The Effects of Drug and Alcohol Abuse on Oral Health
The negative impact that drugs and alcohol have on the body and mind are plentiful, but one that can often go overlooked is the effect that it has on our oral health.
Whether it’s the effect of alcohol on teeth, or what drugs can do to your oral health and gums, none of it is pretty. Find out here why both can be a detriment to your health and how you can solve this should you already be suffering the consequences.
Infographic: Drug and Alcohol Abuse Effects on Oral Health
The infographic below details some of the key effects drug and alcohol abuse has on oral health.
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Effects of Drugs on Teeth & Oral Health
There are various ways that substance abuse can impact the oral health of the user; while often people may think there are only negative effects on the body on the inside, with consistent use, you will likely begin to see the detriment drugs are doing to your teeth when you smile.
Some of these include, but are not limited to:
Tooth decay is a hugely common problem among drug users, and it is something that is caused by drugs such as methamphetamine, crack cocaine and more.
This is often due to the dry mouth effect drugs can have. Dry mouth is a result of reduced saliva production, and when this happens, there isn’t any saliva to neutralise the acid and wash away the bacteria that will build up in the mouth.
This repeated process will contribute to the deterioration of your teeth.
The effect of drugs on teeth and gums, when it comes to aesthetics in particular, is detrimental. Gum disease is not something to underestimate; if you get this, your gums become inflamed, bleed and eventually pull away from the teeth.
This leads to your teeth falling out, among other persistent oral issues that will impact the health of your mouth in the future.
Bruxism (Teeth Grinding)
Some drugs’ effects on teeth can hurt and be very uncomfortable, such as bruxism. This is the action of grinding your teeth, whether it is during drug use as a response to being ‘high’ or afterwards without being consciously aware that you’re doing it.
Whatever it is, this action can wear down the enamel and cause real pain and sensitivity.
Oral cancer is a scary thought, but one that should act as a huge deterrent to using drugs. While smoking and tobacco use is widely known for causing cancer, other substances being smoked can also be a big contributing factor.
Opioid Effects on Oral Health
The oral health of opioid users is similarly precarious. Among opioid dependents, 16% are totally edentulous by the age of 556. Opiate users often have an unhealthy periodontium, suffering from conditions like shallow pockets, calculus, deep pockets, and bleeding6.
Even among those maintaining good oral hygiene, all heroin injectors experience progressive dental caries7.
An alarming 45% of opioid users have poor masticatory performance, and the same proportion cannot smile, negatively affecting their social life8.
Nearly a third of opioid abusers have had six or more teeth removed9, and more than half resort to the use of illicit drugs as analgesics for toothache8.
Salivary hypofunction caused by opioids can lead to multiple complications, including xerostomia, burning mouth, taste impairment, eating difficulties, mucosal infections, and periodontal diseases7.
Additionally, opioids can cause a phenomenon known as ‘masked pain’, preventing users from detecting changes such as decay and periodontal disease10.
In conclusion, the oral health of opioid users is alarmingly compromised. Severe periodontal conditions and tooth loss are prevalent amongst opioid dependents.
Notably, even those with good oral hygiene cannot escape the progressive dental deterioration associated with these drugs.
The negative impacts on social interaction due to masticatory impairment and inability to smile further compound the issue.
Additionally, the opioids-induced salivary dysfunction and masking of pain delay the detection and treatment of dental diseases, thus escalating the oral health crisis in opioid users.
Cannabis Effects on Oral Health
Cannabis use is linked to several oral health problems, including bleeding after brushing or flossing (26% of users), tooth extraction (11% of users), bone loss around teeth (8% of users), and gum disease (7% of users)11.
Further, more than half of cannabis users report poor oral health12, and those who smoke cannabis are 19% more likely to develop periodontitis12 and 20% more likely to develop oropharyngeal carcinoma compared with non-smokers12.
Cannabis users often suffer from dry mouth after use13, and a majority of these users consume sweet foods and drinks, potentially exacerbating oral health issues13.
Pulpitis, a condition involving inflammation of the dental pulp, has been reported in 50% of cannabis users during periods of smoking7.
Alarmingly, cannabis users are at a 2.5 times higher risk of teeth loss than non-users13.
To conclude, cannabis use is associated with multiple adverse oral health outcomes. Not only does it induce gum bleeding and tooth extraction, but it also escalates the risk of bone loss and gum disease.
