ORAL EFFECTS OF METHAMPHETAMINE USE: A STUDY OF "METH MOUTH"

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Abuse of methamphetamine (meth), a potent central nervous system stimulant, is increasing in the United States. It is inexpensive, easy to make and produces an extended high (12 hours versus one hour for cocaine). It can be taken orally, snorted, injected or smoked. The 2003 National Survey on Drug Use and Health reported 12.3 million Americans had tried methamphetamine at least once. In South Carolina, the number of meth addicts seeking treatment in public clinics has increased 7-fold in the past 4 years (SC Department of Alcohol and Other Drug Abuse Services, 2006). Recently a small number of reports have described significant oral disease associated with the use of methamphetamine. "Meth mouth," as it is called, is characterized by accelerated, rampant caries involving the buccal smooth surfaces of the teeth and the interproximal surfaces of the anterior teeth. Additionally some methamphetamine addicts have developed enamel erosion and wear facets. Unfortunately current reports are limited and have not proven that methamphetamine is responsible for dental disease nor do they illuminate potential mechanisms for oral findings. To accomplish these aims we plan to conduct oral screening examinations and collect information on oral health knowledge and the oral hygiene practices of subjects addicted to methamphetamine. This information could serve to generate protocols for the management of oral disease in methamphetamine users. These studies will provide a baseline characterization of the oral health of individuals addicted to methamphetamine, insight into possible pathogenic mechanisms of methamphetamine on oral structures, and identify barriers to care in this population. The specific aims of this project are: Specific Aim 1: To describe patterns of dental caries, oral bacterial burden, periodontal involvement, wear patterns and salivary flow in chronic methamphetamine addicts Hypothesis: Chronic methamphetamine use is associated with a specific pattern of dental conditions including rampant caries, periodontal disease, grey-stained plaque, cracked teeth an oblique cleaving of clinical crowns, and xerostomia. Specific Aim 2: To investigate the relationship between oral health and (1) quantity, frequency and duration of meth use and (2) method of ingestion (i.e., orally, snorted, injected or smoked) of meth. Hypothesis: Oral disease will be positively correlated with quantity, frequenc and duration of meth use and will be found more frequently in addicts, who snort, smoke or orally consume meth. Specific Aim 3: To investigate the relationship between oral health in meth addicts and (1) oral health habits (i.e., regular tooth brushing and flossing; regular visits to dentist), (2) quantity of non-diet soft drinks consumed, and (3) frequency of grinding/clenching of the teeth. Hypothesis: Meth addicts who exhibit poor oral health habits, excessive consumption of non-diet soft drinks, and frequent grinding and clenching of teeth will show more pronounced dental disease than those without these behaviors. Specific Aim 4: To investigate meth addicts' knowledge of the relationship between meth use and dental disease Hypothesis: Meth addicts will have little knowledge of the relationship between meth use and dental disease.