In recent years, the UWC’s faculty of dentistry has noted an increase in young adult patients with severe rotting teeth at the Tygerberg Oral Health Centre.
Professor Sudeshni Naidoo said ordinarily caries or holes form in the fissures and pits of the teeth.
“Instead, these patients were presenting with caries on the smooth surfaces of the teeth leading eventually to total destruction of the tooth,” Naidoo said.
Methamphetamine or tik causes serious mouth and teeth problems commonly known as “meth mouth”.
It presents as extensive tooth decay and gum disease. Once it begins, it is virtually impossible to stop - and in many cases it leads to multiple tooth extractions.
The condition of meth mouth is vastly under-researched. Although studies of the effects of methamphetamine use on teeth exist in international literature, none has been conducted in a sample of any decent size.
Naidoo and Dirk Smit, a dentist at Tygerberg Hospital who is also a specialist in community dentistry, recruited a sample of more than 300 Cape Town patients between the ages of 21 and 29, making it the largest study of its kind.
“Some 98% of methamphetamine patients seen across the provinces come from this city,” Naidoo said.
Their study not only confirmed the harmful effects of tik use on oral health, but also highlights impediments to treatment.
“Patients usually come to the clinic because of pain,” Naidoo said.
“But by that stage, most of the teeth are already badly decayed and need extraction or several sessions to repair.
“And often once the pain is gone, the bigger problem is that patients simply don’t turn up for repeat appointments.”
The use of tik affects the actions of the salivary glands, inhibiting secretion and causing a dry mouth, or xerostomia. Saliva is the primary defence in fighting bad bacteria in the mouth and protecting the teeth.
Why tik has this effect is up for debate, Naidoo said.
One theory is that the drug causes a narrowing of the blood vessels in salivary glands, decreasing the flow of saliva, she said.
Others argue that the use of the drug affects those parts of the brain that control the salivary glands.
To counteract the very dry mouth, tik users often consume vast amounts of sugary, fizzy drinks, she said. And with no or very little protective saliva in the mouth, this creates the perfect acidic conditions for rapid wear and tooth decay by weakening enamel surface.
Tik users also often grind their teeth as a result of drug-induced hyperactivity, anxiety and nervousness. This causes accelerated tooth wear.
Addicts also lose interest in basic personal and dental hygiene. A tik “high” can last for days; users don’t bother brushing their teeth for extended periods causing plaque to accumulate and the bacteria to continue metabolising sugars into acids. The acidic environment often leads to erosion, and when mouth pH drops below critical levels, decay is the result.
“Education is key to the problem. Not only in communities, but also the education of other health care workers,” Naidoo said.