The abuse of methamphetamine - a powerful and highly addictive psychostimulant that is toxic to the nervous system - has reached epidemic proportions in many parts of the United States. The National Institute on Drug Abuse estimates that more than 10 million Americans have tried methamphetamine, while more than 1.4 million are habitual users.
Long-term use of the drug can lead to devastating medical, psychological and social consequences, including mood disturbances, violent behavior, an increased risk of contracting infectious diseases such as HIV/AIDS and hepatitis, and higher rates of crime, unemployment, and child abuse and neglect.
It can also result in a uniquely accelerated form of extensive dental disease known as "meth mouth."
Across all fronts, the economic cost of methamphetamine use in the U.S. reached a staggering $23.4 billion in 2005, according to the RAND Corp., but that doesn't even begin to account for the personal cost in the form of human pain and suffering.
So who should be on the front lines fighting the disease? Emergency room physicians? Law enforcement personnel? How about dentists?
While case reports and media attention surrounding the creation and abuse of methamphetamine abound, very little is known about the epidemiology of "meth mouth" or the underlying mechanisms that contribute to accelerated dental decay. Thus far, the lack of a knowledge base regarding the drug's oral health consequences has prevented dental professionals from recognizing the disease in its early stages and developing best practices for treating the condition.
However, new research supports the idea that dentists could be the key to identifying covert users - and getting them both the medical and dental treatment they sorely need.
The National Institutes of Health's National Institute on Drug Abuse has granted the UCLA School of Dentistry $1.86 million to study the oral and dental consequences of methamphetamine use.
Dr. Vivek Shetty, a professor of oral and maxillofacial surgery, is the principal investigator of the project. For the four-year study, he aims to build on his previous research, which provided the first systematic evidence of higher rates of oral disease among methamphetamine abusers.
In a paper published in the March 2010 issue of the Journal of the American Dental Association, Shetty and his co-authors reported that overt dental disease is a key distinguishing medical co-morbidity in methamphetamine users who otherwise present as generally healthy individuals, especially in the early stages of their drug abuse.
"Our finding that dental disease is a prominent marker of methamphetamine use creates opportunities to implement targeted interventions in the dental office - a hitherto unexploited setting in the management of this epidemic," Shetty said. "Funding from the National Institute on Drug Abuse will allow us to further characterize methamphetamine's oral disease burden so as to support dental professionals who, as oral health specialists, are in a unique position to detect the drug's use and participate as integral members of a collaborative care team tending to methamphetamine users."
"Methamphetamine use is a persistent and pernicious social problem. Dr. Shetty's research will address the 'meth mouth' issue with the scientific rigor that this public health issue deserves," said Dr. No-Hee Park, dean of the UCLA School of Dentistry. "Research projects such as this one underscore our school's commitment to improving the oral health of our communities and advancing clinical practice through scholarship."