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.