Severe dental disease is common among people addicted to methamphetamine and cocaine, as is tooth loss, complicating treatment and recovery. Oral health is often entirely overlooked by individuals addicted to drugs. Yet many illicit drugs directly alter the balance of hormones and neurotransmitters regulating salivary flow, leading to dry mouth, cavities, and oral infections. Most people admitted to treatment programs for substance use disorders (SUDs) haven’t seen a dentist for years—and still won’t see one.

As drug use worsens, finding and using substances become all-consuming, often leading to poor nutritional choices. Junk food contributes to dental decay and gum disease.

"Meth mouth" refers to very severe tooth decay and loss, as well as gum disease. The acidic nature of methamphetamine is conducive to rapid decay. Smoking methamphetamine directly damages oral tissues, leading to inflammation and infections, weakening teeth. Visibly compromised teeth exacerbate individuals’ personal shame, isolation, and mental health issues, making recovery more difficult.

Smoking cocaine or crack does the same thing, causing chronic vasoconstriction, reducing gingival/periodontal blood flow, impairing healing, and weakening the structural support of teeth. These changes can appear in young adults and progress within months of repeated drug use.

In one extensive U.S. study, 96% of meth users had cavities, and 58% had untreated decay. Nearly a third (31%) had fewer than 21 remaining teeth, a figure several times higher than the general population. Meth users were three times more likely to have untreated dental disease and six times more likely to have extensive cavities compared with controls.

“Meth mouth” is the extreme presentation of rampant caries and teeth appearing dark, decayed, crumbling, or fractured. Extensive U.S. surveys have shown nearly all regular methamphetamine users exhibit some degree of dental decay, and more than half have untreated cavities. Patients also often exhibit severe gum inflammation, rapid periodontal........

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