By: Naomi Parker
The use of illicit drug methamphetamine is a widespread health problem in USA. Methamphetamine is manufactured from highly corrosive and acidic substance. It composed of ingredient such as battery acid, lithium, cold medication and ammonium fertilizer. Methamphetamine is a powerful central nervous system stimulant that used as component in recreational drug. It can also be used as second line treatment for obesity and ADHD (attention deficit hyperactivity disorder). Methamphetamine can caused destructive dental caries that resemble early childhood caries (baby bottle caries). The rampant caries associated with the use of Methamphetmine is also called “ meth mouth” or “ crank decay”. The generalized decay usually locate buccal surfaces at the cementoenamel junction and interproximal surfaces of the anterior teeth. According to propensity score analysis, the abusers of methamphetamine were twice likely to have untreated caries, and 4 times more likely to have caries compare to general population. Methamphetamine not just cause cavities but also increase the likelihood of lead to xerostomia (dry mouth), periodontal disease. Methamphetamine abuser are also associated with other negative oral manifestation, such as bruxism, grinding / clenching, disorder of temporomandibular joint, myofascial pain, and trismus. Accurate oral hygiene instruction, nutritional counseling and fluoride are important strategies to help improve the quality of life of patient that has Meth mouth.
Methamphetamine users who have poor oral hygiene will exacerbate the oral problem by increasing build-up of plaque and cariogenic bacteria and increase acid attacks on the teeth. Rinse mouth after eating can help decrease the risk of acid attack when you don’t have tooth brush with you. People usually has poor oral hygiene is due to lack of motivation. Methamphetamine not just cause cavities but also increase the likelihood of lead to dry mouth and periodontal disease. Xerostomia (dry mouth) will increase cavities formation and lead to gingival inflammation and infections (such as candidiasis, glossitis, and cheilitis) in methamphetamine user. Great oral hygiene can help the patient lower the severity of gingival inflammation and halt the progression of periodontal disease. As dental hygienist, it is important to teach patient both the Stillman technique and modified technique to brush the teeth, since many different condition can be happen in meth mouth patient. Stillman brushing technique is suitable for recession and exposed root surface areas in on the teeth. Stillman brushing technique will work well on patient with generalized gingival recession in the mouth. Modified brushing technique work well to clean the entire tooth surface and the areas above the gingival margin. Wax floss can be recommend to patient to use on all the teeth and end-tufted brush is suitable for patient that has furcation area due to recession from the use of Methamphetamine. Most patient doesn’t like to use wax floss, because they think it is difficult and tiresome to use. As dental hygienist, we should recommend interdental brush for patient that lack of motivation in using wax floss. Interdental brush work well and easier for patient to learn. The most important thing is to motivate our patient to want to take care their own teeth by letting them understand the risk of methamphetamine use and how the accurate oral hygiene technique can promote their oral health. Accurate oral hygiene instruction will be a great strategy to help meth mouth patient.
Methamphetamine abuser are more likely to craving for sweet and drink soda or sugary drink due to thirst. It is important to teach patient to drink more water instead of sugary drink. Dental hygienist need to teach patient to understand the risk of acid attack between the food they eat and their teeth. Methamphetamine abuser are likely to experience dry mouth, water can help sustain the salivary flow in the mouth. Water is consider as one of the easiest and most affordable way to keep saliva level in the mouth and prevent tooth deterioration by sustain saliva’s protein and mineral counteract the acid that can wear off your enamel. Water also help the teeth by rinsing away any tooth debris inside the mouth and keeping your teeth clean and healthy. Drinking water, milk and eating cheese can help to neutralized the acid attack in the mouth after eating. Cheese can help to prevent cavity by stimulate saliva and neutralized acid reaction between food and teeth. Recommendation of eating variety of fruits and vegetable is important. Carrot, celery and leafy green lettuce are good source of vegetable. Celery, leafy green lettuce and carrot have the abrasive nature that can help to remove dirt and plaque from teeth and gums when chewing them. Mineral carrots can help to prevent tooth decay by killing harmful germ in the mouth. Variety of fruits, such as apple, grapes, banana can help to stimulate saliva production, messages gums and cut down plaque build up. Nuts are great for teeth as well, it contain tremendous amount of fibers, folic acid, calcium and other vitamins. Almond, peanuts, cashews are great example choice for nuts. Chewing sugar free gum, such as xylitol, can help to battle common tooth decay bacteria ( Mutans streptococci). Xylitol gum or any kind of xylitol food products are beneficial to stimulate saliva production and scour teeth. As dental hygienist, it is important to provide nutritional counseling to help patient understand the food they eat and drinks will has direct impact in their oral and systemic health. Nutritional counseling will be a great strategy to help meth mouth patient to maintain healthy oral and systemic condition.
When methamphetamine is being consumed, the ingredient enter the oral cavity will demineralized the enamel, decrease flow and production of saliva, bruxism and gingival recession. All of the negative impact will increase the likelihood to developing tooth decay. When the methamphetamine users come to dental office to seek treatment, they usually feel embarrassed for their drug use and worry about their unattractive teeth. As dental hygienist, it’s very important to teach patient about the benefit of fluoride. By applying fluoride treatment on our patient every time they come back for recare can help to halt the disease progress of caries. The use of fluoride varnish can help to promote enamel remineralization, decrease the thermal sensitivity on patient’s teeth and neutralized salivary acidity in those patients that has active caries. Dental hygienist should teach patient about the benefit of community fluoridated water and drink more fluoridated community water than drinking from the plastic water bottles sell in super market. Dental hygienist should also recommend patient to purchase oral hygiene products that contain fluoride, such as fluoridated tooth paste, fluoridated mouth rinse. Fluoride is able to help meth mouth patient to experienced less sensitivity, help to halt the disease progress in tooth decay and increase remineralization on patient’s teeth. Fluoride product is a great strategy to help meth mouth patient to maintain good oral health and halt the disease progression.
As conclusion, it is important to teach the methamphetamine user to be aware of the risk of negative oral manifestation. As dental hygienist, we need to teach the patient to try to avoid the use of methamphetamine. If it is necessary for the patient to use methamphetamine as their medication, then we have to teach patient multiple ways to prevent the tooth decay formation and progression. Accurate oral hygiene instruction can let the patient take care their teeth daily and prevent further tooth decay progression. Healthy diets and avoid the foods that will exacerbate the condition of meth mouth can help promote oral health and systemic health. Fluoride products can help lessen sensitivity and health the disease progression in meth mouth patient. Finally, listening to the patient’s need and concern will be the most important tip to help patient create a treatment plan that will best fit patient’s circumstance. Educated our patient and motivate our patient to take care their own teeth will be very important in change patient’s life. As dental hygienist, we are not just there to clean patient’s teeth, but also a teacher to educated and motivated our patient to maintain a healthy mouth and body.
Citations
“- YouTube.” Www.youtube.com, http://www.youtube.com/watch?v=UpPVsjgHzG8. Accessed 16 Feb. 2025.
“Treating Meth Mouth.” Www.colgate.com, http://www.colgate.com/en-us/oral-health/threats-to-dental-health/treating-meth-mouth.
Wikipedia Contributors. “Methamphetamine.” Wikipedia, Wikimedia Foundation, 11 Apr. 2019, en.wikipedia.org/wiki/Methamphetamine.
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