By Angela Hatton
http://stream.publicbroadcasting.net/production/mp3/wkms/local-wkms-944215.mp3
Paducah, KY – Next we begin the first in an occasional series on the personal and financial effects of methamphetamine in western Kentucky. Meth first became a major drug problem in our area in the early 2000s. Since then, it has remained a major issue, with roughly two thousand people in drug treatment for meth statewide. Drug experts say long-term addiction to meth leads to weight loss, hair loss, and skin irritation. While successful recovery and time can relieve those symptoms, another side effect doesn't go away as easily. "Meth mouth" refers to the tooth decay common in meth users. As Angela Hatton reports the condition is nearly unavoidable for addicts, and dental work to repair it is costly.
A meth mouth is not a pretty sight. It's a condition characterized by black and broken teeth, which have rotted and cracked.
"Think of it as they are someone who gargles with battery acid. And that's what the teeth looks like has happened to them. And so it happens very rapidly and just melts the teeth away."
Paducah dentist Dr. Chip Bohle says the chemicals used to make meth damage teeth most extensively. There are other contributing side effects as well. Meth leads to dry mouth, tooth grinding and clenching, as well as extended periods of poor oral hygiene. Bohle says it also causes cravings for the tooth's number one enemy: sugar.
"The drug makes the user crave sugary drinks. Mountain Dew is the drink of choice for meth users. When you look in someone's mouth, that's one of the screening techniques you can use. You don't ask them how many soft drinks they drink a day, you ask them how many Mountain Dews they drink a day."
Dr. Bohle sees about a dozen meth mouth cases each year. He says the majority are young people in their 20s who have gone through severe addictions. Meth mouth wasn't something Bohle, who graduated from dental school in the 80s, learned in college. Dentists around the country began encountering the condition in the early 2000s, parallel to the rise in meth's popularity. Dr. William Hay worked as a dentist for Kentucky prisons for several years. Hay says meth mouth didn't exist in the inmate population for many years.
"I didn't see any up through about 2000, and I saw a huge population that had about everything going on before they got caught."
Dr. Bohle says at the time the dental community hadn't seen anything like it.
"You would talk to colleagues and say I saw this guy and he was a disaster, he's a wreck, everything's beaten off. And you'd found out, I saw another guy and he looked like this.' Started putting stories together and, and, we developed these things before the literature actually came out. Y'know, to have a formal article, you have to have research and it takes time. Y'know the dental community was well aware of this before it became official."
In 2005, the American Dental Association published its first formal articles on meth mouth, including a codified description of the disorder. Dr. Hay says there are some distinctions between meth mouth and tooth decay from simple bad hygiene.
"They tend to not have as much gum disease as most people, but because it's such a rapid transition. But they can have gum disease, but a lot of times the roots still have bones around them, just the crowns are gone."
That means patients may have fissures and holes in their teeth, but still have pink, healthy-looking gums. Dentists treat meth mouth the same as any other dental problem. Dr. Hay says minor cases require root canals, and fillings. Dr. Bohle says for long-term users, the options are limited.
"There is no treatment except to take the affected teeth out and replace them with some kind of dentures or implants."
The extractions and surgeries are expensive. Bohle and Hay say costs range from a few thousand to fifteen thousand dollars. Bohle says dentures come in somewhere in the middle at five or six thousand dollars. Federal legislation introduced last year would provide financial assistance to former meth users for treatment. The measure hasn't made much headway yet, but it could be important for those recovered addicts who need dental work. Bohle says they usually don't have the money to pay for the treatment themselves.
"Typically they have family support. We see family members bringing them in. And once they've quit using then they're family's willing to try to step up and help them. If they're still a user, then they don't want any part of it."
Dentists aren't required to report the number of cases of meth mouth they treat, which means widespread state statistics aren't available. A 2008 University of Kentucky survey did ask primary care physicians which was the most serious drug among their adult patients. A fourth of western Kentucky doctors said meth. It's likely that means many western Kentucky dentists will continue to see a steady stream of meth mouth patients.