Dental Team Considerations

Become familiar with methamphetamine use disorder.

The entire dental team should understand the signs and symptoms of methamphetamine use and methamphetamine use disorder, as well as the clinical considerations necessary to safely evaluate and treat patients with a history of methamphetamine use.^1,13,28

Obtain and document a comprehensive medical and dental history.

When methamphetamine use is suspected or disclosed, obtain and thoroughly document:

1. Personal and family history of substance use

2. Current prescription and nonprescription medications

3. Tobacco and nicotine use

4. Alcohol use

5. Illicit substance use, including frequency, route of administration, and the date and time of last use^1,28

Perform and document a comprehensive clinical examination.

Evaluate and record:

1. Extraoral findings associated with stimulant use

2. Intraoral manifestations of methamphetamine-associated oral disease

3. Dental caries, periodontal status, salivary function, tooth wear, and other oral findings

Clinical findings should be discussed using respectful, nonjudgmental, person-centered language.^1,28

Review the Prescription Drug Monitoring Program (PDMP) when appropriate.

Review your state's Prescription Drug Monitoring Program before prescribing controlled substances whenever required or appropriate under applicable state law. Consider the patient's controlled substance history when making prescribing decisions.¹³

Assess the patient's current physiologic status.

Obtain and document baseline vital signs, including blood pressure, heart rate, and mental status, before initiating dental treatment when methamphetamine use is suspected. Patients demonstrating signs or symptoms of acute methamphetamine intoxication—including severe hypertension, tachycardia, agitation, chest pain, or altered mental status—should have elective dental treatment postponed until medically stable.^1,28

Individualize treatment planning.

Treatment decisions should be based on the patient's current medical condition, physiologic status, decision-making capacity, oral health needs, and readiness to participate in care—not solely on a history of methamphetamine use. Patients who are medically stable, engaged in recovery, and capable of providing informed consent may be appropriate candidates for comprehensive preventive, restorative, periodontal, endodontic, prosthodontic, surgical, and implant therapy when clinically indicated.^1,13,28