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