The high incidence of poor oral health amongst cannabis users, coupled with increased risks of periodontitis and oropharyngeal carcinoma amongst smokers, underlines the detrimental effects of cannabis.
Cocaine Effects on Oral Health
Cocaine can significantly damage oral health, particularly by enhancing the risk of HIV transmission due to oral trauma and ulcers7.
Indeed, cocaine users who smoke crack or inject drugs face a significantly higher risk of oral sores that may facilitate HIV transmission14.
More than half of cocaine users have one or more decayed teeth15.
The stimulating effects of cocaine can also lead to ‘coke jaw’, a condition characterised by erratic jaw movement. Additionally, users might experience oral palate perforation, dental erosion, bruxism, and gum disease caused by rubbing cocaine around the gum area7.
In summary, cocaine use significantly jeopardises oral health, increasing the risk of HIV transmission due to oral sores.
The higher prevalence of decayed teeth amongst cocaine users demonstrates the substantial oral health risk associated with this drug.
Cocaine-induced conditions such as ‘coke jaw’, oral palate perforation, dental erosion, bruxism, and gum disease underline the severe implications of cocaine use for oral health.
Methamphetamine Effects on Oral Health
Methamphetamine abuse has profound effects on oral health, leading to a condition commonly known as ‘meth mouth’, described by patients as having teeth that are “blackened, stained, rotting, crumbling or falling apart”16.
Studies have found that 78% of methamphetamine (MA) users have root caries in three or more teeth16.
Nearly half of MA users report painful aching in the mouth and avoidance of particular food items due to discomfort while eating16.
A high percentage of methamphetamine users also reported dry mouth (72%), jaw clenching (68%), and pain in the temporomandibular joint (47%)17. Almost all meth users have dental caries18, and on average, a meth user has five missing teeth18.
Regrettably, dental professionals often show negative attitudes and unwillingness to treat addicted dental patients7. This further exacerbates the issue, denying these individuals much-needed dental care.
Methamphetamine use has a severe impact on oral health, leading to the extensive deterioration commonly referred to as ‘meth mouth’.
The high prevalence of root caries in methamphetamine users, coupled with significant oral discomfort, illustrates the detrimental effect of this drug.
The frequent reports of dry mouth, jaw clenching, and temporomandibular joint pain underline the broad spectrum of oral health issues associated with methamphetamine use.
The almost universal occurrence of dental caries among methamphetamine users, and their increased tooth loss, emphasise the seriousness of the problem. Regrettably, the reluctance of dental professionals to treat patients with addictions further exacerbates the oral health crisis among methamphetamine users.
Alcohol Effect on Teeth & Oral Health
Whether it is alcohol breath or more serious oral health implications, there are some things that can’t be overlooked in terms of the effect of alcohol on teeth and overall oral health. That in mind, here are some things to consider if you’re struggling with alcohol abuse.
Similar to the effect drug use can have on the teeth, tooth decay can be a huge part of alcohol abuse due to the sugar content.
The sugar-alcohol effect on teeth is detrimental. The problem is that now, alcoholic drinks have become rather tasty, meaning there is a sugary and addictive aspect to keep drinking rather than some sort of deterrent.
Things like cocktails and spirits mixed with sugary drinks should always be limited or avoided. However, still, drinks such as beer and wine contain acids that have the capability to erode tooth enamel and decay the teeth.
If alcohol breath and tooth decay didn’t do it, the staining from drinking alcohol might tip you over the edge.
Another one of the many negative effects of drinking alcohol excessively is that some drinks, like red wine in particular and other dark-coloured drinks, can stain your teeth.
This makes for a less attractive smile, knocking your own self-confidence and losing another battle with alcoholism.
Alcohol Effects on Oral Health
Alcohol abuse poses significant risks to oral health, from tooth loss and periodontal disease to cancer. Studies have shown that those who abuse alcohol are three times more likely to suffer from permanent tooth loss compared to non-alcoholics1. Additionally, one-third of an alcoholic’s teeth are at risk of periodontal disease1.
The likelihood of mucosal lesions is also higher amongst alcoholics (31.5%) compared to non-alcoholics (25%)1. Further, alcohol abuse significantly increases the risk of oral and pharyngeal cancer1, being responsible for a high incidence of various cancers, including pharyngeal (43.3%), oral cavity (29.3%), and laryngeal (25.8%)2.
