It’s no secret that drug use can have a negative impact on your overall health. But can a dentist tell if you do drugs? The answer is yes – drug use can cause a variety of dental problems that dentists can see, including tooth decay, bone decay, gum disease, and even oral cancer. In this article, we will discuss the effects of drug use on oral health, and how dentists can tell if you use drugs. Note this article excludes ways that dentists can tell if you are smoking, how dentists can tell if you’ve been vaping, and the oral health effects of using alcohol (these are covered in separate articles linked above).
How Can a Dentist Tell If You Do Drugs?
The way dentists can tell if you do drugs depends on the type of drug you use. It can also depend on the way that the drug is consumed, whether that’s orally (through the mouth), nasally (through the nose), or intravenously (through injection). We will break down drug use into the following main categories: opiates (including heroin and prescription painkillers), cannabis (aka marijuana), hallucinogens (such as LSD), cocaine- and amphetamine-type stimulants, and club drugs (like MDMA). Many of these symptoms can be signs of other dental or medical problems, so a dentist will have to use this information, information from patients, and other clinical signs to make a determination.
How Dentists Tell If You Do Opiates
Opiates are psychoactive substances that can be derived from the opium poppy. This includes morphine, heroin, and codeine. Opiates can be used for medical purposes to relieve pain, but they can also be abused for their psychoactive effects. The effects of opiates on oral health are well-documented and include:
- Tooth decay: Opiates can lead to tooth decay, especially on the buccal (cheek) and labial (lip) surfaces. In cases of prolonged use, this can lead to tooth loss and require tooth extractions.
- Low Saliva Production: Opiates can lead to a decrease in saliva production (xerostomia). The more common term for this is dry mouth. This can lead to a burning mouth, taste impairment, eating difficulties, and infection.
- Grinding Teeth: Opiates can lead to bruxism, which is grinding or clenching of the teeth.
- Mucosal Dysplasia: Opiates can lead to a change in the lining of the mouth, which can be a precursor to cancer. However, there is insufficient evidence to determine if this is a direct result of opiate abuse.
How Dentists Tell If You Do Cannabis
Cannabis is a psychoactive substance that can be derived from the cannabis plant. It is also known as marijuana, weed, pot, and many other names. Very recently, Cannabis has been legalized in some states in the U.S. for medicinal and recreational use. Cannabis can be consumed in a variety of ways, including smoking, vaping, eating, and drinking. A dentist can tell if you use cannabis by looking for:
- Discoloration of teeth: Cannabis smoking can cause yellowing or browning of the teeth. This is due to the tar in cannabis smoke, which can also lead to staining of the teeth.
- Low Saliva Production: Like opiates, cannabis, can lead to a decrease in saliva production (xerostomia).
- White Mouth Lesions: Cannabis use can lead to the development of white mouth lesions, also known as leukoplakia. These are benign growths that can develop on the mucous membranes in the mouth.
How Dentists Tell If You Do Hallucinogens
Hallucinogens are a category of psychoactive substances that can cause hallucinations. These drugs can be derived from plants or can be man-made. Common examples of hallucinogens include LSD, magic mushrooms, and mescaline. Common signs of use of hallucinogens include:
- Low Saliva Production: Like opiates, cannabis, can lead to a decrease in saliva production (xerostomia).
- Grinding Teeth: Hallucinogen use can lead to bruxism, which is grinding or clenching of the teeth.
- TMJ: Hallucinogen use can lead to TMJ, or temporomandibular joint disorder. This is a condition that causes pain in the jaw joint and can lead to clicking or popping sounds when moving the jaw.
- Oral Necrosis: Topical (direct to the mouth) use of hallucinogens can lead to oral-tissue necrosis, which is the death of tissue. This can also lead to mucosal fenestration, which is the development of holes in the mucous membranes.
How Dentists Tell If You Do Cocaine (And Other Stimulants)
Cocaine is a powerful stimulant that can be derived from the coca plant. Stimulants are psychoactive substances that can increase alertness, wakefulness, and energy. Other examples of stimulants include methamphetamine, Adderall, and Ritalin. The effects of cocaine on oral health are quite extensive (and covered in our “how cocaine affects gum and teeth” article). A summary of this article includes:
- Holes in the Roof of Your Mouth: Palatal perforations, or holes in the roof of your mouth, can be caused by cocaine use. This is caused by the cocaine eroding the roof of your mouth.
- Gingival Lesions (Gum Damage): Cocaine can cause gingival lesions, which are damage to the gum tissue. This can range from mild inflammation to ulcerations.
- Acidic Saliva: Stimulants can cause your saliva to become more acidic, which can lead to tooth decay. They also decrease the production of saliva, which can lead to dry mouth (xerostomia).
- Grinding Teeth: Stimulant use can lead to increased grinding or clenching of the teeth.
How Dentists Can Tell If You Do Club Drugs
Club drugs are a category of psychoactive substances that are commonly used in recreational settings. These drugs can cause a variety of effects, including hallucinations, increased energy, and euphoria. Common club drugs include MDMA, ketamine, GHB, and flunitrazepam. The effects of these drugs on oral health can include:
- Grinding Teeth: Club drug use can lead to bruxism, or grinding and clenching of the teeth.
- Ulcer Development: Club drugs can cause the development of ulcers in the mouth. These ulcers can be painful and can make it difficult to eat or drink.
What Will A Dentist Do If They Suspect You Do Drugs?
Although it is very easy for a dentist to tell if you do drugs, will they do anything about it? Knowing whether you do drugs or not is important to make an informed recommendation about dental treatments. Certain drugs can interact with local anesthetics, for example, which could make your treatment more painful than it has to be. If you are honest with your dentist about your drug use, they can work with you to ensure that you are getting the best possible care.
If you are open to discussion about the benefits of quitting drug use, they may be able to provide you with resources to help you quit.
However, the choice to do drugs or not is completely up to you. Dentists will always act as advisors and give you all the pros and cons of every action you take. From there, it is up to you to make the decision that you believe is best for yourself. A dentist will not judge you for your choice to do drugs, nor will they try to force you to stop. They also will respect your right to privacy and will not tell anyone else about your drug habits unless you give them permission to do so.
If you are under the age of 18 and don’t want dentists to tell your parents, a dentist will only tell parents if they believe that the child is not mature enough to provide consent (aka only if they believe the child is unable to make health decisions for themselves).
At the end of the day, dentist-patient relationships are built on trust. It is important to be honest with your dentist about your drug use habits so that they can best provide you with the dental care that you need and deserve.
Disclaimer
The contents of this website, such as text, graphics, images, and other material are for informational purposes only and are not intended to be substituted for professional medical advice, diagnosis, or treatment. Nothing on this website constitutes the practice of medicine, law or any other regulated profession.
No two mouths are the same, and each oral situation is unique. As such, it isn’t possible to give comprehensive advice or diagnose oral conditions based on articles alone. The best way to ensure you’re getting the best dental care possible is to visit a dentist in person for an examination and consultation.
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