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Drug Use and Your Oral Health

Drugs such as methamphetamine, cocaine, cannabis, ecstasy and opioids can harm teeth and gums, mostly through dry mouth, grinding and missed brushing. Practical ways to protect your mouth, why to tell your dentist, and where to get confidential help.

Updated September 2026·By the OHA editorial team·8 min read·How we write
Key takeaways
  • Many drugs cause a dry mouth, teeth grinding and cravings for sugary food and drinks, and make it easy to miss brushing. Together these can cause fast tooth decay and gum disease.
  • Methamphetamine ("ice" or "meth") can cause severe decay in a short time. Cocaine rubbed on the gums can cause ulcers.
  • Water instead of fizzy drinks, sugar-free gum, fluoride toothpaste twice a day and regular dental visits all help, whether or not you are ready to cut down.
  • Tell your dentist what you have taken, and when. Some drugs, especially cocaine, can react with the adrenaline in dental anaesthetic injections.
  • Free, confidential help is available in the UK, Australia and the US if you want it.

This guide is for anyone who uses drugs, has used them, or cares about someone who does. It sets out, without judgement, what health bodies say and how to reduce harm to your teeth. The Better Health Channel (Victoria) says regular drug use can cause significant tooth damage, and that your dentist can tell you whether a drug is likely to affect your teeth and what you can do.

How do drugs damage teeth and gums?

The Better Health Channel says it is a myth that drugs harm teeth only because they are acidic. Most harm, it says, comes from:

  • Dry mouth. Many drugs reduce saliva. Saliva neutralises the acids that cause decay, repairs early damage to enamel and washes food away, so a dry mouth significantly increases the risk of tooth decay. healthdirect Australia lists methamphetamine and marijuana (cannabis) use among the risk factors for dry mouth. See dry mouth.
  • Grinding and clenching (bruxism), which wears teeth down. See teeth grinding.
  • Missed brushing and dental care. The Better Health Channel says any drug use that leads a person to neglect hygiene, diet and dental care can significantly increase the risk of dental problems.
  • Frequent sugary or acidic drinks.

healthdirect Australia lists using drugs or alcohol among the things that raise the risk of a tooth abscess (a pocket of infection).

Effects of specific drugs

Methamphetamine (ice, meth, speed)

The Better Health Channel says methamphetamine causes severe tooth decay in a very short time, and that the damage is often called "meth mouth". It points to dry mouth, cravings for sugar, grinding and poor oral hygiene, and says heavy jaw clenching can make the face sore.

The American Dental Association (ADA) reports a US study of 571 people who used methamphetamine: 96% had tooth decay, 58% had untreated decay and 31% had six or more missing teeth. The ADA says the high can last up to 12 hours, which can mean long spells without cleaning, and that people often crave sugary fizzy drinks while high. It adds that the more methamphetamine people used, the worse their decay. The US National Institute on Drug Abuse (NIDA) lists tooth decay and tooth loss among the long-term effects of methamphetamine.

The ADA also links methamphetamine with jaw joint problems and trismus (difficulty opening the mouth), and says that people who smoke it do not have more dental disease than those who snort or inject it.

The sources put the emphasis differently. The ADA mentions that methamphetamine itself is acidic, alongside dry mouth and poor oral hygiene. The Better Health Channel says most harm comes from dry mouth, grinding, poor oral hygiene and sugary or acidic drinks, not the drug's acidity alone.

Cocaine

The Better Health Channel says:

  • rubbing cocaine on the gums can cause ulcers in the gums and the bone underneath
  • mixed with saliva, cocaine becomes very acidic and can wear away enamel, exposing the softer layer underneath (dentine) to decay
  • cocaine and crack cocaine cause a dry mouth, and cocaine increases grinding

Cannabis

The Better Health Channel says cannabis can cause a dry mouth and raise the risk of gum problems, and that cannabis smoke can increase the risk of mouth cancer. See gum disease and mouth cancer.

Ecstasy (MDMA)

The Better Health Channel lists teeth grinding, jaw clenching and dry mouth as side effects. The Australian Dental Association lists methamphetamine, MDMA and cocaine among drugs linked with grinding.

Heroin and other opioids

The Better Health Channel says people who use heroin tend to crave sweet foods, which can raise the risk of decay, and that heroin can cause a dry mouth and grinding.

Medicines used to treat opioid dependence need some care too, but keep taking them:

  • Methadone. UK government guidance from the Office for Health Improvement and Disparities says people taking regular liquid prescription medicines such as methadone should use sugar-free versions where possible.
  • Buprenorphine dissolved under the tongue or against the cheek. The US Food and Drug Administration (FDA) says dental problems, including decay, infections and tooth loss, have been reported. It says the benefits clearly outweigh the risks and not to stop suddenly. Once the medicine has dissolved, it advises swishing a large sip of water gently around your teeth and gums, swallowing, and waiting at least an hour before brushing, and seeing a dentist soon after starting.

For alcohol and tobacco, see alcohol and oral health and smoking, vaping and oral health.

How to protect your teeth

Whatever your situation, these steps from the Better Health Channel help prevent tooth and gum problems:

  • Drink fluoridated tap water instead of fizzy soft drinks, which are highly acidic.
  • Cut back on sweet or sticky foods such as biscuits and lollies (sweets).
  • Chew sugar-free gum to keep saliva flowing.
  • Brush gently at least twice a day with fluoride toothpaste, and floss once a day.
  • See a dentist once or twice a year if you can.

