Dealing with meth mouth

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Kniles5

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Say something when you see it, or just say, "You apparently have 20 detrimentally decaying teeth at age 17." or do you address the problem. These can be dangerous people, but the cases are clear. I just want to know where everyone else stands on ignoring these things. What are the implications? Is it worth saying anything?

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What the hell is meth mouth? A drugee with bad oral hygiene?
 
I remember reviewing some orthodontic research on "meth mouth". Pretty disgusting stuff...yet interesting. After approximately 12 months on meth, one guy's teeth were everywhere...buck, crooked, and decaying. The before and after pictures were startling..hmm, wonder how this happens.
 
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I saw a 14 year old girl last week on my admitting rotation. She seemed shy at first but I didnt think anything of it. After reviewing medical history (clear) and doing the extra-oral exam I looked inside her mouth. The facials of all of her maxillary anterior were severely decayed. It looked exactly like meth mouth. No wonder she wouldnt smile. The linguals werent as bad (some obvious decay here and there) and some class V lesions on her mandibulars. Her posteriors all had huge amalgams. She also had some localized discoloration on her gingiva. I thought maybe she had salivary hypofunction, but salivary pool was present and nothing seemed abnormal with the glands. She said she brushes and denied any kind of drug use.

I dont think she could form that level of decay even if she never brushes. I called the instructor over but there wasnt much either of us could do since both she and her mother were generally uncoopertative (maybe from embarrasment). We noted it in the chart and she is scheduled to come back. She has been on my mind but I dont know how to proceed or what to do. What do you guys think?
 
Not sure if there is anything you can do, other than report it to faculty and her guardian (mother). I think the rest is out of your hands. Kinda sucks but that is the way it is.
 
Can you get in legal trouble for bringing it up?

Just be honest straight up and say hey the signs of wear on your teeth at such a young age have been linked to drug use. Explain that they don't have to even anser your question and are in no trouble, but give them encouraging words such as telling them they can get help if needed. If they say anything then maybe ask them if they are interested in talking to someone who can help them in their situation, refer to a rehab program or something. Kinda like an endo ref out, you send them on their way, and the next person does what they can to ultimately fix the problem.

Drug abuse is nothing to play around with, and should be questioned by EVERYONE at the initial signs OF abuse. Be a man and step up, they will thank you when they've recovered their life.
 
I think I should clarify that I didnt ask outright "do you do meth?" But she had checked 'no' on her medical history for recreational drug use and after looking into her mouth I went over the sheet again and confirmed some of her answers (including that one).

Also, appearace wise, she looked like an average 14 year old, 2 pairs of scrunchy socks, neatly dressed, etc..
 
ShawnOne said:
I saw a 14 year old girl last week on my admitting rotation. She seemed shy at first but I didnt think anything of it. After reviewing medical history (clear) and doing the extra-oral exam I looked inside her mouth. The facials of all of her maxillary anterior were severely decayed. It looked exactly like meth mouth. No wonder she wouldnt smile. The linguals werent as bad (some obvious decay here and there) and some class V lesions on her mandibulars. Her posteriors all had huge amalgams. She also had some localized discoloration on her gingiva. I thought maybe she had salivary hypofunction, but salivary pool was present and nothing seemed abnormal with the glands. She said she brushes and denied any kind of drug use.

I dont think she could form that level of decay even if she never brushes. I called the instructor over but there wasnt much either of us could do since both she and her mother were generally uncoopertative (maybe from embarrasment). We noted it in the chart and she is scheduled to come back. She has been on my mind but I dont know how to proceed or what to do. What do you guys think?

Was the patient in question super skinny? and mom as well?
 
tx oms said:
What the hell is meth mouth? A drugee with bad oral hygiene?

Here is some info on oral effects of amphetamines from my PBL library...

Amphetamines​
This can produce xerostomia. In addition, the need to intake carbohydrates is increased. Fizzy drinks are often the type of carbohydrate chosen this increases the risk of tooth decay and tooth erosion. These drugs may lead to a habit of grinding teeth together.

Meth users face some specific issues with their teeth and mouth, partly due to the ingredients and method of use. Meth mouth includes the direct and side effects of the drug and lifestyle choices of the user. Dentists and dental hygienists are urged to become familiar with the symptoms and what precautions to take when treating an abuser. While the symptoms alone do not prove Meth use, taken together with other signs, they may help health workers diagnose abuse.

