Recreational Drug Use and Your Oral Health

As we previously discussed, your full and complete medical history is a critical part of getting the best dental care possible. That includes substances you might be enjoying on weekends! Recreational drug use affects your oral health. It’s important to know what oral health risks you can expect when you indulge. We’re a judgement-free zone here at LBD, so if you ever have questions about what your recreational drug use might be doing to your teeth, never hesitate to ask!

Cavity Risk and Erosion

It may seem like many different things can damage your enamel to cause cavities and erosion. Starchy snacks, sugary treats, sweet drinks… But really it all just comes down to acid. Many drugs, prescription and recreational alike, can make your mouth more acidic. Most medications and drugs can cause dry mouth. Stimulants like MDMA and amphetamines frequently lead to dehydration and dryness. Marijuana is one of the best-known recreational drugs for this particular side effect. While it’s not a big deal to run a bit dry occasionally, chronic decreased salivary flow leads to more plaque buildup and tooth decay.

Some drugs are highly acidic in themselves. Coffee and energy drinks (yes, caffeine counts as a drug!) are highly acidic and frequently contain a lot of sugar as well. Sipping on that Monster or Starbucks cold brew for hours on end bathes your teeth in acid and can cause a lot of damage.

Patients who abuse alcohol may experience frequent decay and severe erosion. Part of this is due to the acidity of alcohol itself, as well as the acidic and sugary mixers that may be added to drinks. Compounding the damage is the reflux and vomiting that can accompany overuse of alcohol.

Many street drugs are so acidic they can eat away your teeth and cause severe damage in very little time. Methamphetamine is a prim example. Part of the process of cooking meth involves hydrochloric acid and the end product can be incredibly acidic as a result. However, because it’s unregulated there is no telling what each sample will look like. Cocaine is another street drug that can erode your enamel. Many users rub it on their gums. When cocaine mixes with saliva, it creates a very low pH environment that’s very destructive to teeth and other oral structures.

Sinus Perforation

Cocaine has another incredibly unpleasant potential side effect that can do serious damage to your oral health. It can kill the tissues of your sinus and eat away at the mucosa and bone underneath. Over time, it can create a hole in the roof of your mouth that connects directly into your sinus. Imagine trying to eat and drink with a hole that lets everything pass into your nasal sinus. This hole cannot heal on its own and requires surgery to correct.

This effect isn’t just limited to cocaine. Any snorted drug has the potential to cause similar types of damage. That includes heroine, meth, and more commonly crushed prescription drugs like oxycodone or Adderall. Snorted drugs can also cause necrosis (tissue death) of the soft palate and tissues in your throat, holes in the tissue that separates one nostril from the other, and a host of other tissue damage.

Oral Cancer Risk

Most of us are aware that tobacco increases your risk for oral cancer. That’s not just cigarettes, either! Cigars, while boasting a slightly lower risk for lung cancer, carry a much higher risk for oral cancers. Chew, dip, and vape all likewise carry oral cancer risks.

Did you know marijuana smoking can also lead to oral cancer? The risks are not as well studied as they are for tobacco. This has a lot to do with how difficult it is to get approval to study any recreational drug. However, with marijuana becoming legal in many states, and being used medically, we are starting to get a clearer picture of how marijuana affects oral health. Regular weed smoking comes with higher risks for oral cancers on the tongue, floor of the mouth, and throat area.

Alcohol can also cause oral cancer. Regular drinkers increase their risks for cancers of the throat, mouth, and esophagus, as well as elsewhere in the body.


We previously discussed how some prescription drugs such as anti-anxiety medications can cause grinding and clenching. Illicit drugs frequently cause much more intense uncontrollable grinding. MDMA, also known as ecstasy, is notorious for the aggressive grinding it can cause. Abuse of stimulants such as ADHD medications like Adderall likewise cause intense grinding and clenching.

Uncontrollable grinding leads to broken teeth, chips, cracks, fractures, and teeth getting worn down. The jaw joint can also suffer with chronic grinding or even acute bouts of intense grinding. Muscle spasms, swollen joint capsules, and even dislocations can result.

For patients who take prescriptions that cause them to grind and clench, we strongly recommend wearing a guard. Avoid over-the-counter mouth guards intended for protection when playing sports, however, as these can make the problem worse. Instead, talk to your dental team about creating a custom-crafted guard that’s properly balanced for your bite.

Gum Disease

Almost every recreational drug and many medications can potentially damage the health of your gums. Nicotine makes small blood vessels shrink, decreasing blood flow. In the gums, that blood vessel constriction chokes out the blood supply to the sensitive tissues supporting your teeth. Over time, the gums lose their integrity and strength, quickly turning gingivitis into periodontal disease. Left to progress, many smokers experience gum recession, a longer appearance to the teeth, loose teeth, and eventually missing teeth. Marijuana smoking has also been shown to cause or aggravate gum disease by a similar process.

As mentioned before, many users rub cocaine on their gums. This can cause blood vessels to shrink in a similar process to nicotine. However, cocaine is also highly abrasive and rubbing it on the gums can cause lesions and ulcers that don’t heal easily. These ulcers can become infected and lead to serious health problems.

Poor Home Care

Frequently, the gum disease and cavities associated with drug use aren’t directly caused by the drugs themselves. Patients who overuse substances frequently neglect their self-care routines. Their personal hygiene can suffer in the cycle of drug use and the exhaustion that follows. They tend to crash without flossing or brushing, allowing heavy plaque to build up and bacteria to flourish. Heavy users may also avoid maintaining their health with regular visits to their doctors or dentist.

We said it before, and we’ll say it again: Lake Baldwin Dental is a strict no judgement zone. You are always safe to fill us in on your habits, including recreational drug use of any kind. For us, it’s important information that we need so we can provide the best possible care for your health! We might give you a gentle nudge toward healthier habits, of course, but we will always respect your privacy. If it’s been a while since you’ve gotten your teeth checked out, there’s no time like the present to get caught up. Give us a call to schedule your next oral health exam. We’re here for you, Orlando!