Meth Mouth

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Meth Mouth

• Dental Issues in Methamphetamine Abusers
• Medical Case Management Clinical Conference
• Christina Eaton, MPHDelta AETC

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The Relationship Between Methamphetamine Use and
Increased Dental Disease

• J Am Dent Assoc, Vol 141, No 3, 307-318
• Vivek Shetty, DDS, DrMedDent
• Larissa J. Mooney, MD
• Corwin M. Zigler, MA
• Thomas R. Belin, PhD
• Debra Murphy, PhD and Richard Rawson, Ph

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Name That Famous Mouth
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What is Meth Mouth?

• Destruction of the teeth and gums directly
  resulting from methamphetamine abuse
• Indirect consequence of methamphetamine abuse
• Neglected or forgotten brushing flossing while
  high or when coming down

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Periodondal Disease Pathogenesis
1. PLAQUE Soft, sticky, fussy deposits
on tooth

• Forms on teeth when starches sugars interact
  with bacteria present in mouth
• Plaque is removed with brushing BUT re-forms
  within 24 hours
• If stays longer than 2-3 days can harden into
  tartar

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TARTAR/CALCULUS/STONE
2. Calculus/Tartar/Stone Hard deposits
on tooth
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Pathogenesis
1. PLAQUE Soft, sticky, fussy deposits
on tooth
2. Calculus/Tartar/Stone Hard deposits
on tooth
3. Periodontal Pocket Due to bone
Ligaments destruction
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PERIODONTAL
POCKET When Periodontitis cause bone
destruction.
P. Pocket
Healthy gum Bone
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Name That Famous Mouth
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How Does MA Use Cause Tooth Decay?

• MA use causes blood vessels to constrict (shrink)
• Blood vessels in mouth can not feed teeth and
  gums
• Repeated shrinking causes vessels to die
• Inhibits bodys ability to repair itself
• Dental tissue starves and breaks
  down

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How Does MA Use Cause Tooth Decay?What is
xerostomia?

1. Calcium breakdown
2. Dryness in the mouth
3. Small cracks in the teeth
4. Bad breath
5. Gum recession

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Xerostomia

• Saliva breaks down acids in the mouth
• MA use blocks the brain mechanism
  causing salivation
• Acids build up and eat away at tooth enamel
• MA can stay in the body for 8 hours
• Sustained reduction in saliva rapid bacterial
  growth

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How Does MA Use Cause Tooth Decay?Self Treatment
for Xerostomia

• Carbonated drinks are often craved to counteract
  the effects of dry mouth
• Provides food for bacteria, creating more acid
• Insufficient saliva to counter decreased pH
• Acid eats away at tooth enamel

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Name That Famous Mouth
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Which method of MA use results in the highest
rates of dental disease?

1. Smoking
2. Snorting
3. Injecting

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How Does MA Use Cause Tooth Decay?

• Prevailing belief
• Smoking gt IV or snorting
• 2000 report in Peridontology
• Snorting gt IV
• 2010 Study
• IV gt Smoking or Snorting
• Why?
• IV MA users have higher level of addiction

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How Does MA Use Cause Tooth Decay?

• Bruxism (Teeth grinding clenching)
• Caused by drug-induced hyperactivity
• Puts large amounts of unnatural pressure on tooth
• Creates small fractures in enamel, exposing
  dentin layer or pulp of the tooth
• Exacerbates TMJ disorders

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Which subset of MA users more often reports
having TMJ problems?

1. Males
2. Females

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Name That Famous Mouth

• Mike Myers (Austin Powers), Austin Powers in
  Goldmember

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Counseling Your Clients

• Plan for dental care before getting high
• Reminder notes to brush and floss
• Keep extra toothbrush and travel sized toothpaste
  in backpack, car, etc if will not return home

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Counseling Your Clients

• Brush daily
• Use soft bristle brush and toothpaste that
  contains fluoride
• Fluoride best defense against tooth decay

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Moment of Truth I floss..

1. Everyday
2. A few times a week
3. Sporadically
4. With my fingernails
5. What is flossing?

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Counseling Your Clients Flossing

• Floss on a regular basis once a day
• Dont floss right before or after oral sex
• Check teeth and gums often for early signs of
  decay and gum disease

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Counseling Your Clients

• Drink water not soda to keep mouth moist
• When high try to drink 64 oz (8 glasses) a day

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Counseling Your Clients

• Suck on sugar-free candy like lemon drops to help
  produce saliva
• See dentist every six months for a routine
  cleaning and check-up

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Summary

• Dental disease is a distinguishing marker of MA
  use
• MA users often have current dental problems
  unmet oral health needs
• MA contributes to dental problems by causing
  xerostomia and bruxism
• Counsel clients to keep up with dental health and
  drink plenty of water if continuing MA use

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Name That Famous Mouth
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Name That Famous Mouth
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