Substance Use Disorders

An example of severe oral consequences resulting from substance use and abuse is "Meth Mouth". Meth mouth is seen in methamphetamine (aka meth, speed, ice, crystal, crank) users when the drug is smoked, snorted, injected, or taken orally.

Rapid onset oral devastation is mainly a problem of teens and young adults. Up to 5% of the 12-to-40-year old population report having used methamphetamines.

Research has shown that behavioral factors, such as smoking, consuming sugary beverages, and poor oral hygiene, are more important than a direct drug effect of methamphetamines.


  • Rampant caries, gingival recession, and dental erosion in a young person
  • Involves the buccal smooth surfaces, anterior teeth, and gums
  • Often accompanied by behavioral changes and sometimes weight loss

Methamphetamine use leads to:

  • Drug induced xerostomia
  • Poor hygiene
  • Increased carbohydrate and carbonated beverage consumption
  • Teeth grinding
  • Direct acid effect of the drug


  • Dental/oral surgery referral and behavioral health referral

Clinical examples of the effects of methamphetamine use on teeth

James Cecil, DMD, MPH
James Cecil, DMD, MPH
James Cecil, DMD, MPH


Curtis EK. Meth mouth: a review of methamphetamine abuse and its oral manifestations. Gen Dent. 2006; 54(2): 125-9.

Clague J, Belin TR, Shetty V. Mechanisms underlying methamphetamine-related dental disease.. J Am Dent Assoc. 2017. 148(6): 377-386.

Spolsky VW, Clague J, Murphy DA, Vitero S, Dye BA, Belin TR, Shetty V. Periodontal status of current methamphetamine users. J Am Dent Assoc. 2018; 149(3): 174-183.