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Drug Use

Illicit drug use and addiction can have devastating effects on your body. Unfortunately, many patient education and addiction programs do not address the oral effects of drug use.

Drugs that are smoked or ingested can interfere with your mouth's normal biology. Drugs can also have indirect effects on your mouth by impacting risk-taking, carelessness, and personal hygiene.¹

Common effects of drug use

Drugs can negatively impact your teeth, gums, lips, tongue, and the soft tissues that line the inside of your mouth:

• Dry mouth: Drug use can seriously affect your salivary glands. In the short term, many drugs can interfere with the nerves that signal these glands resulting in reduced saliva production. Long-term drug use can cause your salivary glands to shrink (atrophy). Reduced saliva creates an environment that supports bacteria growth and tooth decay. This can lead to expensive and potentially painful restorative procedures.
• Bruxism: Many illicit drugs cause users to form a habit of grinding or clenching their teeth. Bruxism can lead to tooth wear, chipped teeth, or cracked teeth.
• Appearance: Drug use can affect your appearance. Drugs that are smoked, such as marijuana, crack, cocaine, and methamphetamine (meth), can stain and badly decay your teeth. In combination with the effects of dry mouth, many drugs cause bad breath. Tooth loss from drug use leaves gaps in your smile, makes it harder to eat, and can negatively impact your long-term oral health.

Additional effects of specific drugs

• Inhaled drugs: Drugs inhaled through the nose like cocaine or heroin increase your risk of sinus infections, burns in the nasal passages, and perforation of the palate (the hard part of the roof of your mouth).¹
• Methamphetamine: People addicted to methamphetamine (meth) often have teeth that are blackened, stained, rotting, and crumbling. This is a condition commonly known as "meth mouth." In many cases, the teeth cannot be salvaged and must be removed. Those that can be saved often require extensive dental work to restore them. The extensive tooth decay is likely caused by the effects of dry mouth combined with long periods of poor oral hygiene.² In addition, meth users commonly crave sugar-rich food and beverages that promote tooth decay. Methamphetamine use can destroy your mouth in less than four months.³

What to do

At home

• The best way to reduce the oral health risks of drug use is not to use them. Whether voluntarily or with the help of abuse recovery programs, achieving and maintaining a healthy, drug-free lifestyle is the best thing you can do for your body.
• If you are taking prescription drugs that dry out your mouth, ask your doctor if there are alternatives that do not. Mention these medications to your dentist as well.
• Drink plenty of water. Water keeps your mouth moist and increases saliva flow to reduce mouth sores and plaque build-up. It will also keep you hydrated.
• Try to avoid using sugary drinks to keep your mouth moist.
• Maintain proper oral health by brushing at least twice a day and flossing daily to help remove plaque.

At the dentist

• See your dentist regularly for oral exams and professional teeth cleanings.
• Be honest with your dentist about your past and current drug use. If you feel you may have a drug problem, talk to your dentist or physician about the guidance they can provide to reduce or eliminate your dependency. Keep in mind that they are there to help you, not make judgments on your personal lifestyle choices.
• Ask your dentist or hygienist about prescription toothpaste or gel containing elevated fluoride levels. The higher amount of fluoride can provide additional protection against tooth decay.
• You may be asked if you would like additional information on the effects of drug use on your mouth.
• Follow all of your dentist's directions regarding your specific oral health needs.

Other considerations

• Oral neglect: Often, drug users set a low priority on their oral health. This may be associated with a need to obtain drugs before anything else, a fear of dentists, the availability of dental services, embarrassment, or other factors in their lifestyle that lead to low use of dental services. Remember that regular preventive care is the best way to avoid the high cost of treating severe dental conditions in the future.
• Self-medication: Rather than seeking dental care, some chronic users self-medicate to relieve mouth pain. This is a short-sighted approach and will not address the underlying issues causing the pain.
• Emergency treatment: Drug users often resort to emergency departments when their pain becomes intolerable. This is an expensive and time-consuming approach. In addition, not all emergency departments are equipped to handle oral health issues other than trauma. A better approach is to regularly see your dentist to identify and treat oral health issues before they require emergency treatment.