Is “Meth-Mouth” a Misnomer? Examining other confounding variables associated with poor oral health of chronic methamphetamine users

Background: With the increasing use of methamphetamine, both illicit use and prescription drug abuse, dental care providers are reporting a characteristic pattern of rampant caries among its chronic users. This clinical picture is popularly called “Meth Mouth". Although the reports have been largely anecdotal, the term “meth mouth” has come to be accepted as if to denote a direct causal relationship between long term methamphetamine use and poor oral health.

Methods: Authors conducted a literature review to examine other possible variables which could confound this apparently strong one to one association. We initially searched English language literature for published studies on methamphetamine use and oral health. We used key words such as methamphetamine, caries, meth-mouth, poor oral health, confounding variables, co-variables, poly-substance use and dental services. We later expanded our search to include the references which have been cited in the selected studies.

Conclusion: We were able to identify 6 main confounding factors; (i) co morbid mental illness, (ii) co morbid infections due to needle sharing, (iii) concomitant use of other substances, (iv) personal factors, (v) toxic byproducts present in the methamphetamine and (vi) concomitant use of other medications. Authors believe that the term “meth-mouth” is a misnomer as methamphetamine abuse does not exclusively account for the poor oral health. Moreover the term is misleading because it fails to capture all the variables associated with poor oral health in this population, thereby compounding the problem of lack of adequate care.