I 

111TH CONGRESS 

1ST SESSION H. R. 1671 

To understand and comprehensively address the oral health problems 

associated with methamphetamine use. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 23, 2009 

Mr. LARSEN of Washington (for himself, Mr. SULLIVAN, Ms. WATERS, Mr. 

WU, Mr. GUTHRIE, Ms. BORDALLO, Mr. SIMPSON, and Mr. SPACE) introduced the following bill; which was referred to the Committee on Energy 

and Commerce 

A BILL 

To understand and comprehensively address the oral health 

problems associated with methamphetamine use. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; PURPOSES. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Meth Mouth Prevention and Community Recovery Act’’. 

6 (b) PURPOSES.—The purposes of this Act are— 

7 (1) to investigate and report on all aspects of 

8 meth mouth, including its causes, public health imVerDate Nov 24 2008 06:37 Mar 24, 2009 Jkt 079200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1671.IH H1671

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1 pact, innovative models for its prevention, and new 

2 and improved methods for its treatment; 

3 (2) to ensure dentists and allied dental per4 sonnel are able to recognize the signs of substance 

5 abuse in their patients, discuss the nature of addic6 tion as it relates to oral health and dental care, and 

7 facilitate appropriate help for patients (and family 

8 members of patients) who are affected by a sub9 stance use disorder; 

10 (3) to determine whether, how, and to what de11 gree educating youth about meth mouth is an effec12 tive strategy for preventing or reducing the preva13 lence of methamphetamine use; and 

14 (4) to underscore the many ways that dentists 

15 and other oral health professionals can contribute to 

16 the general health of their patients, their commu17 nities, and the country as a whole. 

18 SEC. 2. TABLE OF CONTENTS. 

19 The table of contents for this Act is as follows: 

Sec. 1. Short title; purposes. 

Sec. 2. Table of contents. 

TITLE I—EVIDENCE-BASED PREVENTION 

Sec. 101. Findings; purpose; definitions. 

Sec. 102. Methamphetamine prevention demonstration projects. 

Sec. 103. Education for American Indian and Alaska native children. 

Sec. 104. Authorization of appropriations. 

TITLE II—METH MOUTH RESEARCH INVESTMENT ACT 

Sec. 201. Findings; purpose; definitions. 

Sec. 202. Research on substance abuse, oral health, and dental care. 

Sec. 203. Study of methamphetamine-related oral health costs. 


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Sec. 204. Authorization of appropriations. 

TITLE III—SUBSTANCE ABUSE EDUCATION FOR DENTAL 

PROFESSIONALS 

Sec. 301. Findings; purpose; definitions. 

Sec. 302. Substance abuse training for dental professionals. 

Sec. 303. Authorization of appropriations. 

1 TITLE I—EVIDENCE-BASED 

2 PREVENTION 

3 SEC. 101. FINDINGS; PURPOSE; DEFINITIONS. 

4 (a) FINDINGS.—The Congress finds as follows: 

5 (1) According to the Substance Abuse and Men6 tal Health Services Administration, first-time meth7 amphetamine use is most likely to occur between the 

8 ages of 18 and 25. Prevention efforts must therefore 

9 begin during the teen years. 

10 (2) Most young people do not realize that meth11 amphetamine use can quickly leave their teeth black12 ened, stained, rotting, and crumbling or falling apart 

13 and that the treatment options are often limited. 

14 (3) By educating youth about meth mouth, oral 

15 health advocates can play a substantial role in help16 ing to prevent first-time methamphetamine use. 

17 (b) PURPOSE.—The purpose of this title is to provide 

18 for a number of projects to evaluate whether, how, and 

19 to what degree educating youth about meth mouth is an 

20 effective strategy for preventing or reducing methamphet21 amine use. 

