EXCERPT
Often by the time a patient presents to our dental
offices with teeth that are blackened, broken, rotted,
and crumbling from their methamphetamine use, they
are embarrassed by their unattractive smiles and overwhelmed
with dental pain. Similarly, as dentists, we
are often equally overwhelmed by the magnitude of
decay and uncertain about which aspects of treatment
(preventive, restorative, surgical, or prosthetic) to prioritize
and initiate. We may mistakenly develop treatment
plans that do not take into account the decreased
salivary flow, increased oral acidity, increased plaque
levels, increased bruxism, and increased sugar consumption
associated with methamphetamine use, and
subsequently provide treatment that has no real chance
of reversing the cycle of poor oral health for these
patients. Our treatment plans may also be a mismatch
for our patient’s precarious financial situation, which
may include unemployment, homelessness, and a lack
of insurance. We may be so focused on saving that one
tooth with a root canal, crown lengthening, build-up
and crown, that we have depleted the patient’s finances
to address the other 31 teeth which are also blackened,
broken, and rotted! We may even put on our superhero
costumes, hidden underneath our surgical scrubs, and
develop heroic treatment plans that include full-mouth
reconstruction with bone grafts, sinus lifts, implants,
and crowns that shortly succumb to peri-implantitis,
periodontitis, and recurrent caries. Our treatment
plans may also not take into account the most important
factor that drives success or failure: the patient!
We may place implants in patients who go for days
without brushing, or who “nourish” themselves with
energy drinks, caffeinated sodas, and candy bars. As
a result, our best laid plans fail, and our patients’ oral
conditions remain in a state of disrepair and disease.
Therefore, we must approach treatment for our patients
with meth mouth both cautiously and realistically, and
utilize preventive, restorative, surgical, and pain management
strategies to address the myriad of problems
facing both the patient and the dentist