Meth Ingredients and Method
Lithium, muriatic and sulfuric acids, ether, red phosphorus and lye - key ingredients in Meth manufacturing - are all corrosive and will cause skin burns even when used properly. When a person smokes Meth, these substances are heated, vaporized and swirl throughout the user's mouth. They irritate and burn the sensitive skin inside the mouth, create sores and lead to infection. Chronic Meth smokers have teeth rotted to the gum line from the continuous affect of the vapors on tooth enamel.

Snorting Meth also causes chemical damage to teeth. Snorting draws the caustic substances down the nasal passages, draining in the back of the throat and bathing the teeth with corrosive substances. Injecting Meth has no direct impact on dental health, but as you will see, habitual use of the drug does have side effects that do lead to damage.

Meth Mouth Symptoms
• Dry Mouth - Saliva acts as a buffer against acidic substances in the mouth, neutralizing it and protecting teeth against acidic foods like lemons, acid from the gut or acidic plaque. The average person creates around one liter of saliva a day. If saliva production is reduced, oral bacteria levels can increase ten times over normal levels. Meth dries out the salivary glands. Without saliva, the acidic substances can eat away at the minerals in tooth enamel, causing holes or weak spots that turn into cavities. Other medications dry the mouth but Meth is especially bad.

• Tooth Decay - Meth users are notorious for trying to treat cottonmouth with lots of sugary soda. The bacteria that feed on the sugars in the mouth secrete acid, which leads to more tooth decay. Also, Meth users aren’t likely to floss, brush and rinse when high. A typical cavity starts in-between two teeth. It eventually invades the tooth and destroys it from the inside out. Crank decay invariably starts at the gum line - it eventually spreads around the entire tooth, eating swathes of enamel in its wake.

• Cracked Teeth - Because the drug can make them feel anxious or nervous, causing them to clench or grind their teeth, regular Meth users may develop cracks in their teeth.

• Gum Disease - Teeth and gums need blood to stay healthy. Meth causes the vessels that supply blood to oral tissues to shrink up. Reduced blood supply causes tissues to break down. With repeated shrinking, the blood vessels don’t recover and tissues die.

The exact rate of Meth mouth is unknown, but dentists who practice in areas where people have regular access to the drug are beginning to see a pattern. The following is from a January, 2003 article by Reuters Health Information:

"Dr. Eric Curtis, a dentist in Arizona, and a spokesman for the Academy of General Dentistry, reports, "I have a certain number of patients who are starting to show up with it." He adds that the patients it crops up in most commonly are teenagers. Dr. Curtis says that he does not treat the tooth decay and gum disease associated with Meth mouth any differently than he treats the conditions in other patients. However, if he believes his patient is using Meth, he will ask them to stop and he advised other dentists to do the same. If dentists relieve patients of their current dental problems but they continue to use the drug, chances are the same problems will reappear, he noted, "The cycle will occur and occur again." "

Dentists should also be aware that Meth has been shown to have dangerous interactions with common dental anesthetics. These, in turn, could cause major hypertensive episodes or other health problems. Also, anyone who suspects they may be working with a patient using Meth should be familiar with the signs of tweaking and how to deal with a tweaker.
 
L8DYV said:
Was the patient in question super skinny? and mom as well?

No, like I said, appearace wise, she looked like an average 14 year old, 2 pairs of scrunchy socks, neatly dressed, etc.. She didnt look like a junkie and I dont think her mother is involved either... They looked nothing like the stereotypical meth abusers.
 
ShawnOne said:
No, like I said, appearace wise, she looked like an average 14 year old, 2 pairs of scrunchy socks, neatly dressed, etc.. She didnt look like a junkie and I dont think her mother is involved either... They looked nothing like the stereotypical meth abusers.

maybe they did not look like the stereotypical meth abuser on that day...
 
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fightingspirit said:
yes, this is the saddest part.....

by the way, nyc and atlanta have a big meth problem.

As does California and Hawaii. I remember reading somewhere that the Hells Angels are distributing meth in California.
 
I am amused by dentistry's facination with "Meth Mouth". BTW, my first post was tongue-in-cheek. Why does dentistry care so damn much about meth mouth? It's the consequence of a hard life. Very little is actually related to the drugs themselves.

OOOHHH, METH MOUTH! Wow, let me shake my hands and run in circles. You don't hear people obsessing about "Jack Daniels Liver", "McDonalds Coronaries", and "I Can't F-ing Stop Eating Diabetes" do you?

