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Updated on May 19, 2023
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Effects of Drug Addiction on Oral Health

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How Drug & Alcohol Addiction Impacts Your Oral Health

Drug addiction and abuse are global issues.

Drug abuse refers to those who take illegal or legal substances, such as alcohol, excessively or in the wrong way.

Users may suffer from the following:

  • Emotional issues
  • Psychological issues
  • Physical issues
  • Behavioral issues
  • Nutritional issues
  • Liver damage
  • Lungs damage
  • Heart damage
  • Brain damage

In addition, people who abuse drugs are more likely to develop serious oral health conditions.

Drug users can typically quit. They do not suffer from ‘codependency.’ Drug addiction, however, is when a person is physiologically and physically dependent on drugs.

Substances that can lead to poor oral health and general health outcomes 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 — inhaling cannabis through smoking or vaporization
  • Amphetamines — Benzedrine, Adderall, and Dexedrine
  • Abuse of prescription medications — sleeping pills, prescription opioids, amphetamines, ADHD medications, and morphine-based pain relievers
  • Illegal drugs — cocaine, ecstasy, molly, and other “party drugs.”

Oral Health Effects of Tobacco and Nicotine

Nicotine is a highly addictive chemical. It can be found in:

  • Cigarettes
  • Cigars
  • E-cigarettes
  • Chewing tobacco

Nicotine is also one of the leading causes of disease and death in the United States.

About 34 million adults in the United States smoke cigarettes. Additionally, over 16 million cigarette smokers suffer from smoking-related diseases.8

Further, about 1600 American teens under 18 years of age try their first cigarette every day. About 200 of them become regular cigarette smokers.9

Smoking also links to:

  • Heart diseases
  • Respiratory diseases
  • Lung cancer
  • Serious oral health conditions

The serious oral health conditions smoking links to include:

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.

Unremoved plaque turns into calculus, also known as tartar. Calculus is hardened plaque.

Tartar can only be removed professionally by a dentist. 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 is a less serious oral condition occurring when the mouth’s salivary glands do not produce enough saliva.

Tobacco and nicotine slow down how quickly the mouth makes saliva.

This can result in the following conditions, among others:

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

Bad Breath (Halitosis)

The following can lead to chronic bad breath:

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

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

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.

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

Tooth Discoloration

Smoking can stain teeth:

  • Brown
  • Yellow
  • Black

Stains can be removed by a dentist or with at-home whitening treatment. However, smoking makes discoloration more difficult to remove.

Changes in Blood Circulation

Smokers have "masked" or "silent" gum disease.

This is because nicotine reduces blood flow. This reduced blood flow results in less sensitive gums and minor bleeding.

Oral Health Effects of Alcohol

Chronic alcoholism is a highly progressive psychiatric illness. It leads to uncontrollable alcohol consumption.

Moderate alcohol use is defined as one drink a day for women and two drinks a day for men. Women who consume at least eight drinks a day and men who have at least 15 drinks per day are considered “heavy drinkers.” 3

Excessive consumption of alcohol negatively impacts the following:

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

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

  • Similar to tobacco, tooth stains 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. Sugary mixed drinks can also lead to cavities and erosion.
  • Alcohol causes dehydration. Dehydration can result in dry mouth and chapped lips. To prevent these conditions, it is essential to drink water while drinking alcohol to stay hydrated.
  • People addicted to alcohol are more likely to neglect oral care and have more plaque buildup than non-drinkers. Often, they are preoccupied with drinking. They may forget to brush their teeth and visit a dentist for regular teeth cleanings.
  • Drinking alcohol excessively doubles a person’s chance of developing bruxism. Bruxism is a condition that results in excessive teeth grinding.

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 cannot regrow.

Excessive, long-term alcohol consumption can lead to dental erosion.

Enamel erosion linked with alcohol abuse links to regular vomiting and regurgitation. 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 the pH levels of most wines are low.

Dental Caries & Gum Disease

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

Plaque is a sticky bacterial layer that triggers an inflammatory response in the gums.

If plaque isn’t removed completely, tartar (hardened plaque) and cavities develop over time. If the tartar spreads below the gum line, periodontal disease commonly forms.

If the disease is left untreated, permanent bone loss and possible tooth loss can occur.

Mouth Sores & 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

Oral Health Effects of Prescription Medications

Long-term addiction to certain drugs can result in serious oral health complications.

