page_title: Meth mouth
section_title: Causes
hierarchical_section_title: Meth mouth / Causes
caption_attribution_description: English: Powdered methamphetamine in tin foil
context_page_description: Meth mouth is severe tooth decay and tooth loss, as well as tooth fracture, acid erosion, and other oral problems, potentially symptomatic of extended use of the drug methamphetamine. The condition is thought to be caused by a combination of side effects of the drug and lifestyle factors, which may be present in long-term users. However, the legitimacy of meth mouth as a unique condition has been questioned because of the similar effects of some other drugs on teeth. Images of diseased mouths are often used in anti-drug campaigns.
  The condition is difficult to treat, and may involve fillings, fluoride to fight tooth decay and drugs that increase saliva for dry mouth, as well as oral hygiene instruction. It can be dangerous for active methamphetamine users to undergo
  dental surgery because of the cardiac problems that can result from the interaction of local anesthetic with the drug.
context_section_description: The hypothesized causes of meth mouth are a combination of MA side effects and lifestyle factors which may be present in users:
  Dry mouth (xerostomia)
  Clenching and grinding of the teeth (bruxism)
  Infrequent oral hygiene
  Frequent consumption of sugary, fizzy drinks
  Caustic nature of methamphetamine
  The dental effects of long-term methamphetamine use are often attributed to its effects on saliva. The reduction in saliva increases the likelihood of dental caries, enamel erosion, and periodontal disease. Although it is clear that use of the drug decreases saliva, the mechanism by which it does so is unclear. One theory is that the drug causes vasoconstriction (narrowing of the blood vessels) in salivary glands, decreasing salivary flow. This constriction is thought to be due to the activation of alpha-adrenergic receptors by both methamphetamine itself and norepinephrine, the levels of which are dramatically increased by methamphetamine use. These factors can be compounded by dehydration, which occurs in many methamphetamine users after drug-induced increases in metabolism. The characteristics of the saliva produced during use of the drug, which includes high protein content, may also contribute to the sensation of dry mouth.
  Long-term methamphetamine use can cause parafunctional habits, routine actions of a body part that are different than their common use, which can result in tooth wear and exacerbate periodontal diseases. One such habit that may affect the development of meth mouth is bruxism, particularly as the drug's effects wane and stereotypy occurs, a phase that is often referred to as "tweaking". This bruxism may be due to a drug-induced increase in monoamines. Other behaviors of long-term methamphetamine users that may cause or accelerate the symptoms of meth mouth are the failure to pay attention to oral hygiene and excessive food intake during binges, especially sugary foods; the drug's users often report strong cravings for sugar and consume large amounts of high-sugar beverages. The altered mental state that accompanies methamphetamine use lasts longer than that of some other common drugs, increasing the amount of time the user engages in drug-induced behavior.
  Hydrochloric acid is used in methamphetamine's manufacturing process, but academic reviews have not supported the idea that the acid contributes to dental decay. Speculation that oral consumption of the drug causes tooth decay by raising the acidity of users' mouths is also unsupported. Meth mouth is generally most severe in users who inject the drug, rather than those who smoke, ingest or inhale it.
caption: Powder methamphetamine on tin foil
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