I think maybe dentistry sees "meth mouth" as a disease that we can conquer. Like somehow if we can diagnose and magically fix the problem the person's life will be saved. Drug abuse is not a disease of the teeth. It's a disease of life choices and the body. BTW, you confronting someone about drug use has about zero chance of changing anything. It might make you feel good, but simply asking, "Do you use drugs?" doesn't do jack.

There are many, many people in America and the world with bad teeth who don't use drugs. This thread sounds like Marie Antoinette being exposed to the realities of life for the first time: "Oh, my goodness, these peasants hardly bathe! Let them eat cake!" Your compassion sounds more condescending to me. It's like the current race thread, you make it sound like meth people are just too dumb/simple/whatever to realize what's going on.

I also like the post about severe facial decay. Do you realize how ridiculous this sounds? Who cares? Severe decay does not equal drug use. I see people everyday who have the kind of decay you mentioned. My personal record for full mouth edentulation is a 16y/o. I almost talked a 15y/o into, though...it's always the one's that get away you remember. Maybe the kid doesn't brush their teeth and eat candy/cokes all day. If a patient smells like smoke and has yellow fingers I assume they smoke even if they deny it. If someone has a sh1tty mouth I assume they don't brush, even if they swear to it.

Bad teeth aren't the end of the world. This thread makes it sound like if we could only fix everyone's bad teeth the world would be right.

Finally, the title of this thread is "dealing with meth mouth". How about instead of fretting about it we make a treatment plan for those who are interested and move on. You aren't going to save the world. Just pull their teeth and restore however.
 
tx oms,

yea we can't single-handedly save the world as competent dentists, but maybe we can make it better. if we can help one person realize how they are destroying themselves, then maybe we've done something good. what woud you do? would you just ignore the people who seem to not care for help? if you have a sense of humanity you would feel bad and hope that you can do something to help, not for credit of saving the world, but simply to help another human being when they need help.

balance is key.
 
The previous response is what I expected to hear. I am sorry, but what I have seen was so obvious; it was like an elephant in the room. So, what was said... You need several fillings, crowns, bridges, root canals, extractions.... we are looking at enough work to get me through dental school on one patient...ha ha ha.
I guess we can't change anything about these situations. Just show them the door. Their money is better spent on meth. Believe me, physicians do talk about how they go about telling an obese person that their eating is destroying their body, or an alcoholic that they are destroying their life. I thought this was a forum that we could discuss how we handle
*gasp* dental issues. Fortunately, alcoholism doesn't aggressively rot teeth and neither does over eating, but we do see problems with crystal.
 
I am not far in my education yet, but what else causes a tooth to completely rot from the gum line down, on the facial surface? Just curious. I can understand decay on an occlusion surface or between teeth, but on the gingival line of the facial surface, what else would do this to that degree!?
 
Kniles5 said:
I am not far in my education yet, but what else causes a tooth to completely rot from the gum line down, on the facial surface? Just curious. Enamel is the hardest substance the body produces. I can understand decay on an occlusion surface or between teeth, but on the gingival line of the facial surface, what else would do this!?


mountain dew! :laugh:
 
Lidopaine82 said:
mountain dew! :laugh:
Owned!

Kniles5 said:
I am not far in my education yet,
clearly.
Kniles5 said:
but what else causes a tooth to completely rot from the gum line down, on the facial surface? Just curious. Enamel is the hardest substance the body produces. I can understand decay on an occlusion surface or between teeth, but on the gingival line of the facial surface, what else would do this!?
How about last Tuesday's breakfast attached to the gingival margin on the facial? Just because people on your side of the tracks brush their gums doesn't mean everyone does.
 
mlle said:
tx oms,if we can help one person realize how they are destroying themselves, then maybe we've done something good.
How many people have hung up the crack pipe based on your counseling? I'm guessing...umm....maybe....na.....ZERO!

When I actually decide to be a good doctor and counsel on life style issues, I just politely but matter-of-factly state the truth and then move on. I am not going to plead with an adult or adolescent to change their behavior. They aren't retarted, they're just drugies.
 
mlle said:
tx oms,

yea we can't single-handedly save the world as competent dentists, but maybe we can make it better. if we can help one person realize how they are destroying themselves, then maybe we've done something good. what woud you do? would you just ignore the people who seem to not care for help? if you have a sense of humanity you would feel bad and hope that you can do something to help, not for credit of saving the world, but simply to help another human being when they need help.

balance is key.

