Abstract
BackgroundMethamphetamine, a highly addictive sympathomimetic stimulant, is currently widely abused worldwide and has been associated with devastating effects on oral health, resulting in the term “meth mouth”. However, “meth mouth” pathology is primarily based on case reports with a lack of systematic clinical evaluation. Therefore, we have conducted a systematic study to investigate (1) the pharmacological impact of methamphetamine on oral health with regard to saliva function, including the parameters saliva flow rate and total saliva production (ml/5 min) and the buffering capacity of saliva; (2) the contribution of the symptoms of bruxism and muscle trismus to potential oral health damage.MethodsWe assessed the data of 100 chronic methamphetamine abusers and 100 matched-pair comparison participants. Primarily, we conducted an anamnesis with all methamphetamine abusers with regard to saliva dysfunctions, jaw clenching and pain in the temporomandibular joint. Subsequently, in the first part of the clinical enquiry, we tested the saliva flow rate and the total saliva production (ml/5 min) by using the sialometry method and the buffer capacity of saliva by determining the pH-value. In the second part of the clinical enquiry, we evaluated bruxism symptoms with respect to generalized tooth attrition, dentine exposure and visible enamel cracks and examined a potential muscle trismus by measuring the maximal opening of the mouth.ResultsThe majority of methamphetamine abusers reported a dry mouth (72 %) and jaw clenching (68 %). Almost half of all methamphetamine abusers experienced pain in the temporomandibular joint (47 %). With regard to the clinical findings, methamphetamine abusers showed significantly lower total saliva production (ml/5 min) (p < 0.001), lower pH-values of their saliva (p < 0.001) and more bruxism symptoms (p < 0.001). However, we found no relevant trismus symptoms on comparing the two groups (p > 0.05).ConclusionsThe sympathomimetic effects of chronic methamphetamine abuse may lead to dry mouth and extensive bruxism and therefore can increase the risk for caries decay, periodontal lesions and tooth wear. Furthermore, a significant decline of saliva buffer capacity in methamphetamine abusers may trigger the risk for dental erosions. Methamphetamine abusers and practitioners should be aware of these symptoms.
Highlights
Methamphetamine, a highly addictive sympathomimetic stimulant, is currently widely abused worldwide and has been associated with devastating effects on oral health, resulting in the term “meth mouth”
In order to provide the study with adequate statistical power, a sample size calculation was performed for one of the main parameters of this study, namely ‘total saliva production’ (Table 2, Fig. 2), in consultation with the Institute for Medical Biometry, Epidemiology and Medical Informatics of Saarland University, as follows: a sample size of 100 in each group will have 80 % power to detect a difference in means of −1.0 assuming that the common standard deviation is 2.5 when a two group t-test is used with a 0.05 two-sided significance level
The observed power calculation for the results of “total saliva production” showed a 99 % power to detect a difference in means of −2.3 by using a two group Satterthwaite t-test with a 0.05 two-sided significance level
Summary
Methamphetamine, a highly addictive sympathomimetic stimulant, is currently widely abused worldwide and has been associated with devastating effects on oral health, resulting in the term “meth mouth”. Methamphetamine (MA) is a highly addictive stimulant substance with deep historical roots. The need for sleep and for assuaging hunger and thirst is reduced, whereas sexual desire and the flow of words are increased [1, 2]. These psychic and physical effects are brought about by the stimulation of receptors of noradrenalin and, in particular, of dopamine. MA prevents the reabsorption of dopamine into the synaptic vesicles and prolongs the effects of the substance in the synaptic cleft [1]
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