How Drugs Impact Your Oral Health

How Drugs Impact Your Oral Health
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Table of Contents

  1. Prevalence of Substance Use
  2. Common Oral Health Issues
  3. Impact of Different Drugs
  4. Treating Oral Health Problems
  5. Resources

Many people don’t associate drug use with oral health. But it’s a consideration that may be more important than we realize. Many substances cause or contribute to oral health problems that can have a lasting and negative impact on a user’s daily life, self-image, and overall health.1 

Treating oral health issues caused by substance use early can help to prevent long-term (and sometimes, irreversible) problems as well as costly and stressful dental emergencies. But even long-time users with serious oral health problems can benefit from taking steps to address their oral health.

Prevalence of Substance Use

It’s no secret that substance use is popular in our society, especially when including generally widely accepted substances like alcohol, medications, tobacco, and marijuana. In a 2019 study, over 60 percent of individuals over the age of 12 reported using a substance in the past month. 

The issues associated with substance use are also well-known. Many people associate substance use with addiction (substance use disorder), erratic or uncharacteristic behavior, and crime. 

Besides illicit drug use, many people take prescription medications regularly, and these drugs can also contribute to oral health issues.

Common Oral Health Problems Caused by Drugs

While various substances have different effects on the mouth and teeth, some oral health issues are shared by many substance users. These are some of them:

Dry Mouth

Many substances dehydrate the body, affect the salivary glands, and/or cause dry mouth. Dry mouth is a contributing factor in many oral health problems because of the importance of saliva in oral health.

Saliva aids in oral health by rinsing the mouth and teeth, helping to clear away harmful and acid-forming bacteria like plaque, which can eat away at the teeth’s enamel. When someone has dry mouth, they are producing less saliva. This means less harmful bacteria is being washed away, and more is accumulating in the mouth, especially in hard-to-reach areas, like in between the teeth. 

These harmful bacteria, including plaque bacteria, can eat away at tooth enamel, harden into bacteria-filled tartar (which can only be removed professionally), and cause gum irritation and inflammation. This can eventually lead to tooth decay, gum disease, and infection.

Lack of Oral Hygiene

Many substances can overtake a user’s life, causing them to fall into bad habits and forget about healthy routines, including oral hygiene. Regularly skipping brushing or flossing can result in bacteria and particle buildup on the teeth and gums.

Cavities, decay, and gum problems can easily worsen into severe issues, especially if the user isn’t keeping up with regular dentist appointments that would address issues before they become out of control.

Poor Diet Choices

Many substance users have a chaotic lifestyle that can result in less healthy diet choices on a daily basis.2 Some substance users may opt for sugary or starchy snacks while on their substance of choice. Bad bacteria feed on sugar and the sticky food particles are often left behind from starchy snacks like potato chips and fried foods, resulting in decay and gum irritation. 

An unhealthy diet can negatively impact a user’s oral health in other ways as well. A diet lacking in nutrition can leave the user without the minerals and nutrients needed for strong bones and teeth. A poor diet can also contribute to chronic inflammation, which is a factor in gum disease and other chronic health problems.

Teeth Grinding (bruxism)
Many substances, particularly stimulants, may cause users to grind their teeth. Grinding teeth can cause erosion to enamel, irritation to gums, and jaw problems, including TMJ disorders.
Orthodontic Issues
Common oral health problems experienced by substance users — including teeth grinding, jaw problems, and missing or cracked teeth — can cause bite and alignment issues.

How Different Drugs Impact Oral Health

Just as different substances have different effects on the mind and body, drugs differ in how they impact oral health.


Alcohol use disorder is a medical condition involving the frequent or heavy use of alcohol. Over 14 million Americans over the age of 12 suffer from a form of alcohol use disorder. 

Alcohol dehydrates the body and causes dry mouth. Heavy drinkers are at higher risk for gum disease, and gum disease worsens with more drinking. Users of alcohol are also more likely to experience gum bleeding, higher levels of plaque, and tooth loss.


Cocaine is the second most used illicit drug in the U.S., but there is limited research on its effect on oral health. Some studies have shown cocaine use to be associated with gum disease and cavities, especially when used with tobacco or methamphetamine.3 

Teeth grinding is also associated with cocaine use, and smoking cocaine (called crack or freebasing) can increase the risk of infection and lesions inside the mouth.


Methamphetamine is known for causing meth mouth, which is characterized by extreme tooth decay or tooth loss, stained teeth, cracked teeth, gum irritation and gum disease, and lesions in the mouth. 

Meth mouth is caused in part by the intense addiction many users face and the lifestyle that that addiction results in. Meth users can become delusional and out of touch with reality. Many experience memory or time lapses. Insomnia is a common result of meth use, and users may stay up for days. 

Many meth users will neglect any sort of oral hygiene routine. This is a key factor with meth mouth, as bacteria and particles build up on the teeth and result in decay and gum disease.

Other factors that create meth mouth include the following:

  • Dry mouth
  • Teeth clenching and grinding, resulting in cracked or broken teeth
  • Drinking soda and other sugary drinks while high
  • The chemicals used in meth 
  • Smoking meth, as the meth residue may become trapped in areas of mouth, such as in between teeth or in pockets of bacteria forming near the gum line
  • Crashing after a high and passing out with bacteria film on teeth from drugs, snacks, and/ or sugary drinks

Cigarettes and tobacco have a severe negative impact on oral health. In addition to staining teeth and increasing plaque production, tobacco is a leading cause of mouth cancer.