The correlation between alcohol abuse and cancer mortality is significant, with the highest rates observed in oral cavity (24%) and pharyngeal (24%) cancers2. Notably, 75% of upper aerodigestive tract cancers are associated with alcohol and tobacco use3.
Excessive alcohol consumption, defined as more than four drinks per day, can increase the risk of oral and pharyngeal cancer by five times4. Alcohol consumption also significantly contributes to facial injuries and dental trauma4. Indeed, oral cancer is six times more common in people who consume alcohol than those who do not5.
In conclusion, alcohol abuse significantly threatens oral health, increasing risks of tooth loss, periodontal disease, and cancer.
Alcoholics exhibit higher incidences of mucosal lesions and a substantial increase in risks for oral, pharyngeal, and laryngeal cancers.
Furthermore, the link between excessive alcohol consumption and facial injuries or dental trauma is concerning. Hence, the higher prevalence of oral cancer in alcohol consumers underscores the urgency of addressing alcohol abuse to improve oral health.
How to Combat The Effects of Drugs and Alcohol on Teeth
In order to deal with the effect of drugs on teeth and gums, as well as the impact alcohol has on your oral health too, you should practise and maintain optimal oral hygiene.
This means brushing at least twice a day and flossing too. While it may not be at the top of your priority list when you’re in active addiction, you can persist to make this a small step on the road to recovery, whether it be in rehab or out.
If you’re concerned about the type of drink that you are consuming often, reduce the sugary and acidic drinks that have the capability to erode your teeth.
However, when it comes to drugs, in order to combat the toll it is taking on your oral health, you first need to address the drug addiction. To do this, it is a good idea to consider out-patient or in-patient rehab.
This is going to address the drug addiction and or the alcohol addiction at its core to avoid future relapse. This is crucial; you will learn in rehab how to deal with things like abandoning your hygiene through the likes of group and CBT therapy.
Oral hygiene is just one branch of many negative health implications drug and alcohol abuse brings; however, by understanding them one by one, you’re more likely to recognise the signs that you require help.
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 Alcohol Consumption and Periodontal Disease: A Systematic Review and Meta-analysis, ncbi.nlm.nih.gov
 Alcohol Drinking and Cancer Risk: A Series of Meta-analyses, bmccancer.biomedcentral.com
 Alcohol, Tobacco and Cancer, pubmed.ncbi.nlm.nih.gov
 Alcohol and Oral Health, nature.com
 Oral Cancer and Alcohol, teeth.org.au
 Oral Health-related Quality of Life and Oral Health Status of People with Opioid Dependence, bmcoralhealth.biomedcentral.com
 The Effect of Heroin Use on Oral Health: A Review, ncbi.nlm.nih.gov
 Dental Status and Related Behaviours in a Sample of Italian Heroin Addicts, ncbi.nlm.nih.gov
 Dental Health of Habitual Drug Abusers, pubmed.ncbi.nlm.nih.gov
 How Opioid Use Affects Oral Health, ameritasinsight.com
 The Impact of Cannabis Use on Oral Health, jcda.ca
 Cannabis and Oral Health, nature.com
 Oral Health Implications of Smoking Cannabis, onlinelibrary.wiley.com
 Effects of Cannabis Use on Sedation Requirements for Endoscopic Procedures, pubmed.ncbi.nlm.nih.gov
 Cocaine Use Increases the Risk of Oral Sores and HIV Transmission, pubmed.ncbi.nlm.nih.gov
 Oral Health Status of Substance Abusers, scielo.br
 Oral Health Status of Methamphetamine Users, pubmed.ncbi.nlm.nih.gov
 Oral Health of Substance Users: A Study of Methamphetamine Users in Australia, bmcoralhealth.biomedcentral.com
 Effects of Methamphetamine on Oral Health, agapetc.com
John Gillen - Author - Last updated: July 20, 2023
John is one UK’s leading professionals in the addiction recovery industry. Pioneering new treatment techniques such as NAD+ and ongoing research into new therapy techniques such as systematic laser therapy, John is committed to providing the very best treatment for people throughout the UK and Europe. During his extremely busy schedule, John likes to regularly update our blog section with the latest news and trends in the industry to keep visitors to our site as well informed as possible on everything related to addiction treatment.
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