Sympathomimetic effects of chronic methamphetamine abuse on oral health: a cross-sectional study

Abstract

BackgroundMethamphetamine, 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.MethodsWe 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.ResultsThe 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).ConclusionsThe 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.

The effect of methamphetamine abuse on dental caries and periodontal diseases in an Eastern China city

“…The illicit drugs can stimulate α-adrenergic receptors within the salivary gland vasculature, causing vasoconstriction and reduction of salivary flow (hyposalivation), which greatly weakens protective properties such as the neutralization of plaque-induced acids and the remineralization of dental enamel [ 24 ]. Repetitive meth abuse can also lead to a decrease in salivary pH [ 25 ], which elevates the risk for dental erosion. In addition, Tipton DA found that meth can significantly increase bacterial lipopolysaccharide (LPS)-stimulated IL-1β levels secreted by monocyte/macrophages, which could contribute to periodontitis in meth abusers [ 26 ].…”

Oral Manifestation Related to Drug Abuse : A Systematic Review

“…Of the 18 included studies, 12 were cross-sectional studies, 14,15,16,18,19,20,22,24,25,26,27 4 were cohort studies, 11,12,13,17 and 2 were casecontrol studies. 21,23 The total samples from all included studies were 10389, which 4449 were male and 3868 were female. 6 studies did not specify the gender of the samples.…”

“…The characteristics of included studies were recorded on table 1. The most frequent psychotropic drugs used were methamphetamine (MA) (50%) 12,13,14,18,19,20,21,26,27 , cocaine (44%) 12,17,18,22,23,25,26,28 , heroin (38%) 12,14,15,16,17,18,27 , cannabis (38%) 11,12,17,18,22,27 , opium (11%) 24,27 . 6 studies were using polydrug abusers as samples.…”

Microbial forensics: new breakthroughs and future prospects

“…The consumption of methamphetamines is rapidly increasing on a worldwide scale and, therefore, its forensic relevance. Several gastrointestinal microorganisms, such as species belonging to the genera Enterobacterium, Enterococcus, Lactobacillus, Clostridium and Bacterioides, are responsible for the N-demethylation of methamphetamines converting these compounds into amphetamines (Castle et al 2017;Rommel et al 2016).…”