Methamphetamine users get a mouthful of trouble
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MASON CITY Delbert Sankey had beautiful teeth as a child and does now, too, he says.
Except now they come out, the 48-year-old former methamphetamine user said.
Sankey, who began using meth at the age of 12 or 13, suffered from what dentists refer to as meth mouth.
A serious by-product of meth use, it is characterized by broken, discolored and rotting teeth caused by conditions associated with meth use such as dry mouth and bruxism, a clinching and grinding of the teeth that causes teeth to break off.
I had every tooth in my mouth filled, Sankey said. I had root canals. My gums withered away. It was absolutely because of meth.
In about 2000, he got dentures.
Most meth users he knows have dentures, Sankey said. Their teeth were so totally rotted. It s beyond decay.
Mason City dentist Dr. Jon Hardinger said meth mouth may not happen every day, but when you see it, it s devastating.
A Mason City dentist since 1989, Hardinger saw his first case of meth mouth several years ago.
A male patient came in who was methodically taking out one tooth at a time and getting medication for it, Hardinger said.
It s almost astonishing how teeth can get that bad so fast, he said. You combine a diet of fast foods and sugary drinks with dry mouth and poor hygiene and the decay process becomes rampant.
Nora Springs dentist Dr. Kris Kelly services a free monthly dental clinic for uninsured, low-income adults requiring emergency dental care in conjunction with Mercy Medical Center-North Iowa.
There are no easy answers, he said. Either someone is going to get dentures in their mid-20s or they will need a tremendous number of fillings that will need to be redone and redone over the years.
It s probably the most frustrating thing we see, Kelly said. It s kind of like a no-win situation. You re dealing with a person that doesn t have resources, has developed poor habits and the prognosis is not good and they re young. It s a huge problem for society.
Patients tend to be apprehensive about going to the dentist and are ashamed of the appearance of their teeth. They know it s going to take a lot (to fix), said Kelly.
The cost of a full-mouth extraction or a lot of fillings can be $3,000 to $5,000, Kelly said.
Crowns can cost well over $1,000 per tooth.
Some of the patients are on Medicaid-Title 19, Kelly said. Most are uninsured. They re young, healthy adults who don t qualify for Title 19. They re coming because they have no other resources.
Title 19 covers extractions and fillings. It does not cover root canals or crowns.
Some dental patients been referred by agencies such as Beje Clark Residential Facility and Prairie Ridge Addiction Treatment Services, Kelly said. They want to try to get their lives back together or they re in pain.
Sandi Jackson, Prairie Ridge residential program manager, said the agency often refers residents for dental work, including people who formerly used meth.
The meth acted as a tranquilizer for them, she said. Once they stop using it, they experience physical pain.
Residents may have decayed or abscessed teeth. They may need an extraction. Sometimes it s multiple teeth at a time.
When people are on meth, they re not eating, Jackson said. They have poor nutrition. When people are using, they re not taking care of their teeth.
One resident was so frustrated he pulled out his own tooth, Jackson said.
David Hepperly, chief deputy of the Cerro Gordo County Sheriff s Department, said, We see (meth mouth) all the time. People come in here that are longtime meth-users. Their teeth may be falling out or rotting out.
Prisoners who are experiencing severe tooth pain often seek help through the Sheriff s Department, Hepperly said.
They want someone to look at their teeth. We take them to a dentist or oral surgeon.
The county pays to have teeth extracted but not for expensive repair. In 2006, $3,591 was spent by the county to pay for dental work for county prisoners, Hepperly said.
In 2007 to date, $3,614 has been spent. The most ever spent was $5,041 in 2005.
These figures include all dental work for county prisoners, not just that of meth-users, Hepperly said.
Smoking meth has a corrosive effect on tooth enamel, the dentists said.
Meth also causes the salivary glands to dry out which contributes to the erosion.
Dry mouth leads individuals to take excessive amounts of liquid, often sugary drinks.
They get hyped up and eat a high-calorie, high-sugar diet and sugary pop, said Kelly. Because they re up all the time, they re taking in this diet 24 hours a day.
Treatment
Dentists attempt to restore whatever teeth they can. They are hindered in the process because most meth-users do not have a dental history.
But when you get to the point where teeth are cracking and breaking off around the gumline, it gets to the point where you can t restore it, Hardinger said. When people start to get decay around the fillings, you know it s getting away from you.
In that case, the only alternative is dentures.
In a good scenario, treatment might be minor gumline surface fillings, Kelly said. You want to check their diet and make sure they reduce the high-caloric, high acidic foods.
At the opposite extreme, the only remedy is full-mouth extraction and dentures.
As a dentist, he feels he is performing a very small service in comparison to what these patients need, Hardinger said. You hope they re getting the other help they need as well.
Mason City dentist Dr. Jay Lala said the meth-user is behind the 8-ball.
Most of the time when they do quit (meth) and they re on rehab, then there s a financial issue. It can affect everything, including getting jobs. It s so hard for them to get out of that cycle.
Dr. Mike Otto of Mason City said he sees a few cases a year of possible meth mouth.
Typically, they come in for a toothache and you look into their mouth and their teeth are just terrible, he said. They want to have the tooth pulled.
Unfortunately, the anesthetic he uses can adversely affect a person on meth since most anesthetics contain adrenaline. So Otto asks patients with severe decay if they are using meth.
Patients don t usually admit being on it, he said. They typically don t come back.
The solution will probably be in public education and creating public awareness of the problem to prevent young people from using meth, Kelly said. For those on meth, early intervention is key.
Ultimately, it involves a choice people make, including a choice of friends, Lala said.
Some young women think of meth as a diet aid. They just get in over their heads.
Clinic has to absorb treatment costs
BURLINGTON Clear Lake native Dr. Hilary Reynolds routinely sees patients with meth mouth in her work as the dental director of Community Health Centers of Eastern Iowa in Burlington.
We see it once or twice a week, usually among people 20 to 45, she said.
The Health Center provides treatment of medical and dental issues for uninsured, under-insured and Medicaid patients.
We cannot turn anyone away with a dental emergency because of their inability to pay, Reynolds said.
These patients teeth have a characteristic burnt appearance, she said. It s almost like the teeth have become stumped off and it s brown, burnt enamel. It s unmistakable.
Patients who come in high on the meth will act very agitated, Reynolds said. We don t treat them.
Non-Medicaid patients pay out-of-pocket. Those who cannot are treated and the cost is absorbed by the clinic. Eventually it goes to collections.
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