Pubdate: Sat, 24 Jun 2006
Source: Reno Gazette-Journal (NV)
Copyright: 2006 Reno Gazette-Journal
Contact: http://www.rgj.com/helpdesk/news/letter-to-editor.php
Website: http://www.rgj.com/
Details: http://www.mapinc.org/media/363
Author: Alex Newman
Bookmark: http://www.mapinc.org/meth.htm (Methamphetamine)

Series: Meth: Shattering Lives In Northern Nevada

A three-month Reno Gazette-Journal investigation found that 
methamphetamine's grip on the Truckee Meadows has become a stranglehold.

DENTISTS SEE MORE 'METH MOUTH' THAN EVER BEFORE

Dentists Savita Hemrajani and Melinda Kuhn remember the first time 
they saw meth mouth.

Several years ago, the patients with "scooped out," severely decayed 
teeth began to appear.

Now, at the Health Access Washoe County dental clinic, which provides 
sliding-scale dental care, they see it every week.

"They tell you one tooth is hurting and they open their mouth and 
they're almost all decayed down to the gumline," Dr. Kuhn said. "Most 
of them end up losing their teeth at very young ages."

Their patients are usually in their 20s, have trouble sitting in the 
dentist chair for long periods of time and don't always care about 
the appearance of their teeth.

Most just want the pain to go away, dentists said.

"The reason they come in is that it's at the point now where they've 
gone to the walk-in clinics and tried to get the painkillers and now 
it's so bad that they can't live with the pain," said Dave Anderson, 
a program supervisor of the Saint Mary's Take-Care-A-Van, a large 
mobile dentist office that focuses on providing basic dental care to 
at-risk children.

Scientists continue to research the causes of the rapid decay that 
can occur in as little as a few months.

According to the American Dental Association, methamphetamine use 
dries out the mouth, leaving the teeth without saliva to cleanse 
chemicals and bacteria. Users crave sugary, carbonated beverages such 
as soda and don't remember to brush or floss when they engage in 
several day "runners."

Unlike typical cavities that form between teeth, meth mouth decay 
begins at the smooth outer surface of the teeth and rots inward.

"They break off," Kuhn said. "It's like an apple, cored-out."

Addicts are harder for dentists to treat because of their high 
tolerance for pain killers and drugs and the anxiety that comes with 
methamphetamine. Some can't sit in the chairs long enough for more 
invasive, longer procedures, Hemrajani said.

Dentists said patients usually wait until most teeth are destroyed 
before they seek any treatment. The only care options left to them 
are usually limited to pulling the teeth out and possibly getting dentures.

Some recovered addicts seek care to fix their smile so they can get jobs.

"It's really sad when they come in that state," Hemrajani said. "Most 
of them say, 'We can't get a job because of our teeth. No one is 
willing to hire us.'"

Kuhn and Hemrajani said they usually end up pulling teeth and giving 
patients dentures. But patients aren't happy with dentures, which 
many don't realize aren't a replacement for natural teeth.

"You cough, you sneeze, it falls out," Hemrajani said. "The patient 
is never going to be happy with dentures."

Rebuilding the mouth can also carry a heavy pricetag.

"The only thing you can do to restore the teeth is a root canal and a 
crown on each tooth," Anderson said. "That's very expensive and most 
people we see can't afford to do that. Really, the only option at 
that point would be to go ahead and do all the extraction and get a 
set of dentures."

Kuhn and Hamrajani are worried about seeing meth mouth in young 
children whose parents are meth users.

"Parents use it and that's how kids to get access to it," Hemrajani said.

They explain to patients how meth mouth works, even though most don't 
admit to their drug use.

"I think it's definitely important to start bringing awareness into 
society," Hemrajani said.

[Sidebar]

Dental Costs For Typical Meth Mouth-Related Procedures:

All costs are before sliding-scale deductions.

# $200-$300: Cost per tooth for a large filling

# $1,800: Cost per tooth for a root canal or crown

# $200: Cost per tooth for an extraction # $2,000: Cost for one set of dentures

# $40,000: Cost for a full set of implant dentures

SOURCE: HAWC Clinic
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MAP posted-by: Beth Wehrman