Great post. I think people from Texas are naturally inclined toward ignoring other people's problems (*ahem* Bush hates black people). :laugh:
 
EyeAmCommi said:
Great post. I think people from Texas are naturally inclined toward ignoring other people's problems (*ahem* Bush hates black people). :laugh:
I think people from LA are naturally inclined to wring their hands over things they cannot control while looking for someone to blame.
 
tx oms said:
I also like the post about severe facial decay. Do you realize how ridiculous this sounds? Who cares? Severe decay does not equal drug use. I see people everyday who have the kind of decay you mentioned.

I never said severe facial decay = drug use. Maybe she never grew out of drinking from a bottle, or whatever. In any case, I think the etiology needs to be identified and addressed before treatment.

tx oms said:
Finally, the title of this thread is "dealing with meth mouth". How about instead of fretting about it we make a treatment plan for those who are interested and move on. You aren't going to save the world. Just pull their teeth and restore however.

uncompassonate and horrible... She is a 14 year old girl with her whole life ahead of her. She is very sensative about her problem evidenced by her tearing during the apointment and she has come for help. Pulling all her teeth, slapping on a denture and kicking her in the ass on the way out is not the answer. Her smile can probably be restored with veneers or crowns, but first I need to know why this is happening to her and address it before her mom spends $$$ on restoring.
 
ShawnOne said:
I never said severe facial decay = drug use. Maybe she never grew out of drinking from a bottle, or whatever. In any case, I think the etiology needs to be identified and addressed before treatment.
Who cares if it's addressed? The etiology of diabetes in 90% of people is lifestyle yet we still treat the diabetes even if the person doesn't change their life.

ShawnOne said:
uncompassonate and horrible... She is a 14 year old girl with her whole life ahead of her. She is very sensative about her problem evidenced by her tearing during the apointment and she has come for help. Pulling all her teeth, slapping on a denture and kicking her in the ass on the way out is not the answer. Her smile can probably be restored with veneers or crowns, but first I need to know why this is happening to her and address it before her mom spends $$$ on restoring.
Compassion doesn't change the fact that, based on your description, the girl needs extractions. So, stop crying and fix it. If the girl was so concerned why did let the teeth get that way?
 
Lidopaine82 said:
mountain dew! :laugh:
Can just soda really do that to this degree? All of the teeth decaying? I had no idea. I guess the cases aren't as clear as I thought. It seems like you would have to gargle and swish around soda every day to do that! I guess you guys know.....
Good reason not to say anything, I guess. You can always blame the dew!!
 
tx oms,

I hear you, you're obviously intelligent and straight-up, but everything does not neatly fit into being a clear cut issue. there is a lot of gray area and that's where a balance of skill, psychology, humanity, and being part of a force of something good come into play in a good dentist.

ppl are often ignorant and careless to change their bad habits, but that doesn't mean we should stop trying to help them. Of course you can only take someone so far without their cooperation, but how would you affect them positively if you didn't even really try to push them a little past their comfort zone in a lifestyle issue that affects their health in the first place?
 
Kniles5 said:
Can just soda really do that to this degree? All of the teeth decaying? I had no idea. I guess the cases aren't as clear as I thought. It seems like you would have to gargle and swish around soda every day to do that! I guess you guys know.....
Good reason not to say anything, I guess. You can always blame the dew!!
Just wait till you get to the clinics. You'll see. :)
 
i like the way it sounds: meth-mouth....meth-mouth, meth-mouth, meth-mouth...

try saying, meth-mouth-mish-mash repeatedly for 4 times.....
 
mlle said:
tx oms,

I hear you, you're obviously intelligent and straight-up, but everything does not neatly fit into being a clear cut issue. there is a lot of gray area and that's where a balance of skill, psychology, humanity, and being part of a force of something good come into play in a good dentist.

ppl are often ignorant and careless to change their bad habits, but that doesn't mean we should stop trying to help them. Of course you can only take someone so far without their cooperation, but how would you affect them positively if you didn't even really try to push them a little past their comfort zone in a lifestyle issue that affects their health in the first place?
Yeah, I know what the ideal is. I know we should help people and everyone goes into medicine b/c they want to help people. I am good to my patients and I understand psychology and humanism.

