Effects of Drug Addiction on Oral Health

Drug addiction and abuse are global issues. Drug abuse refers to taking illegal or legal substances, such as alcohol, excessively or improperly. Some examples include binge drinking or taking drugs recreationally beyond their medical use.

Drug and alcohol addiction can lead to various health complications, including serious oral health problems. Unless you stop taking these substances and receive help for withdrawal, you’re at risk of staying in a cycle of deteriorating health.

In this article, we discuss the different effects of abusing nicotine, alcohol, and drugs and how each one affects your oral health.

What Are the Oral Health Effects of Tobacco and Nicotine?

Nicotine and tobacco, in particular, can have a drastic influence on your oral health. It’s a highly addictive chemical and one of the leading causes of disease and death in the U.S. It’s present in:

• Cigarettes
• Cigars
• E-cigarettes
• Chewing tobacco

About 34 million adults in the country smoke cigarettes, and over 16 million cigarette smokers suffer from smoking-related diseases.⁸ The serious oral health conditions smoking induces include the following:

Tooth Discoloration

Smoking can stain teeth brown, yellow, or black. A dentist or an at-home whitening treatment can remove these stains. However, continuing to smoke makes discoloration more challenging to remove.

Plaque and Calculus Buildup

Tobacco products contain chemicals that decrease saliva flow. If the mouth doesn’t produce enough saliva, plaque builds up faster and is harder to remove.

Plaque is a sticky bacterial layer that triggers an inflammatory response in the gums. Unremoved plaque turns into calculus (tartar), which is hardened plaque.

Only a dentist can remove tartar. Over time, unremoved plaque and tartar result in cavities and gum disease.

Dry Mouth (Xerostomia)

Similar to plaque buildup, smokers are more likely to develop dry mouth (xerostomia). It’s a less severe oral condition when the mouth’s salivary glands don’t produce enough saliva.

Tobacco and nicotine slow down how quickly the mouth makes saliva. This can result in the following conditions:

• Cavities
• Dental erosion
• Gum disease
• Mouth sores
• Thrush

Gum Disease

Smoking on its own doesn't result in gum disease. However, long-term smoking contributes to dry mouth. Dry mouth leads to increased plaque and calculus buildup, which can lead to gum disease.

Over time, gingivitis (reversible gum disease) or periodontal disease can form. It results in permanent bone loss and, eventually, tooth loss.

Bad Breath (Halitosis)

The following can lead to chronic bad breath:

• Smoking cigarettes
• Chewing tobacco frequently
• Using other tobacco products

There’s no single solution to treating halitosis. However, most people can cure it by changing their lifestyle and oral hygiene routines.

Oral Cancer

Tobacco is the leading cause of oral cancer in adults. About 90 percent of people with oral cancer use tobacco.¹⁰

This type of cancer can affect the following:

• Throat
• Tongue
• Mouth
• Lips
• Gums
• Cheeks

Changes in Blood Circulation

Smokers have "masked" or "silent" gum disease. Nicotine reduces blood flow, resulting in less sensitive gums and minor bleeding.

What Are the Dental Health Effects of Alcohol?

Drinking alcohol occasionally and moderately should have a minimal and temporary impact on your overall health. However, an unhealthy habit of drinking can compromise your health through short- and long-term effects.

Excessive consumption of alcohol negatively impacts the following:

• Teeth
• Oral cavity
• Oral mucosa (mucous membrane lining inside the mouth)

Excessive alcohol consumption can lead to various minor and long-term effects on your oral health.

Minor Oral Health Effects of Alcohol

Minor oral health conditions that may form due to long-term alcohol consumption include:

• Tooth stains — These are a common side effect of long-term alcohol use. For example, if you prefer mixing drinks with dark sodas or drinking red wine often, stains are more likely to develop. Drinking sugary mixed drinks can also lead to cavities and erosion
• Dehydration — Dehydration can result in dry mouth and chapped lips
• Poor oral hygiene — People addicted to alcohol are more likely to neglect oral care and have more plaque buildup than non-drinkers. They may forget to brush their teeth or miss dentist appointments for regular teeth cleanings
• High risk of bruxism — Bruxism is a condition that results in excessive teeth grinding

Long-Term Oral Health Effects of Alcohol Abuse and Addiction

More serious oral health conditions that can develop from long-term alcohol abuse and addiction include:

Dental Erosion

Dental erosion occurs when acidic substances wear away tooth enamel. The condition is irreversible because enamel can’t regrow.

Tooth enamel erosion can result from frequent vomiting and regurgitation caused by alcohol abuse. This is because stomach acid is very acidic.

Consuming acidic alcoholic drinks, such as wine, can also result in erosion over time. This is because most wines have low pH levels, making them acidic.

Dental Caries and Gum Disease

Poor oral hygiene is a common trait in alcoholics. In addition, alcohol’s drying effect can contribute to plaque formation.

If plaque remains, tartar and dental caries (cavities) develop over time. If the tartar spreads below the gum line, periodontal disease commonly forms. It can cause permanent tooth loss.

Mouth Sores and Oral Cancer

Heavy drinking is the second leading cause of oral cancer in adults. People who have at least four drinks a day are about five times more likely to develop mouth or throat cancer than those who never drink or drink moderately.¹¹

How Do Prescription Medications Affect Oral Health?

Long-term addiction to these drugs can result in serious oral health complications: 

• Natural opiates
• Synthetic opiates
• Amphetamines
• Psychoactive drugs

Cavities and gum diseases, such as periodontal disease, are more common in users than in non-drug users. This is because people who abuse drugs don’t visit dentists regularly (twice a year). Therefore, they have more plaque buildup on their teeth.

