Walter White and Your Teeth
by Lola Giusti DDS
Tenured faculty at the Arthur A Dugoni School of Dentistry
Fellow of the American College of Dentists
Many television viewers had a long and rewarding experience with the brilliant series "Breaking Bad". Its central character, Walter White, dealt with the financial ravages of cancer by synthesizing and dealing in methamphetamine. The world portrayed by the cast of characters involved in the show included nefarious plots: criminal networking, money laundering, prostitution, murder and retribution. As terrifying as Walter White's conundrums ever were, the audience was spellbound, waiting for the next plot twist that the writers could develop to more fully illustrate the underworld of methamphetamine. Yet somehow the show never completely depicted the horror that methamphetamine wreaks upon its users' health.
Every day in this and other countries methamphetamine users experience the rush or "flash" that helps them feel more powerful, more in-control, less anxious about their lives. This high can be obtained by smoking, snorting, injecting, or swallowing pills (Yaba) of methamphetamine. Devotees of meth quickly experience a loss of inhibition as well as an alteration of judgment. More than 12 million people in this country have tried it at least once (4.7% of the US population). It can be produced in small "labs" using such relatively inexpensive ingredients as over-the-counter cold medications, battery acid, antifreeze, drain cleaner, lye, or lantern fuel.
The toll of long-term meth abuse is startling: memory loss, aggression, mood disturbances, cardiovascular changes, malnutrition, auditory hallucinations and delusions. It devastates young lives and it destroys families. What is less apparent, yet extremely unsettling to those in the dental profession, is the effect of methamphetamine upon the teeth. Dentists can recognize a distinctive and often severe pattern of decay associated with meth that seems to spread through a mouth like wildfire. In combination with clenching/ grinding of the jaws, and a twelve-hour high that causes a craving for sugary foods, it is nearly impossible to reverse. Researchers from the dental school at UCLA began studying the mechanisms behind this rapid destruction of oral structures in 2010, and published their findings in the Journal of the American Dental Association. It seems that an alteration of salivary pH and buffering can last for up to twelve months after discontinuing methamphetamine use. In combination with poor oral hygiene this biochemical phenomenon exerts a permanent effect on its users. By the time many of these patients seek dental treatment there are often few, if any teeth that can be restored to health. At one time in the not-so-recent past full dentures were mainly the purviews of the elderly, blue-haired population. At this point in time a variety of current or past users of methamphetamines in their twenties and thirties are undergoing full mouth extractions, followed by complete dentures. In many countries the seductions of methamphetamine are eroding the quality of life of men and women alike, to an irreversible degree. Dentists mostly feel that life with teeth is better than life without them. Luckily, dental implants provide an alternative to this destiny, but at a price not affordable to many people.
What I hope to say to you is this: if someone in your family, or circle of friends, is struggling with an addiction to methamphetamine, get them help as soon as you can. The addiction is fierce, and is intertwined with many activities that are difficult to stop. These patients need all the support they can get. If you suspect that your loved one may be using, there are many programs in place to support him or her, and you as well. You will need it to help them unwind behavioral triggers. This type of change is tough. Once those measures are in place, please get them to a dentist, the sooner the better.
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