CrystalMethBC - Meth Information Website - The Biting Grip of Crystal Meth

orion writes "The Biting Grip of Crystal Meth

By JILL MAHONEY
Tuesday, June 21, 2005 Updated at 8:50 AM EDT
From Tuesday's Globe and Mail

Jane Wrinch had never seen anything like it: 20 cavity-riddled teeth in one young man's mouth.
Her patient's smile -- which was marred by brown decay, receding gums and holes a needle could fit through -- bore witness to his crystal methamphetamine addiction. Nothing else explained the severe rot. His siblings had impeccable teeth and he was in his mid-20s, decades before dental disease usually occurs.

As crystal meth sweeps across the country, dentists in high-use areas are increasingly noticing a pattern of unchecked tooth decay that has been dubbed "meth mouth."

The grisly condition, which can destroy an addict's teeth in mere months, is another of the mind-bending drug's extreme side effects, which can include rapid addiction, psychosis, schizophrenia and suspected permanent brain damage.

"It's fairly consistently noticed," said Doug McGhee, a family physician who works with youth in downtown Victoria.
At a community clinic in Vancouver's Downtown Eastside, where the cheap drug is common, Sean Sikorski has treated more than 100 people with meth mouth.

"The worst case is the teeth are largely gone. They'll just rot through and break off, and the sad thing is that it's often in a younger person."

Dr. Sikorski's most heartbreaking patient was an 18-year-old girl. By the time she finally sat in his chair, her mouth was full of tiny stumps at the gum line. Without the means to pay for costly implants, she was left wearing dentures.

"That's hard to see," he said. "She was pretty distraught, but she was still kind of caught up in the addiction."

Over time, Dr. Sikorski has made observations about the roots of meth mouth, which are at least partly supported by the sparse research on the condition.

In chronic meth smokers, the most common form of use, he has noticed the acidic drug leaves a colourless film on teeth that he believes accelerates the rot and turns them a "very dark brown-black."

"A level of decay that would normally take years to occur instead happens over a period of months," he said.

Crystal meth, an amphetamine made entirely from synthetic and such highly toxic ingredients as ammonia, paint thinner, ephedrine, battery acid and even Drano, also causes dry mouth. Without saliva, which helps rinse away bacteria, grime sticks to teeth. In addition, to increase salivary flow and combat low blood sugar, which users also experience, addicts tend to consume a lot of pop and candy.

"You've got this triple whammy. You've got this acidic residue on teeth, you've got [low] saliva and then you've got a low blood sugar," Dr. Sikorski said.

In addition, crystal meth users, who often embark on days-long sleepless binges, do not take care of their teeth. They tend to seek help from a dentist while in rehab.

"There may be periods, weeks or months, where there's no hygiene -- period," Dr. Wrinch, a Victoria dentist, said. Meth also leaves a unique dental signature, Dr. Sikorski said. Decay is concentrated along the roots, which dentists usually see among senior citizens, who tend to have receding gums, decreased saliva and poor diets. Cavities in that area usually advance slowly, but in chronic meth users, who have widespread decay, they deteriorate rapidly. Dr. Sikorski has also noticed a strange burnt odour in users, especially while pulling teeth.

The drug, which arrived from the United States, was largely a West Coast phenomenon a couple of years ago, but has since travelled east and now wreaks havoc from coast to coast, including in small Atlantic communities.

Andrew Tkachuk, a Prince George dentist who works a few hours a week at the local jail, knows an alarming number of the inmates he treats were chronic crystal meth users. Whenever he takes a new assistant or colleague to the prison clinic, they are amazed at the extent of decay: Anyone else would have sought treatment much, much earlier for excruciating toothaches. The drugs clearly dull the pain.

"They're able to tolerate much more advanced disease than most other people would tolerate, so I think it allows the disease process to get more involved and more widespread."

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