Drug abuse can affect patients in many different ways as each drug affects the body differently. It is important, however, to identify drug abuse as the cause of pathologies or abnormalities in patients to ensure appropriate treatment and help is provided for their oral, mental and general health. Common ways drug abuse damages the mouth include a decreased saliva production, acid reflux, decreased blood flow to the gums, grinding teeth, ulcers or sores in the mouth, and a lack of oral hygiene.

One of the most commonly used drugs is alcohol which, while legal, is very damaging and addictive. Binge drinking or regular drinking can be very damaging to someones teeth and general health, especially over long periods of time. Alcohol damages the teeth because it is very acidic and is often very sugary, therefore lowering the pH in the mouth causing tooth erosion. Some alcoholic drinks such as red wine also cause staining on the teeth if drunk in excess. 

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Another very common drug is tobacco which is smoked by a large portion of the population. Because it is addictive it is often used over many years as people find it so difficult to quit the habit. This again, affects many aspects of a patients health but in particular is very bad for the respiratory tract. Smoking also significantly increases the chances of developing cancer, particularly lung, throat and oral cancer. In the mouth, smoking can commonly cause a dry mouth, periodontal disease, staining and tooth loss.

Cocaine is often inhaled through the nose, and as it is acidic can wear away the septum of the nose and create a hole on the hard palate through to the nose in extreme cases. It can also be rubbed on the gums which can cause various problems from gingivitis to tooth loss and serious infections. Many other drugs can be taken by this “gumming” method and cause similar problems.

Amphetamines such as ecstasy and MDMA often causes users to grind their teeth and chew their gums and lips. which if used repeatedly can do damage to the soft tissue, break the teeth and possibly damage the temporomandibular joint. 

Methamphetamine is known to very quickly damage the teeth and can be taken by smoking, inhaling (snorting), injecting or ingesting it. This drug causes the blood vessels of the gingiva to shrivel and die, subsequently damaging the hard and soft tissues of the mouth. People who are addicted to very strong drugs such as meth may neglect their gums if they are under the influence of drugs the majority of the time and do not consider oral hygiene a priority.

It is important to consider drug abuse when prescribing drugs to patients, as patients could become addicted to strong drugs or their prescription could restart an addiction that they previously had and managed stop. This can generally be avoided by ensuring the correct dose is prescribed and strong drugs are only prescribed to those who require it, and do not have a history of drug abuse.

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