As a dentist, I have seen many patients over the years who have abused heavy drugs. In many of those cases, their oral hygiene took a back seat to their addiction, and their teeth and gum tissue suffered as a result. Nearly all dentists have seen cases like this:
This patient suffered from narcotic addiction for many years. This led to extreme teeth decay as seen above.
The same patient as above.
I had a very long and candid conversation with this patient who opened up to me about his past. In addition to abusing prescription painkillers such as Vicodin, Lortab, and Percocet, he also admitted to sucking fentanyl patches. He said that he would feel the effects almost immediately upon putting the patches in his mouth.
On exam, the broken down, rotted teeth did not surprise me – I had seen that many times before. What was surprising were the linear lesions all across his palate (the roof of his mouth) as seen here:
Linear patches on his palate on one side only. This is where he used to suck the fentanyl patches. Clicking on the image will yield a larger, high resolution version.
I had never seen anything like this before over my entire career. Are these lesions scar tissue from the constant placement of fentanyl patches against the soft tissue in the mouth? It is hard to tell. I have shown these photos to several colleagues and no one has seen anything like this before.
Regardless of the origin, it is safe to say that chronic abuse of narcotic painkillers – consumed orally or by sucking on them – can have disastrous results for both the teeth and the soft tissue of the oral cavity.
Those pictures make my teeth hurt just by looking at them. I never would have thought of dental decay or tooth loss as a consequence of narcotic abuse. I have found another reason to be glad I’m me… unfortunately, it’s because I’m glad mine aren’t the teeth pictured.
Tooth decay and/or loss often occurs with narcotic abuse. It is not mentioned that often given all the other bad things that can occur from abuse (accidental overdose, Hepatitis C or B, HIV, etc.). But it can be devastating. The young man in those photos will be in dentures before his 40th birthday.
That’s sick. From someone who legitimately has been prescribed & managed by Stanford University Pain Management clinic I find these closet drug addicts offensive. Prescription drugs are not safe. Long term side effects are inevitable. Age and Gene’s play significant role in one’s oral hygiene. Also diet. People on long acting meds especially opiates tend to crave carbohydrates, caffeine. The amount of water needed to compensate for prescription drug dehydration play’s significant role. I fortunately kept up with xrays & pantographs. For me one prescribed med (patch) was the issue. It’s almost laughable to think of myself or reduce myself to an out of control maniac sucking on something made for skin. People avoid the dentist because its like buying a car or going to a plastic surgeon. Most dental plan’s are horrible. Spending limits. A luxury to have healthy teeth. I need two crown’s. My fillings are too large? The dentist suggest root canal? Yes a dead body part to rot under a fake tooth. Ridiculous. Other option nail metal into my jaw bone and attach yes, fake tooth. Had I not succumb to the let’s pull those healthy wisdom teeth. The body actually does have long term plan for us aging 50 yr olds. Shark’s have it made. So my ramble is the deductible. There goes my vacation.