Pubdate: Wed, 26 Jan 2005 Source: Kansas City Star (MO) Copyright: 2005 The Kansas City Star Contact: http://www.kcstar.com/ Details: http://www.mapinc.org/media/221 Author: Laura Bauer METH MOUTH' AMONG INMATES COSTS TEETH, TAXPAYERS Rodney Rogers remembers the pain. His teeth constantly ached, so severely at times he would dig into his gums with a needle hoping to sever the nerves and stop the pain. As he continued to pump methamphetamine into his veins, the pain got worse. Then his teeth began to change color and deteriorate. "They were getting real soft and brittle," Rogers said from the Lansing Correctional Facility in Kansas, where he is housed in a minimum security building. "Chunks were just flying off. My teeth were all jagged and rotten down to the gums." He had 'meth mouth,' a term that has become widely known in drug circles and is now making its way into private dentistry practices. Meth use has swelled in Kansas and Missouri the past decade, and users who commit crimes are filling prisons and county jails, catching many jail officials in the two states off-guard by the increase in costs associated with inmate dental care. The result? Taxpayers are being asked to foot ever-increasing bills. In Kansas, Crawford County Sheriff Sandy Horton said rising dental costs have been one factor in his request for a 6 percent to 8 percent budget increase for medical expenses in the past five years. "Once we learned what meth was and what it could do to you, we weren't surprised when they came in with it (decaying and rotten teeth)," Horton said. "But we weren't prepared in the budget for this. You can't be prepared for that." Corrections officials in Kansas and Missouri do not separate meth cases from other violations. They do not keep track of how much money goes toward treating meth-related teeth and gum problems, especially when there is no scientific way to diagnose meth mouth. But dentists working inside both systems say the number of cases they see has increased through the years. Ernest W. Jackson, director of dentist services for corrections in Missouri, estimates he sees one or two persons with meth mouth every day. An increasing number of inmates are on waiting lists for dentures. Others are left with chipped and broken teeth, or holes along the gum line where rotten teeth used to be. "They come in here and want us to fix all their teeth," said Capt. Kevin Blaukat, administrator for the Jasper County Jail in southwest Missouri. "They want the system to pay for all their dental work." Most counties cannot afford to do that. "Small counties are just not budgeted for major dental work," said Capt. Quirt Page, who oversees the Stone County Jail in Missouri. Contributing Factors Dentists who have treated meth mouth say they have seen it all -- severe tooth decay, gum disease, cracks in teeth and dry mouth. What causes the problems is the acid content in some of the ingredients used to make methamphetamine, including anhydrous ammonia, ether and lithium. The acid can decrease the strength of the enamel on the teeth. Also, because using meth causes a person to produce less saliva, the erosion of the enamel can be greater than normal. "The bacteria is not being swept or flushed away by the saliva," said Jackson. "That means more acid is getting to the enamel. It's a cascading effect. What you're left with is teeth with no enamel or not enough enamel." Meth users can have extreme levels of paranoia and nervousness, which are reactions to the drug. Because of that, many users may grind their teeth, which causes some of the weaker teeth to chip off or break. The contributors to meth mouth do not stop there. The fact that users often crave sugar-laden sodas and drinks, do not regularly floss or brush their teeth, or visit a dentist exacerbates the problem. "You can see they haven't been brushed in months, there's total lack of care all together," said Horton, the Crawford County sheriff. Not every meth user suffers a severe level of tooth decay. Jackson said it depended on the strength of the drug and the duration of its use. Daniel Johnson said he used meth for nearly 30 years, and by the time he saw any effects in his mouth he had dentures, which he got after several fights damaged his teeth. But the meth ravaged his gums. "They shrank," said Johnson, who is serving an eight-year voluntary manslaughter sentence at the Lansing Correctional Facility for a 2000 car crash that occurred as he was driving his wife to work while high on meth. She was killed in the crash. As his gums began to get infected, his typically tight-fitting dentures began to slip. Dentists in private practice across the nation -- especially in the Southwest and Midwest where meth is most prevalent -- have also been seeing the result of repeated meth use. Though users rarely get regular dental checkups, sometimes pain or family members can force them into the dental chair. Crash Course Dentist Eric Curtis, a spokesman for the Academy of General Dentistry, remembers a high school friend who brought her son to see him. The young man had been using crystal methamphetamine and his mother was concerned about his teeth. "She said, 'I want to make sure he doesn't have meth mouth,'," recalled Curtis, who has a practice in Arizona and has been seeing tooth problems from meth for several years. "I said, 'What is that?'" Since that day, Curtis has gotten a crash course. "It's something people tend to hide," Curtis said. "Patients almost never say, 'Yes, I'm a crystal meth user.'" He tries to assure clients he is not going to turn them in. He just wants to properly diagnose what is wrong in their mouths. "Dentists don't tend to be ministers or moralists," Curtis said. "We just want to take care of the problem." Rogers, the inmate, does not hesitate to explain why all of his teeth are gone. He wants people to realize the extent of what the drug can do. By the time he was 39, Rogers had his last group of teeth pulled while at the Greenwood County Jail in Eureka, Kan. All but one of his teeth were pulled while in county jails in Kansas for alcohol and drug violations. Today he is on a waiting list to get dentures. "You might tell people that when it comes to meth, it will meth your mouth up," said Rogers, flashing a toothless grin. - --- MAP posted-by: Beth