The etiology of this dental disease stems from the caustic nature of the drug and the lack of concern by the user for daily personal hygiene and professional dental care. The acidic ingredients used to make meth as well as the psychological and physiological changes induced by the drug result in a ‘perfect storm’: dry mouth, poor oral hygiene, consumption of sugar-laden soda and stress-induced grinding and clenching. The method in which the drug is administered was thought to play a role in the oral effects: when smoked, the drug emits toxic fumes that contain lithium and muriatic and sulfuric acids, ether, red phosphorous and lye. These highly toxic and corrosive vapors produce significant damage to the oral structures.57 Nasal insufflations (snorting) can also have dental implications. The noxious substances proceed down the nasal pharynx into the back of the throat and coat the oral cavity with the destructive substances. It would seem that smoking or snorting meth should result in more damage. A study reported in the Journal of the American Dental Association did not confirm this. Instead, IV meth users had a higher prevalence of dental disease and missing teeth that those who smoked meth, possibly due to more advanced addiction and greater self-neglect.1
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