22 (c) DEFINITIONS.—In this title: 


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1 (1) ANTI-DRUG COALITION.—The term ‘‘anti2 drug coalition’’ has the meaning given to the term 

3 ‘‘eligible coalition’’ in section 1023 of the National 

4 Narcotics Leadership Act of 1988 (21 U.S.C. 1523). 

5 (2) DENTAL ORGANIZATION.—The term ‘‘dental 

6 organization’’ means a group of persons organized to 

7 represent the art and science of dentistry or who are 

8 otherwise associated for the primary purpose of ad9 vancing the public’s oral health. 

10 (3) DIRECTOR.—The term ‘‘Director’’ means 

11 the Director of the Center for Substance Abuse Pre12 vention. 

13 (4) ELEMENTARY SCHOOL; SECONDARY

14 SCHOOL.—The terms ‘‘elementary school’’ and ‘‘sec15 ondary school’’ have the meanings given to such 

16 terms in section 9101 of the Elementary and Sec17 ondary Education Act of 1965 (20 U.S.C. 7801). 

18 (5) INDIAN; INDIAN TRIBE; TRIBAL ORGANIZA19 TION.—The terms ‘‘Indian’’, ‘‘Indian tribe’’, and 

20 ‘‘tribal organization’’ have the meanings given to 

21 such terms in section 4 of the Indian Self-Deter22 mination and Education Assistance Act (25 U.S.C. 

23 450b). 

24 (6) METH MOUTH.—The term ‘‘meth mouth’’ 

25 means a distinct and often severe pattern of oral 


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1 decay that is commonly associated with meth2 amphetamine use. 

3 (7) SUBSTANCE USE DISORDER.—The term 

4 ‘‘substance use disorder’’ means any harmful pat5 tern of alcohol or drug use that leads to clinically 

6 significant impairment in physical, psychological, 

7 interpersonal, or vocational functioning. 

8 (8) YOUTH.—The term ‘‘youth’’ has the mean9 ing given to such term in section 1023 of the Na10 tional Narcotics Leadership Act of 1988 (21 U.S.C. 

11 1523). 

12 SEC. 102. METHAMPHETAMINE PREVENTION DEMONSTRA13 TION PROJECTS. 

14 (a) IN GENERAL.—In carrying out section 519E of 

15 the Public Health Service Act (42 U.S.C. 290bb–25e), the 

16 Director of the Center for Substance Abuse Prevention 

17 shall make grants to public and private nonprofit entities 

18 to enable such entities to determine whether, how, and to 

19 what degree educating youth about meth mouth is an ef20 fective strategy for preventing or reducing methamphet21 amine use. 

22 (b) USE OF FUNDS.— 

23 (1) MANDATORY USES.—Amounts awarded 

24 under this title shall be used for projects that focus 


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1 on, or include specific information about, the oral 

2 health risks associated with methamphetamine use. 

3 (2) AUTHORIZED USES.—Amounts awarded 

4 under this title may be used— 

5 (A) to develop or acquire instructional aids 

6 to enhance the teaching and learning process 

7 (including audiovisual items, computer-based 

8 multimedia, supplemental print material, and 

9 similar resources); 

10 (B) to develop or acquire promotional 

11 items to be used for display or distribution on 

12 school campuses (including posters, flyers, bro13 chures, pamphlets, message-based apparel, but14 tons, stickers, and similar items); 

15 (C) to facilitate or directly furnish school16 based instruction concerning the oral health 

17 risks associated with methamphetamine use; 

18 (D) to train State and local health offi19 cials, health professionals, members of anti20 drug coalitions, parents, and others how to 

21 carry messages about the oral health risks asso22 ciated with methamphetamine use to youth; and 

23 (E) to support other activities deemed ap24 propriate by the Director. 

25 (c) GRANT ELIGIBILITY.— 


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1 (1) APPLICATION.—To be eligible for grants 

2 under this title, an entity shall prepare and submit 

3 an application at such time, in such manner, and 

4 containing such information as the Director may 

5 reasonably require. 

6 (2) CONTENTS.—Each application submitted 

7 pursuant to paragraph (1) shall include— 

8 (A) a description of the objectives to be at9 tained; 

10 (B) a description of the manner in which 

11 the grant funds will be used; and 

12 (C) a plan for evaluating the project’s suc13 cess using methods that are evidence-based. 

