Methamphetamine's newest victim is users' smiles

MARYVILLE, Mo. -- Jeffery Lotshaw flossed regularly. He brushed faithfully, sometimes four or five times in a day.

It seems incomprehensible today: Lotshaw's grin is toothless after watching his teeth break apart, tarnished with yellow and black.

"Before I started doing meth, I didn't have a cavity in my head," said 33-year-old Lotshaw, now imprisoned on drug charges at the state's Maryville Treatment Center.

As use of highly addictive methamphetamines grows throughout the country, it leaves behind a scar on an increasing number of users -- rotting, brittle teeth that seem to crumble from their mouths.

Methamphetamines can be made with a horrid mix of substances, including over-the-counter cold medicine, fertilizer, battery acid and hydrogen peroxide.

Together, the chemicals reduce a user's saliva, which neutralizes acids and physically clears food from the teeth, said Dr. Eric Curtis, an Arizona-based spokesman for the Academy of General Dentistry.

"When the saliva isn't flowing, the bacteria build up a lot faster," said Dr. Darrell Morton, an Atlanta dentist.

The problem is particularly noticeable among inmates, whose oral problems caused by meth have some prisons struggling to care for them.

"They're rotting teeth, missing teeth, rotting way into the gums," said Kathy Bachmeier, the head of medical services for North Dakota's prisons. "It's ugly."

Statistics on "meth mouth" -- as the condition has come to be known -- are nonexistent because addicts are sometimes reluctant to admit their drug use and because it is difficult to distinguish between damage done from bad dental hygiene and that caused by narcotics. But signs show it is on the rise around the country.

In Missouri, the head of the company in charge of dental care for inmates says he now sees teeth affected by meth nearly every day. In North Dakota, the number of days a dentist was serving inmates jumped from 50 in 2000 to 78 in 2004. And in Minnesota, the tab for dental care of inmates rose from $1.2 million five years ago to about $2 million last year.

"There are more and more urgent care needs, which pushes back routine care cleanings," said Nanette Schroeder, director of health services for Minnesota's Corrections Department. "They're seeing just worse mouths, generally. This is really an emerging problem."

Meth users also may neglect their teeth, try to douse their dry mouths with high-sugar drinks. The anxiety brought on by the addiction also prompts them to grind their teeth, which speeds decay.

But all this comes as a surprise to many users.

Damage beyond brushing

Bryan Rogers, another inmate at the Maryville facility, which is exclusively for convicts with drug problems, said he noticed other users' teeth were rotting, but he made sure to brush regularly.

"I was always thinking that's not going to happen to me because I keep brushing," he said.

Rogers, 30, has had three more teeth pulled since arriving at the prison in August; he's awaiting a dental plate. Lotshaw had his last 11 teeth removed since arriving, also in August; he's waiting for dentures.

In Missouri, such major dental work at state facilities is subcontracted by the company that handles inmates' medical care. The state currently pays $7.50 per day per prisoner for health care, regardless of what's needed, so no major cost increase has been incurred.

"My dentists always opt for the best treatment we could offer our patients, as we would in private practice," said Dr. Ernest Jackson, whose Jefferson City-based company is in charge of dental care for state prisons.

But that philosophy isn't necessarily at play everywhere.

Schroeder said there's a constant juggling act between constitutional obligations to inmates, costs, and the risk of lawsuits.

"Do we always think that it's fair to provide some services to our offender population that people on the outside might not get? Of course not," Schroeder said. "On the other hand, we have to balance that with the risk."

All of those considerations don't matter to those coping with the effects of their drug use.

Lotshaw still finds his tongue feeling around his mouth for the teeth that no longer are there. He's been clean more than five months, but there's no denying what to blame for his empty mouth.

"It reminds me a lot of my addiction," he said.