However, my patients are adults and don't need me to tell them how to live. Furthermore, if I am going to speak to them about lifestyle I'm not going to sugar coat things. I think coddling people is linked to a lot of America's social problems.
 
note that in the context of dentistry tx = treatment plan

am i right?

lol
 
Kniles5 said:
Can just soda really do that to this degree? All of the teeth decaying? I had no idea. I guess the cases aren't as clear as I thought. It seems like you would have to gargle and swish around soda every day to do that! I guess you guys know.....
Good reason not to say anything, I guess. You can always blame the dew!!

Phosphoric acid. Remember that from chem lab? It's used as a preservative in lots of sodas. Its a pretty good preservative because its a strong acid. So if the sugar in the soda doesn't get ya, the acid will.
 
The first patient I got in the clinic is a met mouth guy. Very nice person but denied all drugs related problems. My instructor told me to get a pros consult for whole mouth reconstruction. The pros referred him to pros PG immediately. I was glad the PG was there and took the case for me. Every tooth need restoration, and the guy just screams bloody murder when he sees needles.

Up to now, I have had 3 met mouth patients. But none of them are skinny. 2 are actually overweight
 
Up here in Canada meth isn't much of a problem (yet). I have met patients who claim to smoke pot but did not notice serious problems. What is the way to identify meth users as opposed to heavy pop drinker with poor hygiene? Or is that necessary (i.e. deal with the caries first)?
 
Frank Cavitation said:
Up here in Canada meth isn't much of a problem (yet). I have met patients who claim to smoke pot but did not notice serious problems. What is the way to identify meth users as opposed to heavy pop drinker with poor hygiene? Or is that necessary (i.e. deal with the caries first)?

soda drinkers don't have xerostomia and meth users do (or at least when they are using) which is the main underlying problem which causes rampant caries
 
ShawnOne said:
Here is some info on oral effects of amphetamines from my PBL library...

Amphetamines

This can produce xerostomia. In addition, the need to intake carbohydrates is increased. Fizzy drinks are often the type of carbohydrate chosen this increases the risk of tooth decay and tooth erosion. These drugs may lead to a habit of grinding teeth together.

Meth users face some specific issues with their teeth and mouth, partly due to the ingredients and method of use. Meth mouth includes the direct and side effects of the drug and lifestyle choices of the user. Dentists and dental hygienists are urged to become familiar with the symptoms and what precautions to take when treating an abuser. While the symptoms alone do not prove Meth use, taken together with other signs, they may help health workers diagnose abuse.

Meth Ingredients and Method
Lithium, muriatic and sulfuric acids, ether, red phosphorus and lye - key ingredients in Meth manufacturing - are all corrosive and will cause skin burns even when used properly. When a person smokes Meth, these substances are heated, vaporized and swirl throughout the user's mouth. They irritate and burn the sensitive skin inside the mouth, create sores and lead to infection. Chronic Meth smokers have teeth rotted to the gum line from the continuous affect of the vapors on tooth enamel.

Snorting Meth also causes chemical damage to teeth. Snorting draws the caustic substances down the nasal passages, draining in the back of the throat and bathing the teeth with corrosive substances. Injecting Meth has no direct impact on dental health, but as you will see, habitual use of the drug does have side effects that do lead to damage.

Meth Mouth Symptoms
• Dry Mouth - Saliva acts as a buffer against acidic substances in the mouth, neutralizing it and protecting teeth against acidic foods like lemons, acid from the gut or acidic plaque. The average person creates around one liter of saliva a day. If saliva production is reduced, oral bacteria levels can increase ten times over normal levels. Meth dries out the salivary glands. Without saliva, the acidic substances can eat away at the minerals in tooth enamel, causing holes or weak spots that turn into cavities. Other medications dry the mouth but Meth is especially bad.

• Tooth Decay - Meth users are notorious for trying to treat cottonmouth with lots of sugary soda. The bacteria that feed on the sugars in the mouth secrete acid, which leads to more tooth decay. Also, Meth users aren’t likely to floss, brush and rinse when high. A typical cavity starts in-between two teeth. It eventually invades the tooth and destroys it from the inside out. Crank decay invariably starts at the gum line - it eventually spreads around the entire tooth, eating swathes of enamel in its wake.

• Cracked Teeth - Because the drug can make them feel anxious or nervous, causing them to clench or grind their teeth, regular Meth users may develop cracks in their teeth.

• Gum Disease - Teeth and gums need blood to stay healthy. Meth causes the vessels that supply blood to oral tissues to shrink up. Reduced blood supply causes tissues to break down. With repeated shrinking, the blood vessels don’t recover and tissues die.

