Drugs, Medical, Well-being, Self-help
Date Published: 6/4/2020
“Doctor, your exam patient is ready in operatory #1”! But are you ready when your patient opens his mouth to reveal teeth blackened, broken, and rotted with decay? At first glance, you might think the decay is from poor oral hygiene, candy or your patient’s soda consumption. But could it be from methamphetamine, a drug that causes severe tooth decay? Before you pick up your anesthetic syringe or dental drill, pick up and read “A State of Decay”: Your Dental Guide to Understanding and Treating Meth Mouth. With step-by-step advice and her outspoken style, Dr. Brown, walks you through how to Recognize, Communicate and Treat patients who have “meth mouth”. In these pages you’ll learn:
• What methamphetamine is and why it causes rapid tooth decay
• How to recognize patients in your practice who are using methamphetamine
• Effective strategies to treat your patients with “meth mouth”
Often by the time a patient presents to our dental offices with teeth that are blackened, broken, rotted, and crumbling from their methamphetamine use, they are embarrassed by their unattractive smiles and overwhelmed with dental pain. Similarly, as dentists, we are often equally overwhelmed by the magnitude of decay and uncertain about which aspects of treatment (preventive, restorative, surgical, or prosthetic) to prioritize and initiate. We may mistakenly develop treatment plans that do not take into account the decreased salivary flow, increased oral acidity, increased plaque levels, increased bruxism, and increased sugar consumption associated with methamphetamine use, and subsequently provide treatment that has no real chance of reversing the cycle of poor oral health for these patients. Our treatment plans may also be a mismatch for our patient’s precarious financial situation, which may include unemployment, homelessness, and a lack of insurance. We may be so focused on saving that one tooth with a root canal, crown lengthening, build-up and crown, that we have depleted the patient’s finances to address the other 31 teeth which are also blackened, broken, and rotted! We may even put on our superhero costumes, hidden underneath our surgical scrubs, and develop heroic treatment plans that include full-mouth reconstruction with bone grafts, sinus lifts, implants, and crowns that shortly succumb to peri-implantitis, periodontitis, and recurrent caries. Our treatment plans may also not take into account the most important factor that drives success or failure: the patient! We may place implants in patients who go for days without brushing, or who “nourish” themselves with energy drinks, caffeinated sodas, and candy bars. As a result, our best laid plans fail, and our patients’ oral conditions remain in a state of disrepair and disease. Therefore, we must approach treatment for our patients with meth mouth both cautiously and realistically, and utilize preventive, restorative, surgical, and pain management strategies to address the myriad of problems facing both the patient and the dentist.
About the Author
Dr. Ronni Brown is a dentist, researcher, speaker and author who bridges the gap between dentistry, public health and substance abuse. Her work treating patients with “meth mouth” at a medium-security jail, research on the oral effects of methamphetamine, and courses at the world’s top dental conferences positions her as a leading expert on “meth mouth”. When not treating, speaking, or writing, Ronni can be found hiking, baking and visiting zoos across the world.