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Dental Health And Addiction: How Different Substances Affect Oral Wellness

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How Different Substances Affect Oral Wellness

It’s no secret that substance use and addiction lead to a variety of serious health conditions. Drug use stresses the body and mind and, in some cases, can permanently alter the way both work. But one area of health and wellness that often gets overlooked is that of your teeth and gums.

While oral health is not perceived to be as important as that of your heart or other major organs, the connection between dental disease, addiction, and other life-threatening health conditions is undeniable. Dental disease, especially when left untreated for long periods, can lead to a variety of other, more serious conditions.

  • Endocarditis, an infection of the heart’s inner lining, can occur when bacteria from your mouth spread through your bloodstream and attaches to your heart.
  • Research links cardiovascular disease, clogged arteries, and strokes to oral bacteria and the inflammation and infections it causes.
  • Periodontal disease can lead to premature birth and low birth weight.

According to the National Institutes of Health, dental health problems are “among the most prevalent health problems associated with drug addiction.” Drug users and addicts are more likely to suffer from dental diseases for a number of reasons, including lack of access to oral health services and a user’s tendency to neglect self-care. And the difficulty of addressing these particular factors means treatment is even more challenging.

From tobacco and alcohol to cocaine and meth, different types of legal and illegal drugs come with different consequences — direct and indirect — for your teeth and gums.


Depending on how you use cocaine, the effects of this drug on your overall dental health can vary widely. Snorting cocaine damages the tissue between your nose and the roof of your mouth. In time, this tissue can disintegrate completely. Cocaine users may end up with a hole in the roof of their mouth, which makes it difficult to eat or even talk.

When smoked, the acid in crack cocaine coats your teeth. Enamel, your teeth’ first and best line of protection, breaks down. Teeth with no enamel are more susceptible to decay, discoloration, and disease. Many users will also rub cocaine residue on their gums and teeth, a process that allows the drug to enter the bloodstream quickly. This practice can also cause sores inside the mouth. If left untreated, these sores can become infected.


Meth users are known for having stained, damaged, and missing teeth. The term “meth mouth” is commonly used to describe the oral health of the large percentage of people who suffer from cavities, tooth decay, and tooth loss as a result of their drug use.

Like cocaine, meth is an acidic drug that eats away at the protective enamel on your teeth. Methamphetamines also cause vomiting and acid reflux. These conditions expose the teeth to even more acidity. Furthermore, meth users crave sweet foods and drinks. Excess sugar feeds the bacteria and amps up damage from acid production even further.

Without enamel, teeth are already more susceptible to cavities and decay. This is especially true for the many individuals addicted to meth who do not regularly care for their teeth. Without regular brushing, flossing, and dental checkups, the natural process of remineralization that reverses daily damage does not occur.

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Many marijuana users tout the drug as “natural” and cite the drug’s medicinal uses as supporting evidence for their habit. But “pot” does have some negative side effects, especially for your mouth. First, smoke from the pot is similar in its chemical makeup to that of tobacco. Both are carcinogens, and both can cause cancer of the mouth.

Dry mouth, one of the most common side effects of smoking weed, is also one of the most harmful for your dental health. When you smoke pot, you produce less saliva. Saliva, which contains substances that naturally clean and remineralizes your teeth, is necessary for maintaining a healthy mouth.

In some cases, users who smoke pot often may develop cannabinoid hyperemesis syndrome.  Symptoms of this disorder include nausea and vomiting. Each time a user throws up, acid from the stomach ends up in the mouth. Over time, enamel degrades and teeth can decay.


Opiates like heroin and prescription pain medications cause oral complications similar to methamphetamine: discoloration, decay, broken and missing teeth, and gum disease. By making it difficult for a person to perform basic tasks like brushing and flossing, opioid use may also play a role in a user neglecting to care for his or her oral health.

Furthermore, because opioids are pain relievers, they may prevent a user from feeling the discomfort associated with common oral health complications. In turn, this may cause a user to ignore the issues for far longer than he or she would normally be able to. Without timely treatment, even easy-to-remedy complications such as cavities can end in tooth loss or infection.


Illicit substances are not the only type of drug that can harm your teeth, gums, and mouth. While completely legal to use, the harmful effects of tobacco products like cigarettes and chewing tobacco range from minor to severe.

Bad breath, stained teeth and tongue, and a lessened sense of taste and/or smell are everyday realities for many smokers. In long-term and heavy smokers, tobacco can cause gum disease or oral cancer. Smokers may also be slower to heal after dental surgeries like extractions.


Whether it’s beer, wine, or liquor, alcohol is another legal drug that can have detrimental effects on your dental health. Heavy drinkers, defined as women who drink more than 8 drinks per week or men who drink more than 15 drinks in the same period, are more likely to experience common problems like gum disease, tooth decay, and mouth sores than moderate drinkers.

Alcoholics may also have higher plaque levels on their teeth and are three times more likely to experience tooth loss. Additionally, alcohol use is the second most common risk factor for oral cancer.


Smoking, drinking, and snorting harmful substances are detrimental to a person’s overall health. Of course, the best way to counteract the negative consequences of drug use is to seek treatment and rehabilitation. Unfortunately, for many active users, the damage they are doing to their bodies is of less concern than how they will achieve the high they are constantly seeking.

In truth, even quitting can’t eliminate all of a drug user’s dental health concerns. Once set in action, enamel degradation, tooth loss, and cancer can be irreversible. But there are a few things that can be done to reduce oral health complications caused by drug use.

First, users must be educated on proper periodontal care and the connection between dental health and other disorders. Second, oral health must be incorporated into rehabilitation, maintenance, and harm reduction programs. The hope is that with proper education and increased access to care, drug users will experience fewer oral health issues. In theory, improved dental health will also lead to a reduction in related health concerns like cardiovascular disease.

However, due to the atypical lifestyle of a drug user, changing dental health habits is easier said than done. Frequent and/or heavy drug use commonly results in loss of time, lack of focus, and an inability to perform even the most basic activities.

Furthermore, addiction and substance use disorders commonly co-occur with mental, emotional, and behavioral disorders that can further contribute to a user’s difficulty in maintaining their dental health. In the end, it is up to the individual to make his or her dental health — and overall well-being — a priority.