14 (3) PREFERENCE.—In awarding grants under 

15 this title, the Director shall give preference to appli16 cants that intend to— 

17 (A) collaborate with one or more dental or18 ganizations; 

19 (B) partner with one or more anti-drug 

20 coalitions; and 

21 (C) coordinate their activities with one or 

22 more national, State, or local methamphetamine 

23 prevention campaigns or oral health promotion 

24 initiatives. 

25 (d) LIMITATIONS.— 


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1 (1) GRANT AMOUNTS.—The amount of an 

2 award under this title may not exceed $50,000 per 

3 grantee. 

4 (2) DURATION.—The Director shall award 

5 grants under this title for a period not to exceed 3 

6 years. 

7 (e) EVALUATION AND DISSEMINATION.—The Direc8 tor shall collect and widely disseminate information about 

9 the effectiveness of the demonstration projects assisted 

10 under this title. 

11 SEC. 103. EDUCATION FOR AMERICAN INDIAN AND ALASKA 

12 NATIVE CHILDREN. 

13 Not less than 5 percent of the funds appropriated 

14 pursuant to section 104 for a fiscal year shall be awarded 

15 to Indian tribes and tribal organizations for the purpose 

16 of educating Indian youth about the oral health risks asso17 ciated with methamphetamine use. 

18 SEC. 104. AUTHORIZATION OF APPROPRIATIONS. 

19 There are authorized to be appropriated for the pur20 pose of carrying out this title $1,000,000 for each of fiscal 

21 years 2010 through 2012. Amounts authorized to be ap22 propriated under this section are in addition to any other 

23 amounts authorized to be appropriated for such purpose. 


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1 TITLE II—METH MOUTH 

2 RESEARCH INVESTMENT ACT 

3 SEC. 201. FINDINGS; PURPOSE; DEFINITIONS. 

4 (a) FINDINGS.—The Congress finds as follows: 

5 (1) As the number of regular methamphetamine 

6 users has increased, so has a peculiar set of dental 

7 problems linked to the drug. The condition (known 

8 as ‘‘meth mouth’’) develops rapidly and is attributed 

9 to the drug’s acidic nature, its ability to dry the 

10 mouth, the tendency of users to grind and clench 

11 their teeth, and a drug-induced craving for sugar12 laden soft drinks. 

13 (2) Meth mouth is regarded by many as an an14 ecdotal phenomenon. Few peer-reviewed studies have 

15 been published that examine its causes, its physical 

16 effects, its prevalence, or its public health costs. 

17 (3) Enhanced research would help to identify 

18 the prevalence and scope of meth mouth. Such re19 search would also help determine how substances of 

20 abuse can damage the teeth and other oral tissues, 

21 and offer the possibility of developing new and im22 proved prevention, harm-reduction, and cost man23 agement strategies. 

24 (b) PURPOSE.—The purpose of this title is to provide 

25 for enhanced research examining all aspects of meth 


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1 mouth, including its causes, its public health impact, inno2 vative models for its prevention, and new and improved 

3 methods for its treatment. 

4 (c) DEFINITIONS.—In this title: 

5 (1) CLINICAL RESEARCH; HEALTH SERVICES

6 RESEARCH.—The terms ‘‘clinical research’’ and 

7 ‘‘health services research’’ shall have the meanings 

8 given to such terms in section 409 of the Public 

9 Health Service Act (42 U.S.C. 284d). 

10 (2) INDIAN; INDIAN TRIBE; TRIBAL ORGANIZA11 TION.—The terms ‘‘Indian’’, ‘‘Indian tribe’’, and 

12 ‘‘tribal organization’’ shall have the meanings given 

13 to such terms in section 4 of the Indian Self-Deter14 mination and Education Assistance Act (25 U.S.C. 

15 450b). 

16 (3) METH MOUTH.—The term ‘‘meth mouth’’ 

17 means a distinct and often severe pattern of oral 

18 decay that is commonly associated with meth19 amphetamine use. 

