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Meth Mouth

Meth Mouth. Dental Issues in Methamphetamine Abusers Medical Case Management Clinical Conference Christina Eaton, MPH Delta AETC. The Relationship Between Methamphetamine Use and Increased Dental Disease. J Am Dent Assoc, Vol 141, No 3, 307-318 Vivek Shetty, DDS, DrMedDent

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Meth Mouth

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  1. Meth Mouth Dental Issues in Methamphetamine Abusers Medical Case Management Clinical Conference Christina Eaton, MPHDelta AETC

  2. The Relationship Between Methamphetamine Use and Increased Dental Disease • J Am Dent Assoc, Vol 141, No 3, 307-318 • Vivek Shetty, DDS, DrMedDent • Larissa J. Mooney, MD • Corwin M. Zigler, MA • Thomas R. Belin, PhD • Debra Murphy, PhD and Richard Rawson, Ph

  3. Name That Famous Mouth

  4. What is “Meth Mouth”? • Destruction of the teeth and gums directly resulting from methamphetamine abuse • Indirect consequence of methamphetamine abuse • Neglected or forgotten brushing & flossing while high or when coming down

  5. Periodondal Disease Pathogenesis • Forms on teeth when starches & sugars interact with bacteria present in mouth • Plaque is removed with brushingBUTre-forms within 24 hours • If stays longer than 2-3 days can harden into tartar 1. PLAQUE : “ Soft, sticky, fussy deposits on tooth”

  6. TARTAR/CALCULUS/STONE: 2. Calculus/Tartar/Stone : “ Hard deposits on tooth”

  7. Pathogenesis 1. PLAQUE : “ Soft, sticky, fussy deposits on tooth” 2. Calculus/Tartar/Stone : “ Hard deposits on tooth” 3. Periodontal Pocket: “ Due to bone & Ligaments destruction”

  8. PERIODONTAL POCKET: When Periodontitis cause bone destruction. P. Pocket Healthy gum & Bone

  9. Name That Famous Mouth

  10. How Does MA Use Cause Tooth Decay? • MA use causes blood vessels to constrict (shrink) • Blood vessels in mouth can not feed teeth and gums • Repeated shrinking causes vessels to die • Inhibits body’s ability to repair itself • Dental tissue starves and breaks down

  11. How Does MA Use Cause Tooth Decay?What is xerostomia? • Calcium breakdown • Dryness in the mouth • Small cracks in the teeth • Bad breath • Gum recession

  12. Xerostomia • Saliva breaks down acids in the mouth • MA use blocks the brain mechanism causing salivation • Acids build up and eat away at tooth enamel • MA can stay in the body for 8+ hours • Sustained reduction in saliva = rapid bacterial growth

  13. How Does MA Use Cause Tooth Decay?Self Treatment for Xerostomia • Carbonated drinks are often craved to counteract the effects of “dry mouth” • Provides food for bacteria, creating more acid • Insufficient saliva to counter decreased pH • Acid eats away at tooth enamel

  14. Name That Famous Mouth

  15. Which method of MA use results in the highest rates of dental disease? • Smoking • Snorting • Injecting

  16. How Does MA Use Cause Tooth Decay? • Prevailing belief • Smoking > IV or snorting • 2000 report in Peridontology • Snorting > IV • 2010 Study • IV > Smoking or Snorting • Why? • IV MA users have higher level of addiction

  17. How Does MA Use Cause Tooth Decay? • Bruxism (Teeth grinding & clenching) • Caused by drug-induced hyperactivity • Puts large amounts of unnatural pressure on tooth • Creates small fractures in enamel, exposing dentin layer or pulp of the tooth • Exacerbates TMJ disorders

  18. Which subset of MA users more often reports having TMJ problems? • Males • Females

  19. Mike Myers (Austin Powers), Austin Powers in Goldmember Name That Famous Mouth

  20. Counseling Your Clients • Plan for dental care before getting high • Reminder notes to brush and floss • Keep extra toothbrush and travel sized toothpaste in backpack, car, etc if will not return home

  21. Counseling Your Clients • Brush daily • Use soft bristle brush and toothpaste that contains fluoride • Fluoride best defense against tooth decay

  22. Moment of Truth: I floss….. • Everyday • A few times a week • Sporadically • With my fingernails • What is flossing?

  23. Counseling Your Clients: Flossing • Floss on a regular basis – once a day • Don’t floss right before or after oral sex • Check teeth and gums often for early signs of decay and gum disease

  24. Counseling Your Clients • Drink water not soda to keep mouth moist • When high try to drink 64 oz (8 glasses) a day

  25. Counseling Your Clients • Suck on sugar-free candy like lemon drops to help produce saliva • See dentist every six months for a routine cleaning and check-up

  26. Summary • Dental disease is a distinguishing marker of MA use • MA usersoften have currentdental problems & unmet oralhealth needs • MA contributes to dental problems by causing xerostomia and bruxism • Counsel clients to keep up with dental health and drink plenty of water if continuing MA use

  27. Name That Famous Mouth

  28. Name That Famous Mouth

  29. Name That Famous Mouth

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