'METH MOUTH' BITES INTO PRISONS' DENTAL BUDGETS

Jon Baker, A Central Prison Inmate And Former Meth User, Has Lost Seven
Teeth.

RALEIGH -- Jon Baker is a 30-year-old man with a first-grader's smile.

Mouth closed, Baker could turn heads, with his broad, football-player
shoulders and a dirty-blond buzz cut. When he grins, as many gaps as teeth
line his upper gum. Black crevices nibble at the white edges of some of the
survivors.

Baker, an inmate at Central Prison, suffers from "meth mouth," a strange
dental condition found among methamphetamine addicts. The drug dries out
saliva, teeth's best defense against rotting. Those that don't fall out
must be yanked out.

"It's a bombed-out mouth," said Dr. Norman Grantham, a Johnston County
dentist who treats inmates at Central Prison's dental clinic. "You look
inside, and all you see are stubs and spaces."

Arrests of meth users are starting to have expensive repercussions for
dental care in North Carolina's prisons and some local jails. State
Department of Correction officials say it's only a matter of time before
the cost of treating prisoners with meth mouth blows their $6.5 million
annual dental budget.

In Sampson County, the Sheriff's Department has already overshot its
$15,000 dental budget treating about five meth mouths a month, said Capt.
Kemely Pickett, jail administrator.

In Western North Carolina's Watauga County, where Baker is from, Sheriff
Mark Shook hasn't done the math. But he said in the last year he has hauled
twice the usual number of prisoners to a dentist for treatment of meth
mouth. So far, meth mouth has not drained the dental budgets at jails in
the Triangle.

Methamphetamine, a toxic stimulant made in home labs from items commonly
found in medicine cabinets and garages, has ravaged some Western states
over the last decade. Now it is on the rise in North Carolina, where law
enforcement officers broke up 322 labs last year and expect to hit 500 to
700 this year.

The Department of Correction is getting ready. Dr. James Clare, assistant
dental chief for the department, plans a training session on meth mouth
next month for its 120-member dental staff. This spring, correction
officials also plan to start documenting signs of meth mouth among
prisoners entering the system.

Off meth but in pain

Baker got involved with meth a decade ago and now is awaiting trial on
charges of manufacturing the drug. Watauga County jailers shipped him to
Central Prison in January so he could get medical care for his diabetes.

His teeth began falling apart about three years ago, he said, when he
switched from snorting meth to smoking it. But it never hurt until he went
clean. Behind bars, Baker couldn't mask the pain by bingeing on the drug.

Dental experts have done little research to explain the process of tooth
decay in people who use meth. But dentists in the North Carolina prison
system have their theories.

Meth's base ingredient, cold medicine, dries out the mouth. So there's
little saliva to protect teeth enamel from acidic substances and bacteria,
Clare said. When users get high, they crave sugary, caffeinated sodas such
as Mountain Dew, which hasten tooth decay. Of course, users forget to brush
and floss when they binge.

Then there are grinding and gnashing; users are often anxious and paranoid.
That alone can destroy a healthy tooth, Clare said.

Meth's other ingredients -- chemicals such as brake cleaner and lithium
from batteries -- slow the flow of blood in the tooth, weakening the center.

"It's almost like it's attacking the tooth from within," Grantham said. "By
the time we see them, the tooth has pretty much collapsed."

A year or two of meth use looks like a lifetime of bad hygiene, Clare said.

Baker pushed his tongue against the gaps along his gum, ticking his fingers
as he counted the spaces. Seven teeth were missing, most of which had
fallen out in recent years when he bit into a sandwich or a slice of pizza.

Grantham pulled two this month, including a front tooth. The dentist
declared three others to be lost causes and will extract those soon.

Prisoners are constitutionally entitled to dental care, Clare said. So
Baker will get a denture or a partial appliance soon enough.

Losing three in a row or four teeth in an arch entitles inmates to some
sort of replacement. Inmates at the women's prison in Raleigh make the
dentures for prisoners as part of course work for a dental technicians program.

Back in Watauga County, Baker said, he could buy meth as easily as chewing
gum. Now he wishes he had reached for the gum instead.

"I'm not too happy about my appearance right now," he said. "A lot of women
will look the other way when I get out, I'm sure."