Drug users succumb to rapid tooth decay, straining health care budgets in Georgia prisons
by CARLOS CAMPOS
The Atlanta Journal-Constitution
ATLANTA, Ga. — At a slender 6-foot-3, with close-cropped dark hair and penetrating green eyes, Preston Clark is a nice-looking young man.
But when he opens his mouth, a terrible, ugly side of Clark is exposed.
Most of his upper teeth are gone. The ones that remain are rotted, chipped nubs stained purple-gray. His gums and lower teeth also bear the ravages and terrible discolorations of runaway tooth decay.
Clark’s oral health problems are the result of methamphetamine use, a condition dentists have tagged “meth mouth.” Nowhere is the malady more evident than the dentist’s chairs inside the Georgia Department of Corrections --- a frequent stop for meth abusers who end up in the state prison system on drug possession and distribution, armed robbery, burglary, shoplifting, bad checks and violent crime convictions.
Treating meth mouth has increased dental costs in many states, straining health care budgets. Dental costs in Georgia have risen to $4.3 million, up from $3.4 million in 2002. Prison officials don’t know precisely how much of that increase is because of meth use, but they have no doubt the drug is taking a toll on inmates’ teeth.
Dr. William Batchelor, state dental director for the Georgia Department of Corrections, worries that meth mouth will further strain his already thin staff and budget.
The prison system estimates that as many as 300 people go to prison every month on meth-related charges, compared to about 50 people per month five years ago.
A combination of factors creates fertile ground for bacteria in the mouths of meth users.
Dentists say the ephedrine used to manufacture methamphetamine (also used in sinus medications) dries out a user’s salivary glands. Saliva helps wash away the germs that cause tooth decay. Some addicts drink sugary sodas to counteract cottonmouth. Other ingredients used in making meth --- lye, drain cleaner, battery acid --- eat away at the protective enamel that coats teeth, Batchelor said. Finally, drug addicts are usually not practicing proper oral hygiene.
“If you wanted to manufacture tooth decay, that’d be the way to do it,” said Batchelor.
Clark, a former carpet mill worker in Dalton, said he smoked meth just about every day for eight months. His teeth began chipping and breaking after he quit.
“It shocked me, really, that they were decaying as fast as they did,” said Clark, who is serving a two-year sentence for aggravated stalking.
Batchelor said he’s not surprised by stories of such rapid decay.
Clark said he didn’t know meth was the culprit until his sister told him about an article she’d read on the subject. The decay in his mouth is not painful, Clark said, though he has a hard time eating anything crispy like crackers or potato chips.
Dr. James Barron examined Clark’s teeth upon the inmate’s arrival recently at the Georgia Diagnostic and Classification Prison in Jackson, the first stop for many felons entering the state prison system. Barron noted that the problem is almost exclusive to white people, mostly men, though the incidence of females with meth mouth is on the rise.
Barron estimated it would cost anywhere from $10,000 to $14,000 to fix Clark’s mouth at a private dental practice using a combination of crowns, tooth restoration, partial plates or dentures.
Clark won’t get that kind of dental care in prison.
The prison system doesn’t pay for cosmetic dentistry. Most dental work is done only to relieve pain and suffering, officials said.
“We can’t rehab them like you can on the outside,” Barron said. Most patients will simply have their teeth pulled if problems progress beyond a cavity that can be filled.
As bad as Clark’s mouth looks, Barron says: “I’ve seen a whole lot worse.”
Prison inmates already have far more oral health problems than the average person, he said.
In September 2006, Batchelor studied the files of the 675 inmates that entered the prison system through Jackson that month. He said patients averaged 3.2 extractions and 3.6 restorations --- more than 4,500 dental procedures for just one month of new inmates. Some inmates need work on as many as 26 to 28 of their 32 teeth (including wisdom teeth).
“Private practice dentists rarely see someone with four or five teeth that need repair,” said Batchelor, who once had his own practice.
A January study of more than 21,000 inmates by the Department of Corrections found that 2,372 of them needed major dental work because of widespread tooth decay and gum disease. Of that number needing major work, 408 were identified as being in prison on “meth convictions” and having a drug problem. The study did not look at costs associated with treatment.
It doesn’t take a lot of detective work to spot meth mouth, Batchelor said. Many of the inmates come from North Georgia where the drug is popular --- Rome, Cartersville, Gainesville and Clark’s hometown of Dalton.
“You start asking questions and most of them will tell you,” Batchelor said.
Copyright 2007 Atlanta Journal Constitution