How to manage methamphetamine-induced oral lesions?

From the Guidelines

Methamphetamine-induced oral lesions should be managed with a comprehensive approach that includes referral to addiction treatment services, daily oral hygiene with gentle brushing and flossing, and topical treatments for dry mouth and painful lesions. The management plan should prioritize the patient's overall health, focusing on reducing morbidity, mortality, and improving quality of life. According to the study by 1, a daily oral care plan is essential, which includes:

• Brushing with a small, ultra-soft-headed, rounded-end, bristle toothbrush and prescription strength fluoride toothpaste
• Flossing at least once daily with waxed floss to minimize trauma to the gingivae
• Rinsing the oral cavity vigorously with a bland rinse to maintain moisture and remove debris
• Moisturizing the oral cavity with water or artificial saliva products
• Lip care with animal or plant-based oils such as bees wax, cocoa butter, and lanolin Additionally, patients should be advised to:
• Remove dentures, plates, and prostheses before brushing and soak them in a rinsing solution
• Rinse toothbrush in hot water to soften the brush before using and allow to air dry after use
• Change toothbrush when bristles are not standing up straight
• Have follow-ups with their dentist at least every 6 months It is also crucial to address the underlying addiction and provide nutritional counseling to emphasize a balanced diet low in sugary foods and acidic beverages. Professional dental care should include regular cleanings, caries management, and potential restorative work to prevent further oral complications. By following this comprehensive approach, patients with methamphetamine-induced oral lesions can receive adequate management and improve their overall oral health and quality of life.

From the Research

Management of Methamphetamine-Induced Oral Lesions

Methamphetamine-induced oral lesions, also known as "meth mouth," can be challenging to manage due to the devastating effects of the drug on oral health. The key factors in managing these lesions include:

• Cessation of methamphetamine use, as continued abuse can hinder the patient's ability to improve nutrition and oral hygiene 2, 3
• Obtaining a thorough medical history and performing a careful oral examination to identify the extent of the oral lesions 2
• Restoring the dental appearance to help users regain their self-esteem and improve their oral health quality of life 4

Dental Management

Dental management of methamphetamine users requires:

• Simplifying treatment plans to minimize the duration of each visit 3
• Paying attention to postoperative care to prevent further complications 3
• Using local anesthetics with vasoconstrictors with caution due to the risk of cardiac dysrhythmias, myocardial infarction, and cerebrovascular accidents 2
• Referring patients to specialized substance addiction treatment centers for early management of drug addiction 4

Preventive Measures

Preventive measures for methamphetamine users include:

• Stimulating saliva flow to reduce the risk of caries and tooth wear 5
• Increasing fluoride supplementation to prevent tooth decay 5
• Avoiding carbohydrate-rich soft drinks and opting for water instead 5
• Using oral moisturizers to alleviate xerostomia 5