What Are the Short-Term and Long-Term Effects of Methamphetamine?
Methamphetamine also goes by some names colloquially such as ‘crank,’ ‘super ice,’ ‘crystal meth,’ ‘meth,’ ‘wash, and many more. These slang terms are used illegally in various forms during sales, including ‘LA glass,’ 'chicken feed,' 'trash,' and more. Methamphetamine (MA) is commonly administered through oral, and intranasal routes. Smoking of the drug is also common, while the injection form, that is, through the intravenous route, gives the user or substance abusers a temporary state of euphoria.
Methamphetamine products have both short-term as well as long-term effects on the user's body. Some of the short-term effects are hyperactive states, excessive talkativeness, teeth-grinding or bruxism, euphoria, insomnia, and others. Long-term effects are addiction, increased dependence on MA, immunomodulation, gradual weight loss, and the increased predisposition of individuals to a state of hypertension, cardiovascular events like stroke, skin lesions, anxiety, or psychosomatic disorders.
Methamphetamine upon intravenous administration reaches a high plasma concentration level quite rapidly. This is a false or induced state of euphoria in which the individual experiences a period of relaxation following this peak and feelings of confidence and assured well-being. This immediate sense of euphoria is what encourages many individuals to engage in the societal and individual state of substance abuse.
What Are the Oral Manifestations in Meth Mouth?
The oral manifestations of Methamphetamine are especially characterized by a higher incidence apart from the severity of dental caries that occurs, commonly referred to as ‘meth mouth’ in Methamphetamine users. Several oral issues may exist in regular users of MA such as periodontal diseases, tooth mobility, dry mouth or xerostomia, and tooth loss. Similar to early childhood caries (ECC), in MA users, meth mouth symptoms are linked to the occurrence of caries or cavitation involving the interproximal and facial surfaces of teeth, giving the individual's teeth crown a blackened or rotten appearance.
Methamphetamine use has also been linked to parafunctional habits of clenching, and bruxism that further contribute to severe tooth decay and demineralization of the tooth. It is a known fact that MA users tend to have poor oral hygiene as well as they would have a high intake of calorie-rich beverages (likely carbonated beverages) to maintain their high, which increases their likelihood of tooth decay, periodontal diseases, tooth mobility, and tooth loss.
What Are the Modes of Administration and Substance Abuse?
Administering MA in higher doses can not only make a person easily develop abuse-related issues, but the continued presence of MA in the system is extremely likely to aggravate or trigger pre-existing oral issues. A dry mouth and reduced salivary functions would result in the individual experiencing an altered or affected sense of taste. Oral pathology and oral medicine research specialists suggest that there would be a clear link or possibility of a dose-response relationship in participants who administer MA themselves.
These are the dangerous routes other than smoking which are the oral route, the intravenous, intranasal route, and snorting which makes them chronic substance abusers or create a clear state of addiction. Treating dental patients who are regular Methamphetamine users or substance abusers is a challenge to the dental surgeon because it is important to recognize the symptoms of a ‘meth mouth’ and also ask the patients about their substance or habit history.
What Is the Eliciting Habit History in MA Users?
Most MA users who attend their dental appointments or in dental clinics may not provide valid information about their habits. This is due to the fear that their case history or substance abuse would be reported to the police and also for concerns of being judged personally. This again brings focus onto the dentist's ability and training to recognize the clinical signs and symptoms of MA abuse in patients impacted. After obtaining the due information on the patient’s medical and dental history that they provide, dental surgeons should make other observations like the presence of possible skin lesions on the arm (that commonly indicate intravenous or illegal use of drugs systemically administered by themselves) or medical history or sudden fevers of unknown origin (that also imply substance abuse).
Patients affected may also be suffering from paranoid behaviors or select patterns, mood swings, and might be incompliant in the clinic. Apart from this behavior, any episodes of violence should be carefully assessed or enquired from the immediate family as they might also indicate addiction to the same.
What Are the Cautions to Be Taken for Dental Surgeons and Modified Treatment Strategies in MA Users?
Dental surgeons are instructed to always bear in mind the high risk of acquiring or contracting and transmitting blood-borne diseases - mainly HIV and hepatitis B and C infections. This is because the risk is increased manyfold in MA substance abusers. MA-induced high is mainly associated with a complete lack of inhibition or engagement in risky sexual acts. Hence, the healthcare provider or professional should follow the highest sterilization and disinfection protocols.
To ensure clear safety for dentists themselves, high MA users should receive treatment only six hours after the drug is taken. Also, dental treatment in the initial six hours after the drug is consumed would prove risky because the sympathomimetic effects are at an all-time high. This means the patient would be at an increased risk of developing myocardial ischemia or cardiac arrhythmias. After careful assessment of the MA user and obtaining consent from the physician, if dental treatment is needed, the dentist should ensure that local anesthetics are free from adrenalin or noradrenaline. This is because the dental anesthetic, comprising commonly of adrenaline, would have the potential to accelerate the sympathomimetic response to MA. Hence dental treatment in the hours after substance or MA consumption or abuse may even cause cerebrovascular accidents or myocardial infarction.
On the other hand, general anesthesia or sedation can cause sudden death in MA users because of the increased respiratory rate or tachypnea. Hence, general anesthesia is strongly contraindicated. Also, the dentist should arrange for a lung and heart resuscitation apparatus or an interdisciplinary management team, which is ideally advisable for the treatment of severe or chronic MA users because of their easy predisposition to cardiovascular events.
Conclusion
Methamphetamine substance abuse presents a major social and personal impediment to the users. It can lead to life-threatening sequelae when a user refrains from revealing their habit history. Dental surgeons should be trained to recognize behavioral and oral features of MA users while also refraining from treatment in the initial six hours of drug abuse. The term ‘meth mouth’ is mainly used to describe MA users who suffer from rampant tooth caries or decay, similar to the clinical features of early childhood caries (ECC). This is the reason why a dental surgeon should be able to recognize the use of MA in individuals and prevent further aggravation through proper counseling, oral hygiene instructions, restorative procedures, and periodontal strategies.
