Dental Health

Dentists and Methamphetamines: Detecting Addiction and Preventing Relapse

Because of methamphetamine’s caustic effect on oral hygiene, dentists play a frontline role in spotting patients that have a meth addiction. A dentist that spots possible meth abuse and talks to a patient can increase the chance of intervention and treatment. As patients recover, dentists can use diagnostic tools and cosmetic tools like dental implants that may help patients regain their confidence. With greater self-esteem, patients feel confidence to build positive relationships that can both prevent relapse and allow them to reclaim their lives.


What Are Some Common Signs of Methamphetamine Abuse?

Dentists and dental hygienists may spot a patient’s meth abuse before anyone else. For example, dental professionals may notice discolored, rotting or even broken teeth during a cleaning or routine exam. In addition to eroding oral health, some users experience drastic weight loss. Hair and skin, like teeth, begin to deteriorate and produce a distinct body odor that smells like ammonia. Even in a bright room, meth users often have dilated pupils, and they often have burn marks on their fingers. They may also experience violent mood swings, hallucinations and hyperhidrosis, or excessive sweating.

What to Do When Patients Show Signs of Meth Addiction?

In a busy clinic, dentists may feel that they have no time to talk to patients about addiction. However, initiating a conversation about meth abuse could have a more positive impact than any discussion about oral health. If dentists suspect that they’re treating a meth user, they can use screening tools such as CRAFFT or CAGE-AID to talk to patients. CRAFFT was created for minors by the American Academy of Pediatrics, while CAGE-AID is geared toward adults.

Start by asking patients if they’re willing to discuss a sensitive subject. Assure the patient, whether adolescent or adult, that the conversation will remain confidential until they decide to include others. Ask them whether they have either experimented with or are regularly using mind-altering drugs. If a minor patient admits to using methamphetamines, then ask each of these CRAFFT questions:

  • C—Have you ever ridden in a car with a driver that was high, or have you ever driven yourself around while high?
  • R—Do you use meth to lose weight, get more energy or just feel a little more relaxed?
  • A—Do you use meth when you’re alone?
  • F—Have you forgotten things that you’ve done while you’ve been high?
  • F—Have family and friends suggested that you cut back on your use?
  • T—Has meth use ever gotten you into trouble?

For an adult patient, use CAGE:

  • C—Have you thought about cutting down on your meth use?
  • A—Has anyone ever told you that they’ve been annoyed with you while you were using?
  • G—Does using meth make you feel guilty?
  • E—Do you use meth as an eye-opener first thing in the morning to steady your nerves?

For patients that answer one of the questions with a “yes”, provide non-confrontational advice such as, “I recommend that you stop experimenting with meth at this time. I can already see the effects on your teeth, and I don’t want the problem to get worse”. When patients answer two or more questions with a “yes”, then recommend a four-step approach. Depending on the patient’s wishes, dentists can collaborate with a primary care doctor or mental health professional to increase accountability. If one step fails, then the patient agrees to proceed to the next step:

  1. Let patient try to cut back on his or her own.
  2. Try a period of abstinence lasting three to six months.
  3. Seek community support from a group like Crystal Meth Anonymous.
  4. Enroll in inpatient or outpatient drug treatment.

Helping Patients Recover

Many methamphetamine users experience irreversible tooth decay. Treatments like dentures, dental implants or overdentures can enhance a patient’s self-confidence during the recovery process. If patients can’t afford cosmetic dentistry, then dentists can consider offering the treatments on an income-based sliding cost scale.

From the earliest stages of addiction to the struggles of the recovery process, dentists play a crucial role in detecting and addressing methamphetamine abuse in their patients. By breaking the silence and initiating a conversation about meth, dentists may save both their patients’ teeth and their lives.