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Heroin Teeth: What Is It & Is It Dangerous?

Elena Hill, MD, MPH profile image
Medically Reviewed By Elena Hill, MD, MPH • Updated Apr 29, 2023 • 10 cited sources
close up young man broken teeth

The term heroin teeth is used to describe the physical appearance of a person’s teeth as a result of their long-term use of heroin. 

The condition is characterized by blackened, decaying, and/or missing teeth, which is often the result of neglect, malnutrition and poor oral hygiene during ongoing heroin use.[1] 

Heroin can cause several issues in oral health which will be discussed below. Having “heroin teeth” is a telltale sign of long-term heroin use. It is often associated with negative health effects. Learn more here. 

What Do ‘Heroin Teeth’ Look Like?

Heroin teeth typically appear blackened, decaying and missing. Other signs of the problem include the following:

  • Stained or yellowed teeth
  • Cracked or chipped teeth
  • Decay along the gum line
  • Loose or missing teeth
  • Abscesses or sores in the mouth
  • A buildup of plaque and tartar
  • Bad odors in the mouth

In addition to the poor oral hygiene habits and the wear and tear caused by exposure to heroin, heroin can also cause dry mouth and gum disease. [2]

Many people who use heroin also smoke cigarettes and marijuana.[3] Regular exposure to smoke can worsen dry mouth and exacerbate the other oral hygiene problems that go hand in hand with heroin use. 

As much as heroin teeth are a problem, their presence usually indicates more serious underlying health issues that should be addressed by a dental and/or medical professional. 

How Does Heroin Start to Decay Your Dental Health?

Heroin use can cause dental problems through a combination of physiological and behavioral factors, including: 

  • Decreased saliva production: Heroin use can lead to dehydration and decreased saliva production, which can result in a dry mouth. Saliva helps to neutralize the acids produced by bacteria in the mouth. With decreased saliva production, these acids accumulate, leading to tooth decay.
  • Malnutrition: Heroin use can lead to decreased food intake and malnutrition.[4] This can result in a lack of essential vitamins and minerals needed for good dental health, such as calcium and vitamin D. A diet that is deficient in these nutrients can result in weakened teeth and gums, increasing the risk of decay and gum disease.
  • Neglect: People who use heroin may neglect their dental hygiene, such as brushing and flossing, which can result in a buildup of plaque and tartar on the teeth. Over time, this can lead to tooth decay and gum disease.
  • Drug use: Heroin use itself can also have direct effects on the teeth and gums. The drug can cause the user to grind and/or clench their teeth, which damages the structure of the teeth. Plus, the chemicals in the drug can erode the enamel on the teeth. Together, both of these issues lead to rapid decay.

Which Dental Health Issues Are Caused by Heroin? 

Heroin use in any amount can cause a variety of dental issues, including:

  • Dry mouth: Heroin use decreases the amount of saliva produced in the mouth, which dries out the mouth. This allows bacteria to build up, causing a multitude of problems, including halitosis. 
  • Tooth decay: Due to the buildup bacteria, tooth decay is a common problem that results from the dry mouth caused by regular heroin use. 
  • Gum damage and disease: Heroin use often leads to malnutrition due to a lack of appetite, craving for sugar and a lack of focus on healthy eating. Compounded by the presence of bacteria, vitamin depletion can weaken the gums, making them more susceptible to gum damage and disease.
  • Oral infections: Thanks to a lack of hygiene and a buildup of bacteria as well as exposure to the toxins found in heroin, it is not uncommon for people living with heroin use disorders to experience infections in their mouths. Bacteria in the gums and mouth can reach the bloodstream which can cause more serious systemic infections, sepsis, and even death. 

Addressing the Underlying Opioid Use Disorder

Preventing dental complications is just one of the many reasons to seek treatment for OUD. 

One of the most well-researched and effective methods for treatment of an opioid use disorder is Medication for Addiction Treatment (MAT). MAT includes medications like Methadone, Suboxone and Naltrexone. 

Suboxone (buprenorphine/naloxone) is a medication FDA approved for OUD that helps to prevent withdrawal symptoms and cravings. Suboxone has repeatedly been shown to effectively manage opioid use disorder, increasing rates of retention in recovery and reducing instances of relapse.[10] 

To learn more about the medication options available to you or your loved one, call Bicycle Health today. We can help you put heroin use, and its many associated dangers, in the past.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More

  1. The Poor Oral Health Status of Former Heroin Users Treated With Methadone in a Chinese City. Medical Science Monitor April 2012. Accessed January 2023.
  2. Teeth and Drug Use. Better Health Channel. December 2021. Accessed January 2023.
  3. Oral Health of Drug Abusers: A Review of Health Effects and Care. Iranian Journal of Public Health. September 2013. Accessed January 2023.
  4. Nutritional Status and Eating Habits of People Who Use Drugs and/or Are Undergoing Treatment for Recovery: A Narrative Review. Nutritional Reviews June 2021. Accessed January 2023.
  5. Effect of Long-Term Addiction to Heroin on Oral Tissues. Journal of Public Health Dentistry Spring 1975. Accessed January 2023.
  6. Dental Caries and Periodontal Disease Among People Who Use Drugs: A Systematic Review and Meta-Analysis. BMC Oral Health February 2020. Accessed January 2023.
  7. Gum Disease and Heart Disease Link. Penn Medicine. May 2022. Accessed January 2023.
  8. Cardiovascular Complications of Recreational Drugs. BMJ September 2001. Accessed January 2023.
  9. Gum Disease and Heart Disease: The Common Thread. Harvard Health Publishing. February 2021. Accessed January 2023.
  10. Medication-Assisted Treatment for Opioid Use Disorder. National Academies Press. November 2018. Accessed January 2023.
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