Smoking cigarettes greatly increases the risk of gum disease, in part because it lowers the oxygen level in the bloodstream, hindering the gums’ ability to heal themselves. 

Smoking also can affect a user’s immune system, making the person more susceptible to infection and inflammation. This can include infections and inflammation in the mouth and gums.

Tobacco and smoking can also cause other oral health problems, including these:

  • Dry mouth
  • Bad breath
  • Tooth decay, cavities, and missing teeth
  • Increased bone loss in the jaw
  • Lower rate of success for dental implants
  • Slower recovery from dental procedures
  • Dulled sense of taste
Limited research has been conducted to study the connection between marijuana (cannabis) and oral health. While cannabis may have positive effects on oral health, it is known to cause dry mouth, and it could be linked to a higher risk of gum disease or cavities.

Heroin is highly addictive, and its users may engage in a lifestyle that promotes poor oral health.4 Oral hygiene is often neglected, and many users will not keep up with dental cleanings or checkups. 

Heroin also causes dry mouth, cravings for sugary (plaque-forming) food and beverages, and teeth grinding. 

Heroin users experience higher levels of gum disease, tooth decay, and tooth loss.

Smoking heroin can also increase the risk of mouth or gum infection, lesions in the mouth, and stained or discolored teeth.

Ecstasy (MDMA or Molly) use causes dry mouth, teeth grinding and clenching, and an increased risk of enamel erosion.

Treating Oral Health Problems Caused By Substance Use

Depending on the types of substances used and the length of use, the oral health issues caused by drug use may be mild, moderate, or severe. The first step in regaining oral health should be visiting a dentist to identify oral health issues and discuss a treatment plan. 

Possible treatments may include the following options:

  • Fillings
  • Deep cleaning
  • Root canal 
  • Braces or clear at-home aligners
  • Whitening treatments
  • Dental implants and/or bridges
  • Tooth bonding

Starting (or re-starting) an effective daily oral health routine can help to establish good oral health and prevent any problems from getting worse. 

A good oral hygiene routine should include the following steps:

  • Brush twice a day with a fluoride toothpaste and soft-bristled toothbrush.
  • Floss every day with traditional floss, a water flosser, or interdental brushes.
  • Use an antimicrobial mouthwash daily.

Taking control of your oral health can be a powerful step in recovery, improving self-image, positively impacting overall well-being, and encouraging healthy habits. Take the first step toward better oral health, and better overall health, today.


Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Date fetched: October 25, 2022.

Oral Health: A Window to Overall Health. (October 2021). Mayo Clinic. Date fetched: October 25, 2022.

Dry Mouth. (February 2018). Mayo Clinic. Date fetched: October 25, 2022.

Dental Plaque. (October 2020). Cleveland Clinic. Date fetched: October 25, 2022.

Gum Disease. (February 2020). Mayo Clinic. Date fetched: October 25, 2022.

Foods that Fight Inflammation. (November 2021). Harvard Medical School. Date fetched: October 25, 2022.

Bruxism (Teeth Grinding). (August 2017). Mayo Clinic. Date fetched: October 25, 2022.

TMJ Disorders. (December 2018). Mayo Clinic. Date fetched: October 25, 2022.

Alcohol Use Disorder. (June 2021). Cleveland Clinic. Date fetched: October 25, 2022.

The Surprising Truth About Alcohol and Oral Health. (April 2018). Penn Dental Medicine. Date fetched: October 25, 2022.

Cocaine and Oral Health. Mount Sinai Hospital. Date fetched: October 25, 2022.

Meth Mouth. Maine Center for Disease Control and Prevention. Date fetched: October 25, 2022.

Treating Meth Mouth. (November 2022). Colgate. Date fetched: October 25, 2022.

Smoking and Oral Health. Oral Health Foundation. Date fetched: October 25, 2022.

The Effects of Smoking on Your Teeth and Gums. Cigna. Date fetched: October 25, 2022.

Cannabis and Its Impact on Oral Health. University of Illinois Chicago. Date fetched: October 25, 2022.

Teeth and Drug Use. Victoria State Government Department of Health (AU). Date fetched: October 25, 2022.

Medical Resources

1 Factors Influencing the Impact of Oral Health on the Daily Activities of Adolescents, Adults, and Older Adults. (April 2018). Reviste de Saude Publica. Date fetched: October 25, 2022.

2 Nutritional Status and Eating Habits of People Who Use Drugs and/or Are Undergoing Treatment for Recovery: A Narrative Review. (September 2020). Nutrition Reviews. Date fetched: October 25, 2022.

3 Cocaine, Polysubstance Abuse, and Oral Health Outcomes, NHANES 2009 to 2014. (January 2020). Journal of Periodontology. Date fetched: October 25, 2022.

 4 The Oral Health of Heroin Drug Users: Case Study in Bosnia and Herzegovina. (December 2013). BMC Public Health. Date fetched: October 25, 2022.

5 Ecstasy (MDMA) and Oral Health. (January 2008). British Dental Journal. Date fetched: October 25, 2022.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.