Pubdate: Sun, 09 Oct 2005
Source: Press-Enterprise (CA)
Copyright: 2005 The Press-Enterprise Company
Contact:  http://www.pe.com/
Details: http://www.mapinc.org/media/830
Author: Rocky Salmon, The Press-Enterprise
Bookmark: http://www.mapinc.org/meth.htm (Methamphetamine)

'METH MOUTH'

Lost Teeth Due To 'Meth Mouth' Among Consequences Of Drug Abuse

As Albert Falls chewed on a croissant, he slowly worked his jaw with
the caution of someone twice his age. His jagged, yellowing teeth took
careful measure with each bite into the soft bread.

"A man my age shouldn't have to be gumming my food," the 32-year-old
construction worker said. "It's disgusting, and plain sad."

The Quail Valley man lost many of his teeth because of an addiction to
methamphetamine. Now he faces a less-obvious cost of doing drugs -- a
dental bill of about $6,000.

Falls' woeful condition, which has come to be known as "meth mouth,"
is a growing problem among countless meth users across the country,
and as the number of meth users grow, so does the amount of tax
dollars set aside for their dental treatment in prisons and jails. And
federal grant monies are now used by clinics to treat meth users who
can't afford dental insurance.

The drug, which creates a feeling of euphoria and is highly addictive,
is manufactured from common ingredients that can be purchased in
stores and manufactured at home.

The California Department of Corrections will spend millions more
annually for emergency dental work in its prisons. The San Bernardino
County Sheriff's Department is spending $400,000 this year for one
full-time and two part-time dentists, plus a dental assistant.
Officials there say it still isn't enough to keep pace with the
patient volume.

The Riverside County Sheriff's Department will spend $225,000 this
year on a full-time dentist and dental assistant.

And throughout the penal systems, officials estimated about 80 percent
of their dental patients have a history of methamphetamine use.

William Shropshire, 35, is one of those inmates. He is taking
advantage of the nearly free dental service offered at the West Valley
Detention Center in Rancho Cucamonga. Inmates are charged a $3 co-pay,
the most allowed by state law, to have rotting teeth pulled.

"It's the cheapest dentist work I have ever had," Shropshire said with
a laugh, seconds before a dentist yanked out two of his teeth. He said
he broke one merely biting into a piece of toast.

"I once had a beautiful smile, but once you get on meth it just eats
your teeth up," Shropshire said.

In Bad Taste

According to dentists, methamphetamine -- with ingredients including
paint thinner, Freon and camp-stove fuel -- are not the sole cause of
tooth deterioration among drug users. Cocaine can affect people the
same way. The ingredients in methamphetamine, however, speed up the
process. Meth can shut down the body's ability to fight decay.

Imagine your mouth as the body of an octopus, said Dr. Rodney Turner,
an assistant professor of dental-education services at Loma Linda
University School of Dentistry who treats meth users at dental clinics
in San Bernardino County. The tentacles are the ways the body fights
infection through saliva, genetically strong teeth and good hygiene.

"When you take meth you are chopping off those arms of protection,"
Turner said. "In the end, it becomes catastrophic."

Dentists say the effects of meth abuse can vary with each user.
Smoking methamphetamine causes the most dental problems, although some
users can go years with only a slow weathering effect on the teeth.
Others notice a change after a few months.

They caution that methamphetamine can destroy a mouth by drying it
out, introducing chemicals that speed up gum disease, creating an urge
for sugary acids that eat away enamel, and producing an anxiety that
leads to teeth grinding.

Dentists say that methamphetamine can lead to such euphoria that daily
hygiene is not a priority.

"On meth, I didn't even care about showering, eating or sleeping,"
said Falls, who finally sobered up in the Los Angeles County Jail.

"Then, when I was off the drug, it was like I had glass teeth. I had
to be careful when I ate, because sometimes I would be swallowing
pieces of my teeth."

Turner said stories like Falls' are not unusual as he spends each year
rebuilding about 20 seriously damaged sets of teeth for about $14,000
a mouth. The work often includes implants, root canals, veneers and
treating gum disease. The cost fluctuates depending on how many teeth
are beyond repair. The procedure often takes several visits and is
mostly paid for at the clinics by money from federal grants.

