs of cavities.
  • Stage 1: Cavities become more severe and apparent, gum tissue begins to withdraw from the teeth, and lesions begin to form on the gums and lips.
  • Stage 3: Lesions on the mouth are quite obvious, teeth have decayed all the way back to the gum line, and some teeth are missing.

Tooth decay caused by meth use begins at the gum line and eventually spreads throughout the tooth. The front teeth are typically the first to be affected, leaving an overt sign of meth use. 

Meth mouth during each of the above stages is highly painful. However, many meth users may not realize the pain, as methamphetamine can block or lessen the sense of dental pain. 

Treatment Options for Meth Mouth 

Stopping meth use is the most effective way to prevent meth mouth from occurring. As long as someone continues to use meth, they expose themselves to all of the factors that cause meth mouth. 

The study in the Journal of the American Dental Association identified behavioral interventions as a treatment option, especially for people who are concerned about the appearance of their mouth. 

In most cases, teeth affected by meth mouth cannot be saved and must be removed. Some cavities can be filled, but rotting, broken, or extensively decayed and damaged teeth cannot be saved, explains the American Dental Association. 

The specific dental treatments for meth mouth include filling cavities, pulling teeth out, dental implants, and dentures, in severe cases. However, experts agree that the most important treatment is drug addiction treatment. Meth mouth is a side effect of a meth addiction, and until the addiction is effectively treated, meth mouth is likely to be a recurring problem.

Updated March 20, 2024
  1. Dental Disease Patterns in Methamphetamine Users. (December 2015). The Journal of the American Dental Association.
  2. Meth Mouth. Maine Center for Disease Control and Prevention.
  3. Meth Mouth – A Growing Epidemic in Dentistry? (December 2017). Dentistry Journal.
  4. Meth Mouth: How Methamphetamine Use Affects Dental Health. American Dental Association.
  5. Methamphetamine Research Report. (October 2018). National Institute on Drug Abuse.
  6. Osteonecrosis of the Jaw (ONJ). (September 2022). Cleveland Clinic.
  7. The Relationship Between Methamphetamine Use and Dental Caries and Missing Teeth. (April 2015). Journal of Dental Hygiene.
  8. Methamphetamine Abuse and “Meth Mouth” in Europe. (March 2015). Medicina Oral, Patología Oral y Cirugía Bucal.
  9. Understanding the Basis of METH Mouth Using a Rodent Model of Methamphetamine Injection, Sugar Consumption, and Streptococcus Mutans Infection. (March 2021). mBio.
  10. “Meth Mouth”: An Interdisciplinary Review of a Dental and Psychiatric Condition. (July/August 2017). Journal of Addiction Medicine.
  11. The Effect of Methamphetamine on Human Dentition. (February 2023). BDJ Student.
  12. Sympathomimetic Effects of Chronic Methamphetamine abuse on Oral Health: A Cross-Sectional Study. (May 2016). BMC Oral Health.
  13. Oral Manifestations of “Meth Mouth”: A Case Report. (January 2010). The Journal of Contemporary Dental Practice.
  14. Dental Considerations in the Management of Meth Mouth: A Case Report. (2020). Journal of Prosthodontics and Restorative Dentistry.
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