'METH MOUTH' COSTS COUNTY

Drug Wears Out Teeth, Budget For Dental Care

The cost for dental treatment for inmates in the Minnehaha County Jail has
nearly doubled during the past two years, due in part to a side effect of
methamphetamine abuse - a condition called meth mouth.

"Our dentist tells us as soon as they (inmates) open up their mouths, he is
able to recognize the rotting and brittle teeth, all symptoms of meth
mouth," Sheriff Mike Milstead said.

Many of the teeth become unsalvageable, said assistant sheriff Michelle
Boyd.In 2002, Minnehaha County paid $18,000 for dental treatment for
inmates. The cost grew to $32,000 in 2004, Milstead said. Dental costs are
a part of the overall medical budget.

"Correctional facilities across America, in particular in areas where
methamphetamine use is on the rise, are being hit with the financial
realities of meth abuse," he said.It's inflating the cost of locking up
meth addicts, according to law enforcement officials nationwide.

"The costs just go on and on," Wisconsin Attorney General Peggy
Lautenschlager said of meth's impact on prison budgets. "Dental costs alone
are skyrocketing."

In Coffee County, Tenn., Sheriff Steve Graves said meth-addicted inmates
are depleting the money he has budgeted for prisoners' tooth and gum
problems."It's not uncommon for us to take a vanload at a time to the
dentist," he said.

The additional financial burden comes at a time when many states are
struggling to balance their budgets and the federal government is cutting
back funding for local drug-fighting programs.The Bush administration,
which has recommended cutting money for local anti-meth programs, does not
have national figures on the drug's economic toll.

"We just don't track this data," said Jennifer DeVallance, a spokeswoman
for the Office of National Drug Control Policy.

Methamphetamine is the fastest-growing drug threat in the nation, according
to federal officials. As the meth epidemic has swept eastward from
California and the Pacific Northwest, it has created unique - and expensive
- - problems in a variety of areas.The South Dakota Department of Corrections
also is experiencing rising dental costs.

The number of inmates in prison rose from 2,781 in fiscal year 2002 to
3,059 in fiscal year 2004, according to the state DOC. During that same
time, the average per-inmate expenditure for dental care went from $238.69
to $239.36, an increase of 67 cents.In state fiscal year 2004, 22 percent
of male state prison inmates and 15 percent of female state prison inmates
had a primary diagnosis of amphetamine dependence, according to the DOC.

"When you think about the ingredients (anhydrous ammonia, phenyl acetone
and battery acid) that go into making meth, it's caustic," Milstead said.
"It's no wonder that these people's teeth are literally falling out of
their gums.

"And in my conversations with physicians, the devastating effects these
toxic chemicals have on teeth could be the tip of the iceberg on the
long-term effects on an abuser's general health."Meth use triggers a cycle
that aggravates base causes of problems in healthy mouths. Intentionally or
not, addicts frequently ingest large amounts of sugar because meth leaves a
cottonball feeling in the mouth.

"They're always drinking pop or sucking on hard candy" to stimulate
salivary glands, said Lonna Jones, a dental hygienist and supervisor for
the Sioux River Valley Community Dental Clinic. "They don't know that's
what they're trying to do, but that's why their bodies need them to do
it."Jones deals with the lingering effects of meth mouth after patients
have decided to clean up. At the downtown public health center, a
city/county partnership, Jones sees the tell-tale signs: excessive decay on
unlikely tooth surfaces.

"It's the facial surfaces, the part of the teeth you see when someone
smiles or talks during an interview to try to get a job," Jones said.

That's atypical for dental patients as a whole, who most often get cavities
in the pitted chewing surfaces of their molars. The anterior teeth, or
those at the front of the bite's arc, are less dense than those tough
molars and wear away more quickly.Six months of meth use may be enough to
cause irreparable damage, Jones said.

"The decay is much more serious with meth" than that found in those who
smoke cigarettes or use chewing tobacco, she said.And unlike the dental
problems that follow those addictions, meth mouth isn't confined to the
drug's user. It's a communicable disease.

"If you have a parent or other caregiver with rampant decay, and they kiss
their baby on the lips, they can pass it to the child," Jones said. "We
preach that all day long. Even if they won't stop or get help for
themselves, there's the hope that they'll do it for their children."

Widespread abuse has catapulted meth into the national spotlight as a
public health hazard. The community dental clinic opened in 2001, and Jones
said cases of meth mouth have steadily increased."It has a huge impact on
our entire way of living," she said. "Almost as soon as they start using,
they're unemployable. And that puts them on welfare."

Few patients deny previous meth habits."Most will say, 'Oh, yeah, I got
into it and it ruined my teeth,' " Jones said. By then, it's often too late
for any remedy other than extraction - a cost-effective way to permanently
relieve pain via the pinched Medicaid budget.

Those payments, which together with Medicare made up 36 percent of the
Community Health Clinic's revenue last year, don't cover more expensive
restoration or cosmetic therapies. A root canal might run $700 to $1,000,
with the crown to follow at another $600 or so.

"That's for just one tooth," Jones said, "and it's usually seven or eight"
that need care when meth mouth's involved.Milstead said his department will
have to consider the cost of meth mouth when it puts together its next budget.

"We're about to start our budget process with the county commission," he
said. "And like other line items in our budget, we'll need to sit down and
review our medical expenses knowing what kind of impact methamphetamines
are having on our inmates, and work to predict what our best estimate for
our medical expenses will be for 2006."