Teeth and drug use

Some drugs can damage your teeth, so it is important to tell your dentist about any drugs you take. Your dentist can tell you whether a drug is likely to affect your teeth and what you can do to help prevent dental problems.

Healthy teeth and gums depend on good oral hygiene, a diet low in added sugar, healthy saliva and regular dental visits.

Why saliva matters#

Saliva protects your teeth in several ways. It:

• helps repair tooth enamel (the hard surface layer that protects the tooth) after it is damaged by acids, in a process known as remineralization
• washes food particles away from tooth surfaces
• reduces the number of bacteria in the mouth
• neutralizes the mouth acids that cause tooth decay

Drug use and dry mouth#

Some drugs reduce the flow of saliva and cause a condition called dry mouth, which significantly increases the risk of tooth decay. Ask your dentist whether any drugs you take could be causing dry mouth.

How different substances affect teeth and gums#

Regular drug use can cause significant tooth damage. Some substances we may not think of as drugs also carry a high risk to oral health, especially when combined with smoking:

• Alcohol. Most alcoholic drinks are acidic, so regular drinking can cause dry mouth and tooth erosion. It can also increase the risk of mouth cancer, especially when combined with smoking.
• Tobacco. Smoking is linked to a higher risk of gum disease, poor gum healing and cancer, including mouth cancer (particularly when combined with regular drinking).
• Cannabis (also called marijuana, pot or weed). It can cause dry mouth and increase the risk of gum problems, and the smoke can increase the risk of mouth cancer.
• Cocaine (also called coke or blow). Users sometimes rub cocaine on their gums, which can ulcerate the gums and the bone beneath. Mixed with saliva, cocaine becomes very acidic and erodes enamel, exposing the underlying dentine to decay-causing bacteria. Cocaine and crack cocaine also cause dry mouth and tooth grinding, which further wears the teeth and raises the risk of decay.
• Ecstasy/MDMA (also called the love drug, “E”, “eckies”, “pingers” or “caps”). Side effects include tooth grinding, jaw clenching and dry mouth.
• Heroin (also called smack, horse or hammer). People who use heroin often crave sweet foods, which can increase tooth decay if dental care is neglected. It can also cause dry mouth and tooth grinding.
• Methamphetamine (also called ice, crystal meth, glass, shards or puff). This drug causes severe tooth decay very quickly; the term “meth mouth” describes the extensive damage it typically causes. It is highly acidic and attacks tooth enamel, and other effects include dry mouth, teeth grinding and jaw clenching.

Drinks that contain a lot of caffeine, such as energy drinks and drip or percolated coffee, are acidic and can cause tooth erosion if consumed regularly in large amounts, so it is best to limit or avoid them.

Any drug dependence or drug use that leads a person to neglect their personal hygiene, diet and dental care can greatly increase the risk of dental and many other problems.

Treating tooth and gum problems#

Professional treatment depends on the drug involved and its effects on your teeth and gums. It may include:

• Fluoride, which strengthens teeth and reduces the risk of decay. Your dentist may apply topical fluoride, and may recommend fluoride mouthwash or higher-strength fluoride toothpaste for use at home.
• Fillings or other restorative work for decayed teeth.
• Removal of badly decayed teeth, with replacements such as bridges, dental implants, or partial or full dentures.
• Crowns where needed.
• Cosmetic treatments, such as veneers, to improve the look of your smile if that is important to you.

Preventing tooth and gum problems#

• Drink fluoridated tap water instead of fizzy soft drinks, which are highly acidic and can erode enamel.
• Cut back on sweet or sticky foods such as biscuits or sweets.
• Chew sugar-free gum to encourage a steady flow of saliva.
• Brush thoroughly at least twice a day with standard fluoride toothpaste, and floss once a day. Be gentle to avoid damaging your gums.
• Visit your dentist at least once or twice a year where possible.
• Minimize your intake of alcohol, and consider quitting smoking.
• If you would like support with a substance use disorder, consider talking to your doctor about support services or a drug treatment program.

Drug use and dental treatment#

If you are scheduled for dental treatment, tell your dentist about your alcohol and smoking intake, as well as any drugs you take or have recently taken. Also mention any medications, including prescription, over-the-counter and herbal products. Ask your doctor and dentist for further self-care advice, and follow it carefully.

Key points#

• Some drugs can cause tooth damage, so it is important to tell your dentist about any drugs you are taking.
• Your dentist can tell you whether a drug is likely to affect your teeth and what you can do to help prevent dental problems.
• Regular use of drugs can cause significant tooth damage, often through dry mouth and acid erosion.
• Cannabis smoke can increase the risk of mouth cancer.
• Cocaine and crack cocaine cause dry mouth, which further increases the risk of tooth decay.

Where to get help#