'Meth mouth' a consequence of drug abuse (Maine)

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Thursday, February 02, 2006 - Bangor Daily News << Back

Each front tooth was the shape of an apple core, with the rotten enamel eaten away and the exquisitely sensitive central nerve exposed. The back teeth were decayed beyond repair as well. The patient lived in a constant vigil of pain, unable to chew, drink or even speak without eliciting the unbearable ache. His only hope for relief was that someone would extract all his nonrestorable teeth - teeth that should have lasted him a lifetime.

This pattern of tooth decay, caused by unrelenting sugar cravings, dehydration and an absence of dental hygiene, is what we call "early childhood caries" and generally occurs in young children in rural areas with poor hygiene and no access to dental care. But this condition is now seen in people in their teens, twenties and beyond - even in those whose teeth have been healthy and well-cared for throughout their lives.

What is ravaging the mouths of our older adolescents and young adults? The answer is simple and very frightening. The popularity of methamphetamine, an easily produced drug that is being abused throughout rural America, is leading to the destruction of adult dental health. Here in Maine, methamphetamine use is growing, and we can safely predict a parallel rise in serious dental problems among those users.

"Meth mouth" is the result of methamphetamine's pronounced drying effect on the mouth and the user's constant consumption of carbonated beverages to relieve that dryness. Combined with little or no tooth brushing, the end result is quick, devastating tooth decay - often in just a few months.

Furthering this crisis is the fact that most methamphetamine users are poor, with little access to dental care. The cost of fixing the teeth of a person ravaged by meth mouth is almost limitless, yet many of those affected have little or no way to pay for this care. The net result for our society will be a growing segment of poor adults with ravaged mouths.

Dr. Robert Brandjord, president of the American Dental Association, testified before a special U.S. Senate panel on the dental effects of methamphetamine abuse in late January. During his testimony, he said: "Often, there is no hope of treating methamphetamine damaged teeth, leading to full-mouth extractions. This can, and in some cases already has, led to significant increases in oral health care costs for society."

Not immune to this epidemic will be the children of those addicted to methamphetamine. The theory of vertical transmission, where a parent or caregiver infects a child with the bacteria that causes tooth decay, is multiplied when a parent has very active dental disease. Thus, methamphetamine use now further complicates our attempts to take control of the rise in tooth decay among children in Maine and across the United States.

Ultimately, the solution to this dental epidemic is not to find more dental providers to treat those impacted by meth mouth. The solution is to eliminate the abuse of methamphetamine. Already, positive steps have been taken here in Maine by making it more difficult to possess the ingredients to produce this dangerous drug. But, as with most narcotics, new ways will be found to produce a popular product.

In the meantime, we will be faced with a prison population with escalating dental costs, overwhelmed community health centers struggling to provide adequate services, increased emergency room costs due to dental pain and infection and the undeniable social stigma associated with rampant tooth decay in adults.

Ultimately, it is the people of the state of Maine who will lose the most, as we watch our rural communities deteriorate.

Dr. Jonathan Shenkin specializes in children's dental care. His practice is in Bangor.



From the heart



"Hard drugs" vs "soft drugs" - make the distinction

There is a middle ground between drug prohibition and blanket legalization. Switzerland's heroin maintenance trials have been shown to reduce disease, death and crime among chronic users. Addicts would not be sharing needles if not for zero-tolerance laws that restrict access to clean syringes, nor would they be committing crimes if not for artificially inflated black-market prices. Heroin maintenance pilot projects are under way in Canada, Germany, Spain and the Netherlands. If expanded, prescription heroin maintenance would deprive organized crime of a core client base. This would render illegal heroin trafficking unprofitable and spare future generations addiction.

Marijuana should be taxed and regulated like alcohol, only without the ubiquitous advertising. Separating the hard- and soft-drug markets is critical. As long as marijuana distribution remains in the hands of organized crime, consumers of the most popular illicit drug will continue to come into contact with sellers of hard drugs such as cocaine. This "gateway" is the direct result of a fundamentally flawed policy. Given that marijuana is arguably safer than legal alcohol, it makes no sense to waste tax dollars on failed policies that finance organized crime and facilitate the use of hard drugs.



Robert Sharpe, MPA

Policy analyst

Common Sense for Drug Policy

Washington, D.C.



Please join our weekly conversation about Maine's substance abuse problem. We welcome comments or questions from all perspectives. Letters may be mailed to Bangor Daily News, P.O. Box 1329, Bangor 04401. Send e-mail contributions to findingafix@bangordailynews.net. Column editor Meg Haskell may be reached at (207) 990-8291 or mhaskell@bangordailynews.net.