The exact rate of Meth mouth is unknown, but dentists who practice in areas where people have regular access to the drug are beginning to see a pattern. The following is from a January, 2003 article by Reuters Health Information:

"Dr. Eric Curtis, a dentist in Arizona, and a spokesman for the Academy of General Dentistry, reports, "I have a certain number of patients who are starting to show up with it." He adds that the patients it crops up in most commonly are teenagers. Dr. Curtis says that he does not treat the tooth decay and gum disease associated with Meth mouth any differently than he treats the conditions in other patients. However, if he believes his patient is using Meth, he will ask them to stop and he advised other dentists to do the same. If dentists relieve patients of their current dental problems but they continue to use the drug, chances are the same problems will reappear, he noted, "The cycle will occur and occur again." "

Dentists should also be aware that Meth has been shown to have dangerous interactions with common dental anesthetics. These, in turn, could cause major hypertensive episodes or other health problems. Also, anyone who suspects they may be working with a patient using Meth should be familiar with the signs of tweaking and how to deal with a tweaker.

Don't forget http://youtube.com/watch?v=02ngAsHRg4A Mugshots of people and how they looked before and after they used meth. It's quite sad, especially to that one woman who she looks like grandma after 3 years!
 
superchris147 said:
soda drinkers don't have xerostomia and meth users do (or at least when they are using) which is the main underlying problem which causes rampant caries
No, the main underlying problem is lifestyle and poor hygiene.
 
Anuwolf said:
Don't forget http://youtube.com/watch?v=02ngAsHRg4A Mugshots of people and how they looked before and after they used meth. It's quite sad, especially to that one woman who she looks like grandma after 3 years!

meth is nasty ****. im sure many of us have encountered freinds or family that are dealing with this. all i gotta say is: help them, stop them and save them. if not, everyone is gonna be doing it and the world is gonna be a sadder place. cmon people lets do what we can to educate and change the hearts and minds of the meth addicts around us!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
 
Sprgrover said:
This is so sad and disturbing. I'm at a loss of words after seeing those images.
Ditto.

I think these type of cases are not common, and if you ever get one, you will probably be lucky to deal with it.

Think about it, put yourself in a meth-patient's shoes, wouldn't you think about seeing a dentist twice, unless you have no other choice.
 
tx oms said:
No, the main underlying problem is lifestyle and poor hygiene.

while i'm not arguing with you that the lifestyle/poor hygiene contributes to rampant caries, but he asked for the difference between rampant caries between soda drinkers and meth users. and that's the main difference, xerostomia.
 
Cold Front said:
Ditto.

I think these type of cases are not common, and if you ever get one, you will probably be lucky to deal with it.

Think about it, put yourself in a meth-patient's shoes, wouldn't you think about seeing a dentist twice, unless you have no other choice.

The teeth yes, but I was refering to the images of the children that either tested positive for meth (it's HIGHLY addictive and without a doubt those children will have longterm complications), suffered physically and emotionally from being in an environment with meth and its production or at the hands of an abusive and addicted parent. Because of both its highly addictive nature (one exposure is all that is needed to ignite an addiction) and that the easily accessible ingredients in meth make it an easy cottage industry are some of the primary reasons why it's spreading rapidly across America. My sister, a social worker, deals with the consequences of meth with her clients everyday and she says the problem is getting worse by the minute. I believe that a lot of America is unaware of this problem and that we, as dentists, are bound to see more and more such cases in our practices.
 
Cold Front said:
Ditto.

I think these type of cases are not common, and if you ever get one, you will probably be lucky to deal with it.

Think about it, put yourself in a meth-patient's shoes, wouldn't you think about seeing a dentist twice, unless you have no other choice.
You might be surprised. A number of my classmates have already treated some unmistakeable meth users. I haven't had any yet, but I figure it's only a matter of time.
 
1FutureDDS said:
Can you get in legal trouble for bringing it up?

Just be honest straight up and say hey the signs of wear on your teeth at such a young age have been linked to drug use. Explain that they don't have to even anser your question and are in no trouble, but give them encouraging words such as telling them they can get help if needed. If they say anything then maybe ask them if they are interested in talking to someone who can help them in their situation, refer to a rehab program or something. Kinda like an endo ref out, you send them on their way, and the next person does what they can to ultimately fix the problem.

Drug abuse is nothing to play around with, and should be questioned by EVERYONE at the initial signs OF abuse. Be a man and step up, they will thank you when they've recovered their life.

http://www.mappsd.org/Office Procedures.htm
 
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