20 (4) PUBLIC HEALTH RESEARCH.—The term 

21 ‘‘public health research’’ means research that fo22 cuses on population-based health measures. 

23 (5) SECRETARY.—The term ‘‘Secretary’’ means 

24 the Secretary of Health and Human Services. 


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1 (6) SUBSTANCE USE DISORDER.—The term 

2 ‘‘substance use disorder’’ means any harmful pat3 tern of alcohol or drug use that leads to clinically 

4 significant impairment in physical, psychological, 

5 interpersonal, or vocational functioning. 

6 SEC. 202. RESEARCH ON SUBSTANCE ABUSE, ORAL 

7 HEALTH, AND DENTAL CARE. 

8 (a) EXPANSION OF ACTIVITY.—In carrying out part 

9 A of title III of the Public Health Service Act (42 U.S.C. 

10 241 et seq.), the Secretary shall expand and intensify the 

11 clinical research, health services research, and public 

12 health research on associations between substance use dis13 orders, oral health, and the provision of dental care. 

14 (b) ADMINISTRATION.—In carrying out subsection 

15 (a), the Secretary— 

16 (1) may enter into contracts or agreements with 

17 other Federal agencies, including interagency agree18 ments, to delegate authority for the execution of 

19 grants and for such other activities as may be nec20 essary to carry out this section; 

21 (2) may carry out this section directly or 

22 through grants or cooperative agreements with 

23 State, local, and territorial units of government, In24 dian tribes, and tribal organizations, or other public 

25 or nonprofit private entities; and 


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1 (3) may request and use such information, 

2 data, and reports from any Federal, State, local, or 

3 private entity as may be required to carry out this 

4 section, with the consent of such entity. 

5 SEC. 203. STUDY OF METHAMPHETAMINE-RELATED ORAL 

6 HEALTH COSTS. 

7 (a) IN GENERAL.—In carrying out section 202, the 

8 Secretary shall conduct a study to determine whether, 

9 how, and to what degree methamphetamine use affects the 

10 demand for (and provision of) dental care. The study shall 

11 account for both genders, all racial and ethnic groups (and 

12 subgroups), and persons of all ages and from all geo13 graphic areas as appropriate for the scientific goals of the 

14 research. 

15 (b) REPORT.—Not later than 1 year after the date 

16 of enactment of this Act, the Secretary shall publish a spe17 cial report detailing the results of the study described in 

18 subsection (a), with findings that address— 

19 (1) the prevalence and severity of oral health 

20 problems believed to be associated with methamphet21 amine use; 

22 (2) the criteria most commonly used to deter23 mine whether a patient’s oral health problems are 

24 associated with methamphetamine use; 


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1 (3) the therapies most commonly used to treat 

2 patients with meth mouth; 

3 (4) the clinical prognosis for patients who re4 ceived care for meth mouth; and 

5 (5) the financial impact of meth mouth on pub6 licly financed dental programs. 

7 SEC. 204. AUTHORIZATION OF APPROPRIATIONS. 

8 There are authorized to be appropriated such sums 

9 as may be necessary for the purpose of carrying out this 

10 title for each of fiscal years 2010 through 2012. Amounts 

11 authorized to be appropriated under this section are in 

12 addition to any other amounts authorized to be appro13 priated for such purpose. 

14 TITLE III—SUBSTANCE ABUSE 

15 EDUCATION FOR DENTAL 

16 PROFESSIONALS 

17 SEC. 301. FINDINGS; PURPOSE; DEFINITIONS. 

18 (a) FINDINGS.—The Congress finds as follows: 

19 (1) The use of certain therapeutic agents in 

20 dental treatment can jeopardize the health and af21 fect the relapse potential of patients with substance 

22 use disorders. 

23 (2) Screening patients for substance abuse is 

24 not a common practice among dentists, according to 

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1 nal of the American Dental Association’’. Limited 

2 time, inadequate training, and the potential for 

3 alienating patients are among the reasons often 

4 cited. 