John Cahill, of Riverside, used meth nearly 10 years ago and is now
facing a $4,000 dental bill. Half of his upper teeth are already gone.

"Needless to say, my grill isn't what it used to be," he
said.

Cahill, who works as a drug counselor in Riverside, said he ruined his
credit when he was on drugs. Now he can't borrow money for the dental
treatment. He must save part of his paycheck and hope his teeth hold
up.

"Everyday I wait to get my mouth fixed it gets more expensive," said
Cahill, whose vacation time will be spent in oral surgery. "In the
meantime I try to hide them. I don't want to look at my mouth, so why
should anyone else?"

Doctor's Choice

Meth mouth has been found in Southern California over the last two
decades but has gained more attention recently because it's spreading
to the nation's heartland, Turner said.

"It becomes a national problem when Midwest housewives begin smoking
the stuff," he said.

And as meth mouth spreads, dentists are increasingly faced with
ethical decisions.

Do they inform law enforcement officers of patients who use illegal
drugs? Or do they honor the doctor-patient privilege?

Published reports indicate some dentists have admitted to tipping off
parents or authorities to meth users.

Dr. Thomas Rogers, also an assistant professor of education services
at Loma Linda University, thinks those dentists should have their
licenses revoked.

"The relationship between a dentist and the patient is one of trust,"
Rogers said. "We took an oath to maintain that trust."

His colleague, Turner, said if he knows patients are using drugs he
will often ask them about it. He has set aside time to talk about the
effects of drugs and offer his patients ways to find counseling.

VOLATILE INGREDIENTS

Ingredients often used to make methamphetamine:

Ephedrine

Cold tablets

Rubbing alcohol

Ether - (starting fluid)

Benzene

Paint thinner

Freon

Acetone

Chloroform

Camp-stove fuel

Anhydrous ammonia

White gasoline

Phenylacetone

Rock, table or Epsom salt

Iodine crystals

Red phosphorous (matches, fireworks)

Red Devil Lye

Drain cleaner

Battery acid

Lithium from batteries

Diet aids

Iodine

Energy boosters

Source: Prairie View Prevention Services, Inc.

Public Problem

Officials at county jails and state prisons say more money is needed
to treat drug burdens such as meth mouth.

The California Department of Corrections is expected to spend $73.5
million on dental care in its prisons over the next year, up from
$56.5 million last year. The settlement of a lawsuit is factored into
most of that increase, but an additional $6.2 million is necessary to
keep up with dental treatment.

The Riverside County Sheriff's Department spends $225,000 for a full
time dentist to work on inmates from the Robert Presley Detention
Center in Riverside and the Southwest Detention Center in French
Valley, said Ray Smith, county spokesman.

In San Bernardino County jails, officials say a need still exists for
at least another part-time dentist, in addition to the $400,000
budgeted for dental care.

"There is such a high volume of people with tooth decay here that
realistically we would need 30 dentists to treat everyone," said Kathy
Wild, health-care administrator for the San Bernardino County
Sheriff's Department.

In July, Dr. Heike Olafsen, full-time dentist at West Valley Detention
Center, saw 750 patients. The vast majority of them, she said, were
losing teeth because of meth mouth.

In most cases she numbs the patient's mouth, pulls out the rotten
tooth and sends the inmates on their way. It can take as little as
five minutes to pull an infected tooth, Olafsen said.

"I don't ask the patients if they are using meth," she said in her
small brick office in the heart of the Rancho Cucamonga jail. "I ask
them for how long."

Olafsen once pulled 18 teeth from the mouth of a woman who was doing
meth. Another woman lost all of her teeth before the age of 50 because
of meth use.

Ryan Didur, 28, one of Olafsen's patients, said he used meth for eight
months. He noticed his mouth was often dry, his teeth chipped easily
and his gums felt as though they were "on fire." He said he finally
needed medicine to numb the pain.

Olafsen said she has heard worse stories. Some of her patients pour
battery acid on their teeth to ease the pain or try to extract their
own teeth without numbing the mouth.

As the dentist prepared to remove three of Didur's rotting teeth a few
weeks ago, Didur said he regretted using methamphetamine.

"I'm scared," he said. "I don't want to be one of those people who
have to gum their food. It's part of taking drugs you don't think
about. And it's something that sticks with you forever."
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