Naidoo S, Smit D
Department of Community Dentistry, Faculty of Dentistry, University of the Western Cape, Tygerberg.
SADJ. 2011 Apr;66(3):124-7.
Methamphethamine (TIK) is a highly addictive drug that acts as a stimulant for the central nervous system. It increases wakefulness and physical activity and can cause cardiac dysrhythmias, hypertension, hallucinations and violent behavior. Dental patients abusing methamphetamine often present with poor oral hygiene, xerostomia, rampant caries ("meth mouth") and excessive tooth wear. Management of these conditions is often challenging. A 24-year-old Caucasian man presented with severe dental pain, halitosis and self-reported poor dental appearance. A comprehensive examination including his medical history, panoramic radiographs and extra- and intraoral examination revealed 19 carious and erosive lesions. He reported using methamphetamine for eleven years and had not experienced much caries prior to using the drug. The patient's medical and dental histories along with radiographic and clinical findings led to a diagnosis of "meth mouth." Although various dental treatment options were offered to the patient, he opted for extraction of the most painful teeth in the left lower madibular quadrant and has yet to return for further treatment. This literature review and clinical case description of the oral manifestations of "meth mouth" is intended to alert dental practitioners to recognize and manage patients who are abusing methamphetamines. They should also be aware that these patients are often unreliable at following prevention advice as well as keeping follow-up appointments.
甲基苯丙胺(摇头丸)是一种极易上瘾的药物,对中枢神经系统起刺激作用。它会增强清醒度和身体活动能力,并可能导致心律失常、高血压、幻觉及暴力行为。滥用甲基苯丙胺的牙科患者常伴有口腔卫生差、口干、猖獗龋(“冰毒嘴”)和牙齿过度磨损等问题。对这些情况的处理往往具有挑战性。一名24岁的白人男性因严重牙痛、口臭及自述牙齿外观不佳前来就诊。包括其病史、全景X线片以及口内和口外检查在内的全面检查发现了19处龋损和侵蚀性病变。他自述使用甲基苯丙胺已有11年,在使用该药物之前未患过太多龋齿。患者的病史及影像学和临床检查结果确诊为“冰毒嘴”。尽管为该患者提供了多种牙科治疗方案,但他选择拔除左下颌象限最疼痛的牙齿,且尚未回来接受进一步治疗。这篇关于“冰毒嘴”口腔表现的文献综述及临床病例描述旨在提醒牙科从业者识别并处理滥用甲基苯丙胺的患者。他们还应意识到,这些患者在遵循预防建议以及按时复诊方面往往不可靠。