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Sympathomimetic effects of chronic methamphetamine abuse on oral health: a cross-sectional study
Niklas Rommel1, Nils H Rohleder2, Steffen Koerdt2
1Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, Munich, D-81675, Germany. niklas.rommel@tum.de.
Background:
Methamphetamine, a highly addictive sympathomimetic stimulant, is currently widely abused worldwide and has been associated with devastating effects on oral health, resulting in the term "meth mouth". However, "meth mouth" pathology is primarily based on case reports with a lack of systematic clinical evaluation. Therefore, we have conducted a systematic study to investigate (1) the pharmacological impact of methamphetamine on oral health with regard to saliva function, including the parameters saliva flow rate and total saliva production (ml/5 min) and the buffering capacity of saliva; (2) the contribution of the symptoms of bruxism and muscle trismus to potential oral health damage.
Methods:
We assessed the data of 100 chronic methamphetamine abusers and 100 matched-pair comparison participants. Primarily, we conducted an anamnesis with all methamphetamine abusers with regard to saliva dysfunctions, jaw clenching and pain in the temporomandibular joint. Subsequently, in the first part of the clinical enquiry, we tested the saliva flow rate and the total saliva production (ml/5 min) by using the sialometry method and the buffer capacity of saliva by determining the pH-value. In the second part of the clinical enquiry, we evaluated bruxism symptoms with respect to generalized tooth attrition, dentine exposure and visible enamel cracks and examined a potential muscle trismus by measuring the maximal opening of the mouth.
Results:
The majority of methamphetamine abusers reported a dry mouth (72 %) and jaw clenching (68 %). Almost half of all methamphetamine abusers experienced pain in the temporomandibular joint (47 %). With regard to the clinical findings, methamphetamine abusers showed significantly lower total saliva production (ml/5 min) (p < 0.001), lower pH-values of their saliva (p < 0.001) and more bruxism symptoms (p < 0.001). However, we found no relevant trismus symptoms on comparing the two groups (p > 0.05).
Conclusions:
The sympathomimetic effects of chronic methamphetamine abuse may lead to dry mouth and extensive bruxism and therefore can increase the risk for caries decay, periodontal lesions and tooth wear. Furthermore, a significant decline of saliva buffer capacity in methamphetamine abusers may trigger the risk for dental erosions. Methamphetamine abusers and practitioners should be aware of these symptoms.
Insights
Chronic methamphetamine abuse significantly impairs oral health by reducing saliva flow and buffer capacity, leading to dry mouth and bruxism. This increases risks for tooth decay, gum disease, and wear.
Area of Science:
- Oral Health
- Pharmacology
- Addiction Medicine
Background:
- Methamphetamine abuse is linked to severe oral health issues, commonly termed "meth mouth."
- Existing "meth mouth" pathology relies on case reports, lacking systematic clinical evaluation.
- This study systematically investigates methamphetamine's oral health impact, focusing on saliva function and bruxism.
Purpose of the Study:
- To evaluate the pharmacological effects of methamphetamine on saliva flow rate, total saliva production, and buffering capacity.
- To assess the contribution of bruxism and muscle trismus symptoms to oral health damage in methamphetamine abusers.
- To provide a systematic clinical evaluation of "meth mouth" pathology.
Main Methods:
- Assessed 100 chronic methamphetamine abusers and 100 matched controls.
- Conducted anamnesis for saliva dysfunction, jaw clenching, and temporomandibular joint pain.
- Measured saliva flow rate, total saliva production, salivary pH, and maximal mouth opening.
Main Results:
- Methamphetamine abusers reported significantly higher rates of dry mouth (72%) and jaw clenching (68%).
- Clinical findings revealed significantly lower saliva production (p < 0.001) and lower salivary pH (p < 0.001) in abusers.
- Abusers exhibited significantly more bruxism symptoms (p < 0.001), but no significant trismus was observed.
Conclusions:
- Sympathomimetic effects of methamphetamine cause dry mouth and bruxism, elevating risks for caries, periodontal lesions, and tooth wear.
- Reduced saliva buffering capacity in abusers increases susceptibility to dental erosions.
- Awareness of these oral health risks is crucial for methamphetamine abusers and healthcare practitioners.
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