How Drugs Impact Your Oral Health

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.

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.

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.

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.

Common oral health problems experienced by substance users — including teeth grinding, jaw problems, and missing or cracked teeth — can cause bite and alignment issues.

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.