Some drugs, like cocaine, also weaken the immune system. This increases an addict’s risk of developing oral infections.

What Substances Affect Your Oral Health?

People who abuse drugs and similar harmful substances are more likely to develop serious oral health conditions. Some substances that can lead to poor oral health include:

• Tobacco — Cigarettes, chewing tobacco, and cigars
• Alcohol — Beer, wine, and hard liquor
• Natural opiates — Morphine, codeine, and thebaine
• Synthetic opiates — Hydromorphone, hydrocodone, oxycodone, and heroin
• Cannabis — Inhaled cannabis through smoking or vaporization
• Amphetamines — Benzedrine, Adderall, and Dexedrine
• Abuse of prescription drugs — Sleeping pills, prescription opioids, amphetamines, ADHD medications, and morphine-based pain relievers
• Illegal drugs — Cocaine, ecstasy, molly, and other “party drugs”

If you’re addicted to any of the substances above, you may need to consult an addiction specialist to help you stay sober. Otherwise, you will start experiencing the detrimental effects of these substances on your body.

What Are the Oral Health Consequences of Drug Addiction?

Similar to tobacco and nicotine, drug addiction can lead to:

• Plaque and tartar buildup leading to cavities
• Dry mouth and bad breath
• Tooth discoloration and hard-to-remove stains
• Gum diseases, such as gingivitis and periodontal disease
• Loss of blood flow to roots and gums or silent gum disease
• Oral cancers, such as cancerous ulcers affecting the mouth, throat, and surrounding areas

In addition, long-term drug addiction can cause:

Bruxism (Teeth Grinding)

Bruxism is the habit of grinding teeth while sleeping or throughout the day. It affects about 90 percent of the U.S. population.¹²

Some children outgrow the habit, while others don’t. Certain drugs that may cause teeth grinding include psychotropics (psychoactive drugs), including:

• Xanax
• Zoloft
• Celexa
• Prozac
• Ativan
• Lexapro
• Other antidepressants

Nutritional Deficiencies, Unhealthy Diet, and Poor Oral Care

Drug users are less likely to visit their doctor or take care of themselves generally. Once they’re dependent on a substance, they only care about getting more of that drug.

As a result, people who use drugs may not brush their teeth regularly. They also typically only eat inexpensive foods that are high in sugar.

Depending on the drug, some users stop eating altogether, resulting in malnutrition. All of these factors lead to poor dental health, including:

• Large cavities
• Gum diseases
• Dry mouth
• Possible tooth loss
• Other conditions

What are the Commonly Abused Drugs and Medications?

People can misuse drugs in several ways, from snorting to rubbing the substance on gums. The latter is performed because it allows faster drug absorption into the bloodstream.

While some drug addicts don’t directly apply drugs to their mouths, their oral health may still be affected regardless of the method of using the drug.

Some commonly used drugs that harm the oral cavity include:

Cocaine

Frequent cocaine users are more likely to develop oral infections because the drug has immunosuppressive effects. These effects weaken the immune system.

Cocaine users have a higher chance of developing:

• Cavities
• Gum diseases
• Gingival lesions
• Nasal damage
• Bruxism
• Temporomandibular joint dysfunction (TMD)

Ecstasy or Molly

Ecstasy is an amphetamine or a psychoactive drug. It alters bodily sensations and increases energy.

Long-term use of ecstasy can lead to:

• Dry mouth
• Cavities
• Dental erosion
• Bruxism
• Other mucosal changes

Heroin

Heroin is a synthetic and highly addictive opioid drug. It comes from morphine, a natural opiate.

Addiction to this drug causes poor oral hygiene due to malnutrition. The following are also common in those dependent on heroin:

• Periodontal disease
• Abnormally high levels of tooth decay
• Dental trauma
• Clenching or grinding teeth, resulting in tenderness in the jaw muscles

Methamphetamine (Meth)

Chronic addiction to methamphetamine can result in tooth loss and “meth mouth.” The latter involves large cavities, fractured teeth, and poor dental health.

Common signs of meth mouth include:

• Dry mouth
• Cracked teeth
• Lockjaw
• Periodontal diseases
• Cavities along the gum lines of the teeth
• Bruxism
• Rotting teeth
• Bad breath

Cannabis

Cannabis, or marijuana, is a common medical and recreational drug. Frequent cannabis users typically have poorer oral health than non-users.

Cannabis users are more likely to develop:

• Cavities
• Periodontal diseases
• Oral lesions
• Dry mouth
• Greenish-brown stains on the teeth

Certain Prescription Medications (Long-Term Abuse)

Long-term addiction or abuse of prescription medication can lead to severe oral conditions, such as cavities, gum diseases, and dry mouth.

Common drugs include:

• Adderall (ADHD medication)
• Sleeping pills
• Opioids
• Prescription-based pain relievers (such as morphine)

Finding Help for Your Addiction

If you or a loved one is suffering from nicotine, alcohol, or drug addiction, seek treatment immediately. In addition to finding an addiction treatment center and mental health facility, you should also address your oral health problems.

Visit a general dentist or dental specialist as soon as possible to explore your treatment options. They can help with abnormal development of cavities, gum inflammation, sensitive teeth, or unexpected tooth loss, among other symptoms.

Summary

Drug addiction can lead to detrimental effects on the body, including complications to oral health. The three most notable addictive substances that affect oral health are nicotine, alcohol, and drugs.

Addiction to these substances can lead to minor dental health issues such as dry mouth or tooth discoloration. However, these can progress to more severe illnesses, such as periodontal disease and oral cancer.

Drug dependence must be treated simultaneously with your oral health problems. Doing so can prevent your addiction symptoms and dental complications from worsening.