For example:

  • Natural opiates
  • Synthetic opiates
  • Amphetamines
  • Psychoactive drugs

For example, cavities and gum diseases are more common in users than in non-drug users. For example, periodontal disease.

This is because people who abuse drugs do not 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.

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

  • Plaque and tartar buildup. This buildup can result in cavities
  • Dry mouth and bad breath
  • Tooth discoloration and hard-to-remove stains
  • Gum diseases. For example, gingivitis and periodontal disease
  • Loss of blood flow to roots and gums. This condition is known as silent gum disease
  • Oral cancers. For example, 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 do not. However, bruxism can also result from long-term drug abuse or addiction.

Certain drugs that may cause teeth grinding include psychotropics (psychoactive drugs).

These stimulant drugs are chemical substances that change how the brain functions.

This results in:

  • Drastic mood
  • Behavioral and cognitive changes

Commonly prescribed psychoactive drugs include:

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

Nutritional Deficiencies, Unhealthy Diet & Poor Oral Care

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

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

Depending on the drug, some people stop eating altogether. This results in malnutrition.

All of these factors lead to poor dental health, including:

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

Commonly Abused Drugs and Medications

Many drugs have negative effects on an individual’s oral health.

For example, some commonly used drugs that harm the oral cavity include:


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:

Ecstasy or Molly

Ecstasy is an amphetamine, otherwise known as a psychoactive drug.

It alters bodily sensations and increases energy. It is an illegal substance that people take recreationally.

However, long-term use of ecstasy can lead to:

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


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

Addiction to this drug is directly linked with poor oral hygiene due to bad personal hygiene and long-term malnutrition.

The following are also common in heroin addicts:

  • Periodontal disease
  • Abnormally high levels of tooth decay
  • Dental trauma

Many users of this drug also clench or grind their teeth and experience tenderness in the jaw muscles.

Methamphetamine (Meth)

Chronic addiction to methamphetamine can result in “meth mouth,”.

This condition is characterized by:

  • Large cavities
  • Fractured teeth
  • 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

People addicted to meth typically lose teeth, especially if they do not receive treatment.


Cannabis, also known as marijuana, is a common medical and recreational drug.

Frequent cannabis users typically have poorer oral health than non-users.

They are more likely to develop:

  • Cavities
  • Periodontal diseases
  • Oral lesions
  • Dry mouth

Heavy marijuana use also causes greenish-brown stains on the teeth.

Certain Prescription Medications (Long-Term Abuse)

Long-term addiction or abuse of prescription medication can lead to serious oral conditions, such as:

  • Cavities
  • Gum diseases
  • 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 are suffering from nicotine, alcohol, or drug addiction, it is crucial to seek treatment.

In addition to finding an addiction treatment center and mental health facility, oral health treatment should also be a high priority.

If you are experiencing any issues related to dental health, visit a general dentist or dental specialist as soon as possible to explore your treatment options. For example, abnormal development of cavities, gum inflammation, sensitive teeth, or unexpected tooth loss.

Last updated on May 19, 2023
12 Sources Cited
Last updated on May 19, 2023
All NewMouth content is medically reviewed and fact-checked by a licensed dentist or orthodontist to ensure the information is factual, current, and relevant.

We have strict sourcing guidelines and only cite from current scientific research, such as scholarly articles, dentistry textbooks, government agencies, and medical journals. This also includes information provided by the American Dental Association (ADA), the American Association of Orthodontics (AAO), and the American Academy of Pediatrics (AAP).
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  4. “Current Cigarette Smoking Among Adults in the United States.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 4 Feb. 2019
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  8. Current Cigarette Smoking Among Adults in the United States, Centers for Disease Control and Prevention (CDC), December 2020
  9. Youth and Tobacco Use, Centers for Disease Control and Prevention (CDC), December 2020
  10. Jiang, Xiaoge et al. “Tobacco and oral squamous cell carcinoma: A review of carcinogenic pathways.” Tobacco induced diseases vol. 17 29. 12 Apr. 2019
  11. Alcohol and oral cancer, Drink Aware, November 2017
  12. Murali, R V et al. “Bruxism: Conceptual discussion and review.” Journal of pharmacy & bioallied sciences vol. 7,Suppl 1 : S265-70
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