METH ABUSERS SINKING THEIR TEETH INTO JAIL'S DENTAL BUDGET

BACKGROUND: "Meth mouth" a condition which destroys the teeth and gums
of methamphetamine users is being increasingly diagnosed among inmates
at the Butte County Jail.

WHAT'S NEW: In recent years treatment procedures have switched from
extracting teeth to saving as many as possible but dental hours at the
jail have doubled recently and costs have increased
dramatically.

"Meth mouth" has taken a bite out of the Butte County Jail medical
budget. A big one.

Inmates with the condition, common among users of the manufactured
drug methamphetamine, are being diagnosed by dentist Larry Kyle at
nearly twice the rate of just a year ago.

The drug is known to cause users to constantly grind their teeth,
abandon brushing and consume large quantities of sugary drinks to
combat dry mouth.

Kyle said he sees two or three inmates a day with meth mouth in the
jail, where he visits two days a week. As a comparison, the dentist
said he spends two days a week at the Solano County Jail in Fairfield
and encounters only two or three inmates a month with the condition.

Last year the Butte Interagency Narcotics Task Force, just one of
several departments making drug busts in the county, arrested 298
people for methamphetamine.

Nearly all of them wound up in the jail and many of them wound up in
the dentist's chair.

"We've had to double our dental hours," said Linda Russell, an
administrator with Monterey-based California Forensic Medical Group,
which contracts with health care providers at Butte and 26 other
county lock-ups.

Where he could once handle the dental load in five hours, Kyle now
spends 10. And doubling the hours actually means more than double the
cost, since meth mouth sufferers usually require more procedures than
patients who've simply neglected their teeth.

Kyle has an assistant to help him with each procedure and inmate
medical visits require that a guard be present so the weekly staff
hours for dentistry in the jail has actually increased to 30.

Despite a grind which includes up to 15 patients in a single session,
Kyle said he gets a lot of gratification from treating jail inmates.
He's given up private practice altogether,

"We care about the welfare of the patients and try to make their time
in the chair as painless and positive as possible partly so they'll be
more likely to keep seeing a dentist when they get out of jail," Kyle
said.

About 80 percent of the inmates he sees never had regular dental care
and are generally afraid of dentists, Kyle said.

He admitted that he sometimes thinks of his jail practice as a
ministry that heals the soul as well as the teeth.

On Friday his rapport with a young female inmate bubbled to the
surface as he told her "You're going to have a beautiful smile again."

The pretty 19-year-old girl grinned widely, revealing teeth that had
been ravaged beyond description from just four years of smoking
methamphetamine and free-falling through the neglectful lifestyle it
promotes.

Between Kyle's probing of her crumbling teeth, the young woman said
her advice to anyone thinking about trying meth would be "don't."

She said she started at 15 at the insistence of her boyfriend, who
wanted her to share his addiction. She said her decision to try it was
also justified by claims that it could help her lose weight.

Prior to that, she had experimented with marijuana and smoked
cigarettes from the age of 9.

After just four months of smoking meth, the girl said she started to
notice her teeth turning bad. She stopped eating virtually altogether
and slept infrequently.

The Magalia resident said meth use was popular among a group of people
all older who hung out together on the ridge. She said she knew where
the drug was coming from, but never saw it being made and didn't know
what was in it.

She said detoxing from methamphetamine involved a lot of pain, a lot
of sleeping and trying to get back on a normal diet.

Dental work was started on the young woman last year during a previous
incarceration.

Just to relieve enough pain so she could handle solid food, Kyle
pulled seven teeth.

She left the jail on probation, but didn't continue dental work. Now
that she's back in, Kyle said enough work can be done before her next
release date to get her teeth on the road to recovery.

"You may not believe it from looking at them, but we can save the rest
of her teeth," he said.

Beyond the seven extractions already done, accomplishing that may
require nine root canals and up to 20 fillings far more work than the
inmate was motivated to seek on the outside.

Kyle said he can start the root canals in jail and stabilize the
teeth, but the process will have to be finished by a dentist equipped
to do it on the outside.

The young woman said she started high school on the ridge, but never
finished. She hopes to get her GED and eventually be reunited with her
husband the man who started her on methamphetamine and is currently in
state prison.

Kyle said virtually every inmate who seeks dental work in the jail
knows if they have meth mouth. And chances are they do if they spent
much time on the drug.

Smoking it seems to hasten the condition, because, when heated, meth
bathes the gums, teeth and throat in caustic vapors. But other forms
of use snorting it and injecting it provide no immunity from meth mouth.

That's because, experts say, its real causes are the lifestyle changes
addiction to the drug virtually assures.

Eating and sleeping regularly has little appeal. Brushing and flossing
is forgotten, or becomes too painful as deterioration begins.

According to the Meth Awareness and Prevention Project of South
Dakota, meth halts the production of saliva in the mouth. Without it,
acids from food, plaque and the digestive system aren't neutralized
and viciously attack the teeth.

Holes and weak spots begin to appear in the teeth, then an enveloping
decay begins, eventually causing teeth to crack and crumble.

Two meth side effects accelerate the process. One is an anxious
feeling which causes users to grind their teeth almost constantly.

"Some people say it feels like their teeth are itching," Kyle
said.

The other is an overwhelming desire for carbonated sugary drinks to
combat the cottonmouth effect.

Among hundreds of street names for meth and crystal meth, Russell said
one she's heard is "doing the Dew."

Kyle said methamphetamine use causes other health problems, as well,
but jail officials said meth mouth has accounted for a huge increase
in the number of "sick slips" requested by inmates.

Kyle said the standard treatment for meth mouth a few years back was
to pull the teeth and fit the inmate for dentures and patients still
expect that to happen. "Our approach now is to save as many of the
teeth as possible," Kyle said.

Inmates are surprisingly cooperative in the chair, the dentist said.
"By the time they get to us, they're hurting, and they know we're just
trying to help."