5 (3) Dentists receive little formal education and 

6 training in screening patients for substance abuse, 

7 discussing the nature of addiction as it relates to 

8 oral health and dental care, and facilitating appro9 priate help for patients, and family members of pa10 tients, who are affected by a substance use disorder. 

11 (4) The American Dental Association maintains 

12 that dentists should be knowledgeable about sub13 stance use disorders in order to safely administer 

14 and prescribe controlled substances and other medi15 cations. The American Dental Association further 

16 recommends that dentists become familiar with their 

17 community’s substance abuse treatment resources 

18 and be able to make referrals when indicated. 

19 (5) Training can greatly increase the degree to 

20 which dentists, allied dental personnel, and other 

21 health professionals can screen patients for sub22 stance abuse, discuss the nature of addiction as it 

23 relates to oral health and dental care, and facilitate 

24 appropriate help for patients, and family members of 


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1 patients, who are affected by a substance use dis2 order. 

3 (b) PURPOSE.—The purpose of this title is to provide 

4 for enhanced training and technical assistance to ensure 

5 that dentists and allied dental personnel are able to recog6 nize the signs of substance abuse in their patients, discuss 

7 the nature of addiction as it relates to oral health and 

8 dental care, and facilitate appropriate help for patients, 

9 and family members of patients, who are affected by a 

10 substance use disorder. 

11 (c) DEFINITIONS.—For the purposes of this title: 

12 (1) ALLIED DENTAL PERSONNEL.—The term 

13 ‘‘allied dental personnel’’ means individuals who as14 sist the dentist in the provision of oral health care 

15 services to patients, including dental assistants, den16 tal hygienists, and dental laboratory technicians who 

17 are employed in dental offices or other patient care 

18 facilities. 

19 (2) CONTINUING EDUCATION.—The term ‘‘con20 tinuing education’’ means extracurricular learning 

21 activities (including classes, lecture series, con22 ferences, workshops, seminars, correspondence 

23 courses, and other programs) whose purpose is to in24 corporate the latest advances in science, clinical, and 

25 professional knowledge into the practice of health 


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1 care (and whose completion is often a condition of 

2 professional licensing). 

3 (3) CONTINUING EDUCATION CREDIT.—The 

4 term ‘‘continuing education credit’’ means a unit of 

5 study that is used to officially certify or recognize 

6 the successful completion of an activity that is con7 sistent with professional standards for continuing 

8 education. 

9 SEC. 302. SUBSTANCE ABUSE TRAINING FOR DENTAL PRO10 FESSIONALS. 

11 (a) IN GENERAL.—In carrying out title V of the Pub12 lic Health Service Act (42 U.S.C. 290 et seq.), the Admin13 istrator of the Substance Abuse and Mental Health Serv14 ices Administration shall support training and offer tech15 nical assistance to ensure that dentists and allied dental 

16 personnel are prepared to— 

17 (1) recognize signs of alcohol or drug addiction 

18 in their patients and the family members of their pa19 tients; 

20 (2) discuss the nature of substance abuse as it 

21 relates to their area of expertise; 

22 (3) understand how certain dental therapies can 

23 affect the relapse potential of substance dependent 

24 patients; and 


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1 (4) help those affected by a substance use dis2 order to find appropriate treatment for their condi3 tion. 

4 (b) CONTINUING EDUCATION CREDITS.—The Ad5 ministrator of the Substance Abuse and Mental Health 

6 Services Administration may collaborate with professional 

7 accrediting bodies— 

8 (1) to develop and support substance abuse 

9 training courses for oral health professionals; and 

10 (2) to encourage that the activities described in 

11 paragraph (1) be recognized for continuing edu12 cation purposes. 

13 SEC. 303. AUTHORIZATION OF APPROPRIATIONS. 

14 There are authorized to be appropriated such sums 

15 as may be necessary for the purpose of carrying out this 

16 title for each of fiscal years 2010 through 2012. Amounts 

17 authorized to be appropriated under this section are in 

18 addition to any other amounts authorized to be appro19 priated for such purpose. 

Æ 


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