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Heroin Teeth: How Heroin Affects Your Oral and Dental Health

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Mar 12, 2024 • 9 cited sources

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 oral health issues, which can affect the rest of a person’s physical health. Having “heroin teeth” is one possible sign of chronic heroin use or heroin addiction, also known as opioid use disorder.

How Do You Treat Heroin Teeth?

Quick Answer

The best way to treat heroin teeth is to quit heroin misuse and receive proper dental care. Receiving dental care while continuing to use heroin won’t address the root of the issue. The good news is that you don’t need to try to quit on your own. Professional treatment options, such as medications for opioid use disorder (MOUD) and rehab are available.

Does Heroin Use Lead to Teeth Problems?

Yes, studies have linked heroin use to various teeth problems, such as decayed teeth, missing teeth, increased cavities and severe gum disease.[8] Heroin itself can damage gums and teeth, and its use fosters a lifestyle that doesn’t support dental health.   

What Do Heroin Teeth Look Like?

Heroin teeth typically appear blackened, decaying and missing. Other signs of the heroin mouth 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, the drug can also cause dry mouth and gum disease.[2] Gum disease can lead to a host of medical issues, such as heart disease.

Many people who use heroin often 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. 

Look for Signs of Dental Issues Early

The sooner you can address dental issues related to heroin use, the better the long-term prognosis. If you notice heroin teeth in someone you love, it can be a starting point to a larger conversation about substance misuse and addiction.

Here are some early signs of oral health issues related to heroin use:[8]

  • Chips in teeth
  • Overall tooth sensitivity
  • Significant stains
  • Jaw pain
  • Swollen gums
  • Headache or pain around the mouth

If you notice these signs, start a conversation. Don’t delay on getting help since the damage can compound, even becoming permanent.

How Does Heroin Damage Dental Health & Cause Tooth Decay?

Heroin use can cause dental problems through a combination of physiological and behavioral factors, including: [4,5]

  • 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. 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.
  • Poor hygiene: People who use heroin may also have poor overall hygiene, which can lead to infections and abscesses in the mouth, further worsening dental health.

Oral & Dental Problems Caused by Heroin Use

Heroin use in any amount can cause a variety of dental issues, including these:[6]

  • Halitosis: 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 of bacteria, tooth decay is a common problem that results from 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.
  • Tooth loss: People who use heroin may neglect their dental hygiene, allowing plaque and tartar to build up on the teeth, leading to tooth loss over time.
  • 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 opioid use disorders to experience infections in their mouths. Bacteria in the gums and mouth can reach the bloodstream. which can cause serious systemic infections, sepsis, and even death.

Bacteria in the gums and mouth can reach the bloodstream, which can cause systemic infections, sepsis and even death.

Treatment for Oral Health Issues

The first step in any treatment program is going to be stopping use of heroin. Even if dental and oral health problems are treated, they will simply recur if the underlying heroin misuse is not addressed. If the individual is not in active treatment or recovery, only emergency and palliative care should be administered.[9]

In conjunction with treatment for opioid use disorder (OUD) related to heroin use, these treatments can help to improve oral health:[

  • Regular screenings and cleanings: If someone has been using heroin regularly, it’s unlikely that they have been getting regular dental cleanings and exams. These visits can be vital in improving overall oral health and catching problems early.
  • Fluoride treatments: Fluoride strengthens teeth, making them more resistant to decay.
  • Fillings and crowns: If cavities are present, these should be properly cleaned and filled. In some cases, they may be so extensive that crowns are needed rather than fillings.
  • Extractions: If decay or damage is substantial, teeth may need to be pulled.
  • Bridges, dental implants or dentures: A significant amount of restorative dental work may be needed, depending on the extent of the damage caused by active heroin use.  
  • Antibiotics and lasers: Infections can be treated with antibiotics. Lasers might also be used to kill bacteria that is contributing to gum disease.

 Your dentist may need to consult other specialists, such as periodontists, depending on the extent of oral health issues. While teeth often cannot be fully restored to their natural state, there are many options for improving the function, structure and look of teeth and gums after damage from drug use.

How to Maintain Oral Health While Dealing With OUD

It can be incredibly tough to manage your oral health while attempting to stop misuse of opioids like heroin. Follow these steps:

  • Get help for your OUD. You won’t be able to effectively improve your oral health until you stop misusing opioids.
  • Brush daily. While the goal is to brush two times per day, aim for at least one if you are struggling with active addiction.
  • Drink water. Water flushes bacteria and debris from the mouth. Drink often, and swish water around your mouth occasionally.
  • Chew sugar-free gum. This can increase saliva production, which is beneficial to your mouth.
  • See a dentist. Whenever possible, try to maintain some regularity in seeing a dentist. These visits are key to maintaining overall oral health.

If you are seeking treatment for heroin misuse, talk to your treatment team about how to best address your dental problems.

Addressing the Underlying Opioid Use Disorder

Preventing dental complications is just one of the many reasons to seek treatment for opioid use disorder (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 and Suboxone. 

Suboxone (buprenorphine/naloxone) is an FDA-approved medication for OUD that helps to prevent withdrawal symptoms and cravings. Suboxone therapy has repeatedly been shown to effectively manage opioid use disorder, increasing rates of retention in recovery and reducing instances of relapse.[7] 

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.

Frequently Asked Questions About Heroin Dental Health

What drugs cause rapid tooth decay?

Many drugs in addition to heroin cause rapid tooth decay, including methamphetamine, amphetamines, cocaine, other opioids, ecstasy/MDMA, marijuana and tobacco.

How do heroin teeth affect physical health?

Your dental health greatly affects your physical health. Tooth decay and gum disease can cause many health problems, such as heart disease, high blood pressure, diabetes and stroke.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... 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. Medication-Assisted Treatment for Opioid Use Disorder. National Academies Press. November 2018. Accessed January 2023.
  8. Saini G, Prabhat K, Gupta N. Drug addiction and periodontal diseases. Journal of Indian Society of Periodontology. 2013;17(5):587.
  9. Cuberos M, Chatah EM, Baquerizo HZ, Weinstein G. Dental management of patients with substance use disorder. Clinical Dentistry Reviewed. 2020;4(1).

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