Oral and Dental Consequences of Methamphetamine Use

Burgeoning clinical reports and media coverage link methamphetamine (MA) use with accelerated and extensive dental deterioration, leading to the common moniker “meth mouth”. The oral effects may be exacerbated in immune-compromised individuals who are at increased risk for caries and periodontal disease. Despite the emergent personal and societal impact, actual occurrence of the condition is unclear, clinical descriptions remain anecdotal, underlying mechanisms poorly understood, and diagnosis overlooked or belated until the damage is manifestly overt.
We propose to carry out the first systematic study of the oral health ramifications of MA use, combining detailed dental examinations with extensive sociobehavioral assessments including a comprehensive drug-use history. We hypothesize that MA users will have a substantially greater occurrence of oral consequences, particularly dental caries and periodontal disease, and a lower oral health related quality of life than a demographically similar group of propensity-score matched individuals from the National Health and Nutrition Examination Survey (NHANES).

Using a cross-sectional survey of 500 adult MA users, we will :

  1. Validate that the rates and patterns of dental caries experience and oral disease are substantially different in methamphetamine (MA) users than non-MA users.We hypothesize that the patterns of dental caries and other indicators of adverse oral health (e.g., periodontal disease, dry mouth) will be more common in MA users than in demographically comparable samples from the NHANES general population surveys.
  2. Characterize the relationship between dental consequences, patterns of MA-use and other individual characteristics. We hypothesize that greater dental consequences will be associated with the frequency, amount, mode of MA use as well as individual variables such as HIV infection.
  3. Develop a composite index of dental disease, based on a detailed pattern of dental caries experience, that can help dentists reliably distinguish MA users from non-users. We hypothesize that the specificity of the tooth surfaces involved and the oral health effects will help dentists distinguish MA-users from non-users.
  4. To investigate the extent to which negative self-image among MA-users is associated with a willingness to seek treatment. We hypothesize that MA-users with a low dental self-image will be more willing to engage in substance abuse treatment.

A key goal is to summarize and disseminate our research findings through a web based, centralized repository of high-quality, indexed digital images documenting the range of oral manifestations and their association with the levels of MA use. Understanding the oral consequences of MA use and the contextual sociobehavioral determinants will help dental professionals distinguish the condition at an early stage, develop best practices for managing the consequences, and set the stage for targeted prevention and intervention
strategies that meaningfully involve the dental community in the healthcare of MA users.