Meth users' dental bills eating up taxpayer money

Rae's teeth throbbed with pain as the guards led him from his prison cell to a chair in the dental clinic at the Monroe Correctional Complex.

A short time later, seven of the convicted meth cook's teeth, left rotted and infected after years of abusing the homemade drug, were removed from his mouth.

"I knew I needed those teeth out or an infection would go to my brain and kill me," said Rae, who is no longer in prison and asked that his full name not be used for fear of losing his job as a welder. "I had no choice."

Similar scenes are being played out with alarming regularity in the state's prisons, where, officials say, inmate dental clinics are being overwhelmed by the damage wrought by methamphetamine.

Dr. Mike Morton, chief of the state Department of Corrections (DOC) dental services, estimates that of the state's nearly 17,000 prison inmates, more than 30 percent have severe tooth decay related to drug abuse, much of it due to meth use.

About $5 million of the DOC's $12 million annual inmate dental budget goes toward repairing or removing the teeth of these inmates.

State prison dentists are so overwhelmed repairing infected abscesses and removing blackened, jagged stumps that were once teeth from the mouths of meth addicts that they don't have time or money to handle nonemergency dental problems, Morton said.

Dental hygiene among drug users has generally been poor, but meth use, which rapidly speeds up tooth decay, has proved to be catastrophic, according to a UW dental professor. There's even a term to describe the drug's impact on oral health: "meth mouth."

"It just mows the teeth down. It's like a wildfire in a forest," said Dr. Bart Johnson, associate professor in the University of Washington's School of Dentistry. "It can ruin a beautiful mouth in a very short period of time."

Some have theorized that meth's damaging effect on teeth comes from the caustic products used to make the drug, which include lye, muriatic acid, acetone, red phosphorus, drain opener, driveway cleaner, paint thinner and pseudoephedrine. Users can inject, smoke, snort, eat or dilute it into liquid, according to a Snohomish County narcotics sergeant.

But Johnson says the damage is a result of the drug slowing down the salivary system of users, inhibiting the mouth's ability to neutralize bacterial acids.

"By revving themselves up they're getting their high and a lengthy adrenaline rush," Johnson said. "Their body is just shutting down their saliva."

Causes of damage

Users cause further damage by excessive teeth grinding, guzzling sugary sodas when coming down from a high and not brushing.

"If we could magically get their salivary flow back it would slow the [decay] process," Johnson said.

Dr. Mark Bogdan, a dentist at Airway Heights Corrections Center near Spokane, says his clinic sees up to 25 inmates each day, and he estimates about 35 percent of his patients have decay patterns that appear to be caused by meth.

Dentists have two choices when it comes to meth mouth: rebuild teeth with root canals and crowns, or pull them out. Johnson leans toward pulling teeth because unless the patient has completely kicked their drug habit, their teeth will continue to rot.

It's not unusual for prison dentists to remove all of the teeth from patients as young as 18, several Department of Corrections dentists said. Unless an offender is serving more than a year behind bars, he or she won't be considered to receive state-funded dentures, Morton said.

Johnson says meth mouth is often seen in emergency rooms, such as at UW Medical Center, but said it hasn't been studied carefully because of the difficulty getting addicts to show up for appointments.

In Albuquerque, N.M., dentist Stephen Wagner said he's in the midst of a two-year study on meth's impact on teeth.

"We don't have any conclusive results, but we're finding there might be hints to solve the problems," said Wagner, whose study is being done at the University of New Mexico. "Basically, if you clean your mouth you won't have the problems."

A 10-year meth user participating in the study has made Wagner question all previous indications that meth mouth stems from changes in the salivary system. Throughout her drug abuse, the woman has brushed, flossed and even used a football mouth guard to protect her teeth during the excessive grinding done while on a meth high, Wagner said.

Wagner said her decay patterns are no different from those of someone who never used the drug.

Beyond Washington, prisons and jails in other states have attributed similar problems to meth, although it's difficult to find a consensus on whether the drug is responsible for an unprecedented wave of poor dental health among inmates.

A spokeswoman for the Oregon Department of Corrections, for example, said "meth mouth is, at best, regarded as an anecdotal phenomenon."

"There have been no results published of scientific studies that document meth mouth," Perrin Damon wrote in an e-mail. "I cannot, with confidence, verify a correlation between our dental budget and a subset of our incarcerated population."

Wagner acknowledges some consider meth mouth to be a myth, but says, "It really is an entity that is poorly defined, but it is a big public-health dental issue."

Worse among females

Morton of the Washington state DOC says dental problems attributed to meth appear to be worse among female inmates.

Morton, previously chief dentist at the Washington Corrections Center for Women at Purdy, used to ask patients what drugs they had been using before they were sent to prison. About 40 percent of his patients said they were heavy meth users.

Many, particularly women, started using the drug as a way to lose weight, he said.

"I've always said methamphetamine is a woman's drug because when you use it you can clean house like crazy, you feel great, you lose weight and you can stay up all night having sex," said Jennie Lindberg, residential-services clinical manager at Evergreen Manor, a drug-treatment program in Everett. "It gives women all the things culturally we say women should be doing."

Shaye Dallas, who served time in the Purdy prison for forgery, possession of stolen property and theft, said her addiction to meth developed while her boyfriend was selling the drug.

"It was accessible," said Dallas, 21, who became a patient at Evergreen Manor after her prison release in January. "It's the high that keeps you up and makes you do crazy things."

Because she was addicted to the drug nearly four years, Dallas said, her molars "rotted out." She said her gums still hurt, and some teeth are loose and continue to rot.

When interviewed last month, Dallas had been clean of drugs for a month and a half.

The problem doesn't affect only prisons. Some jails, which generally hold people for less than a year, also have seen a spike in costs for dental care as a result of meth abuse.

Counties affected, too

Jim Harms, spokesman for the Snohomish County Jail, said about $46,000 of the jail's $52,000 annual dental budget goes toward emergency repairs for meth users' teeth.

Matias Valenzuela, a spokesman for Public Health — Seattle & King County, said meth mouth isn't a diagnosis, so his agency doesn't keep track of inmates being seen at the King County Jail dental clinic for the condition.

Before his January 2003 arrest for making meth, Rae, the former prison inmate, didn't give much thought to what the drug was doing to his mouth.

"I just kind of got high," he said. "I didn't think about anything happening to me because I had good teeth."

After his release from prison last year, Rae, 40, had an eighth tooth yanked because of meth damage. He expects to lose two more in the coming months.

Rae says he hasn't used the drug in more than three years.

"I lost everything I own as far as physical possessions. I can't believe I let something like that possess me," he said of his addiction to meth. "I'm glad it was only my teeth, not my life, that I lost."

Jennifer Sullivan: 206-464-8294 or jensullivan@seattletimes.com