Your dentist can help too. The Better Health Channel says they may apply fluoride, suggest a fluoride mouthwash or higher-strength fluoride toothpaste, repair decay with fillings or crowns, and replace teeth that need to come out. It adds that stopping drug use helps prevent further damage, but existing damage often still needs treatment. See how to brush your teeth and replacing missing teeth.

Why tell your dentist?

The Better Health Channel says to tell your dentist about any drugs you are taking or have recently taken before treatment, for your safety:

  • Anaesthetic injections. Some dental anaesthetic injections contain adrenaline. The NHS Specialist Pharmacy Service, which advises dental teams, says adrenaline-containing anaesthetic should not be given for at least 24 hours after last using cocaine, because together they may raise the risk of high blood pressure, an irregular heartbeat and heart problems.
  • Sedation and pain relief. For people who use methamphetamine, the ADA advises dentists to take care with local anaesthetics containing a vasoconstrictor (a medicine such as adrenaline that narrows blood vessels), sedatives, general anaesthesia, nitrous oxide ("gas and air") and opioid painkillers.

Your information is protected (see the questions below), and the NHS says anyone with a drug problem is entitled to treatment in the same way as anyone else with a health problem.

Where to get confidential help

  • UK: the NHS says a GP is a good place to start, or you can contact your local drug service yourself. The Frank drugs helpline, 0300 123 6600, can talk you through your options.
  • Australia: the National Alcohol and Other Drug Hotline, 1800 250 015, is free and confidential, 24 hours a day (8.30am to 10pm from South Australia), and connects you to your state service.
  • US: SAMHSA's National Helpline, 1-800-662-HELP (4357), is free, confidential and open 24/7, and refers people to local treatment. It is free even if you have no insurance.
When to see a dentist
  • Your teeth have become sensitive, discoloured, chipped or broken, or you have holes in them.
  • Your mouth is dry most of the time.
  • You have mouth ulcers or sore gums, including where you have rubbed a drug.
  • Your jaw aches or you grind or clench your teeth.
  • You have started buprenorphine or methadone and have not had a dental check-up recently.
Get help urgently
  • Overdose: the NHS says call 999 or go to A&E if someone's life is at risk, for example they have taken an overdose. In Australia, healthdirect says call triple zero (000) and ask for an ambulance if someone is not breathing or is unresponsive. In the US, NIMH says call 911 in a life-threatening situation.
  • Facial swelling: the NHS says call 999 or go to A&E if you have a lot of swelling in your mouth, or find it hard to breathe, speak, swallow or open your mouth. See dental abscess.

Frequently asked questions

Can meth mouth be fixed?

Damaged teeth can be repaired or replaced. The Better Health Channel lists fillings, crowns, bridges, implants and dentures, and says stopping drug use helps prevent more damage. The ADA says badly affected teeth often cannot be saved and must be removed.

Should I stop my methadone or buprenorphine because of my teeth?

No. The FDA says not to stop buprenorphine suddenly without talking to your health professional. Ask about sugar-free methadone and see a dentist.

Will my dentist tell the police?

In the UK, the General Dental Council says dental professionals must protect your confidentiality and share information without your permission only in exceptional circumstances, such as a serious risk to someone's safety or to help prevent or detect a serious crime, or when a court or the law requires it. Your dentist needs to know what you take to treat you safely.

Sources

  1. Teeth and drug use, Better Health Channel (Victoria), accessed September 2026
  2. Meth mouth, American Dental Association (MouthHealthy), accessed September 2026
  3. Methamphetamine, American Dental Association, accessed September 2026
  4. What are the long-term effects of methamphetamine misuse?, NIH National Institute on Drug Abuse, accessed September 2026
  5. Teeth grinding, Australian Dental Association, accessed September 2026
  6. Dry mouth syndrome, healthdirect Australia, accessed September 2026
  7. Tooth abscess, healthdirect Australia, accessed September 2026
  8. Drug overdose, healthdirect Australia, accessed September 2026
  9. Adult oral health: applying All Our Health, GOV.UK, accessed September 2026
  10. FDA warns about dental problems with buprenorphine medicines dissolved in the mouth, US Food and Drug Administration, accessed September 2026
  11. Managing interactions with local anaesthetics in dentistry, NHS Specialist Pharmacy Service, accessed September 2026
  12. Maintain and protect patients' information, General Dental Council, accessed September 2026
  13. Drug addiction: getting help, NHS, accessed September 2026
  14. Where to get urgent help for mental health, NHS, accessed September 2026
  15. Dental abscess, NHS, accessed September 2026
  16. National Alcohol and Other Drug Hotline, Australian Government Department of Health, Disability and Ageing, accessed September 2026
  17. SAMHSA's National Helpline, Substance Abuse and Mental Health Services Administration, accessed September 2026
  18. Help for mental illnesses, NIH National Institute of Mental Health, accessed September 2026

This article is general information about oral health. It is not a diagnosis or a substitute for advice from a dentist or doctor who knows your situation. If you have pain, swelling, bleeding that does not settle, or a problem that is getting worse, see a dental professional. In an emergency, contact your local emergency service.

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