Methamphetamine Abuse

Methamphetamine (meth) is a commonly abused, potent stimulant drug that is part of a larger family of is an amphetamine derivative with similar stimulant properties. It is sometime referred to a poor man's cocaine.

Street Terms for Methamphetamine

“Chalk”   “Crank”   “Crystal”

“Crystal meth”   “Fire”

“Glass”   “Ice”   “Speed”

“Tina”   “Yaba”

Methamphetamine (Meth) use is increasing rapidly in the U.S. Meth production is inexpensive, easy to make and the effect lasts longer than crack cocaine (12 hours versus one hour for cocaine). Meth is a powerful central nervous system stimulant, which leads to permanent brain damage. Oral health effects of meth use are coupled strongly to severe oral health effects. Additionally heavy soft drink use, due to severe xerostomia caused by meth, adds to the devastating effects in the oral cavity.



Q: How is meth used?
A: Methamphetamine is smoked, snorted, injected, or taken orally. Typically, it is a pungent tasting powder that easily dissolves in beverages. Another common form of the drug is a clear, chunky crystal. This is the form known as “ice” or “crystal meth” and it is smoked in a manner similar to crack cocaine. Meth is also found as small, brightly colored tablets often called by their Thai name, Yaba.

Q: How does meth affect your health?
A:Methamphetamine stimulates release and blocks re-uptake of neurotransmitters monoamines (dopamine, norepinephrine and serotonin) in the brain. Several areas of the brain are affected: the nucleus accumbens, prefrontal cortex, and striatum. When meth alters levels of neurotransmitters in the brain, it causes feelings of bliss and euphoria. Meth is a neurotoxin and powerful stimulant, which causes cerebral edema and hemorrhage, paranoia, and hallucinations. Short-range effects include insomnia, hyperactivity, and decreased desire for food, increased respiration, and tremors. Long-standing effects include mental addiction, stroke, aggressive behavior, anxiety, confusion, paranoia, auditory hallucination, mood disturbances, and delusions. Meth use ultimately causes depletion of monoamines in the brain, which can have an effect on learning.

Systemic effects with high doses include increases in both systolic and diastolic blood pressure due to cardiac stimulation and arrhythmias. Other systemic effects include: shortness of breath, hyperthermia, nausea, vomiting, and diarrhea.

Q: How does meth affect the mouth and teeth?
A: The oral effects of methamphetamine use can be overwhelming. Unusual rampant caries is a hall mark sign of “meth mouth”. A unique severe pattern of decay is seen on the facial smooth surface of the teeth and interproximal surfaces of the anterior teeth (see Panels A & B).

The rampant caries associated with meth is caused by a combination of drug-induced psychological and pharmacological l changes causing xerostomia, poor oral hygiene, frequent use of high calorie, carbonated drinks and bruxism, and clenching, and the acidic nature of the drug is a contributing factor.

Q: Who uses meth?
A: The prevalence of methamphetamine use is estimated at 35 million people worldwide. In the United States the prevalence of methamphetamine use is beginning to decline but methamphetamine trafficking and use are still significant problems. The overall prevalence of current non-medical methamphetamine use in the U.S. was estimated to be 0.27 percent.  Lifetime use was estimated to be 8.6 percent. Methamphetamine use is most common among males between the ages of 18 and 49. The latest National Survey on Drug Use and Health released in 2013, revealed 12.3 million Americans age 12 and older used methamphetamine at least once in their lifetimes (5.2 percent of the population), and most between 18 and 34 years of age. Within the age subgroup with the highest overall methamphetamine use (18 to 25 year olds), non-students had substantially higher methamphetamine use (0.85 percent) than students (0.23 percent). These users were mostly white and male and live in the West though increasing in the east. Men are more likely to use meth than women.  The number of  methamphetamine users decreased between 2006 and 2008, but then increased in 2009. The numbers were 731,000 (0.3 percent) in 2006, 529,000 (0.2 percent) in 2007, 314,000 (0.1 percent) in 2008, and 502,000 (0.2 percent) in 2009.

Q: Where do users get meth?
A: In 2008-2009, 40.9 percent of past year methamphetamine users aged 12 or older reported that they obtained the methamphetamine they used most recently from a friend or relative for free, lower than the 49.7 percent reported in 2006-2007. About three tenths (29.2 percent) bought the methamphetamine they used most recently from a friend or relative, and 21.2 percent bought it from a drug dealer or other stranger.

Traffickers have aggressively targeted rural areas in an effort to escape law enforcement, and most use is found in the western, southwestern, and Midwestern U.S, but increases are reported in the eastern U.S.

Q: What do dentists look out for?
  • Unaccounted for and accelerated decay in teenagers and young adults.
  • Distinctive pattern of decay on the buccal smooth surface near the gums of the teeth and the interproximal surfaces of the anterior teeth.
  • Malnourished appearance in heavy users, because methamphetamine acts as an appetite suppressant."
Q: What dental health-care providers can do when they suspect methamphetamine use:
  • Complete a comprehensive oral examination that includes taking a thorough dental and medical history. 
  • Express concern regarding the dental findings. 
  • If the patient is receptive to a medical consult, have the phone number of a local physician, clinic or substance abuse rehabilitation facility available and be familiar with their protocol, so that the patient can be told what to expect. 
  • Use preventive measures such as topical fluorides. 
  • Encourage consumption of water rather than sugar-containing carbonated beverages. 
  • Be cautious when administering local anesthetics, sedatives or general anesthesia, nitrous oxide, or prescribing narcotics. 
  • Take opportunities to educate your patients about the risks associated with methamphetamine or any illicit drug use. 
  • Refer for treatment: The Matrix Model: An evidence-based intensive outpatient treatment program for alcohol and drugs, also effective in the treatment of methamphetamine addiction (see recommended link).

Recommended Links:

Prepared by J. Cade and the AAOM Web Writing Group
Updated 31 January 2015
The information contained in this monograph is for educational purposes only. This information is not a substitute for professional medical advice, diagnosis, or treatment. If you have or suspect you may have a health concern, consult your professional health care provider. Reliance on any information provided in this monograph is solely at your own risk.