Carle Jasmin (Image : Meta AI / Gay Globe)
There is a little-known phenomenon among the general public that unfortunately causes serious problems for street drug users: tooth loss, as well as the resulting oral and dietary issues.
Who has never crossed paths with or spoken to someone who regularly uses hard drugs and is missing several teeth — or sometimes has lost them all? This phenomenon is, unfortunately, a direct consequence of using these substances and represents a major oral health problem for users.
The drugs most often involved in this type of deterioration are hard drugs, commonly found on the street, such as: heroin, cocaine (including powdered cocaine), crack, methamphetamine (meth), fentanyl and its analogues, carfentanil, MDMA (ecstasy), PCP (phencyclidine), ketamine, and synthetic cannabinoids (often sold under the names K2/Spice).
A Recent Eye-Opening Example on Addiction and Oral Health
Two years ago, the editor of Gay Globe, who frequents the Montreal Gay Village almost daily, found himself in a situation as absurd as it was enlightening.
“I was leaving the bakery La Mie Matinale, located between De Champlain and Papineau streets in the Village, with my two fresh baguettes as usual, when a young woman in very poor condition — clearly a user of the hard drugs mentioned above — politely asked if I could give her something to eat, as she hadn’t had anything to eat for 24 hours,” recalls Roger-Luc, who did not expect the reaction that followed.
“Of course, I had two baguettes in my hands. I couldn’t just tell her I had nothing — I’m not that kind of person — and since she asked so kindly, I handed her one baguette, wishing her a good day despite everything.”
But barely had he turned to head to his vehicle when, unexpectedly, Roger-Luc was struck violently on the back of the head with the baguette, like a baseball bat. Pain and shock. He turned around, stunned, to ask the young woman what was happening.
“She was furious. The baguette was broken in two, and she was yelling at the top of her lungs for me to look closely: she had no teeth left — as she herself said — and she would never be able to eat a baguette! Then she started insulting me, calling me the names of several saints from the Bible,” Roger-Luc now recalls with humor.
How Hard Drugs Cause Tooth Loss
Certain hard drugs cause tooth loss through a combination of biological and behavioral factors. First, several substances dry out the mouth by reducing saliva production, which promotes bacterial growth and the formation of cavities. The acidity of some street drugs, or the smoke inhaled, directly attacks tooth enamel and weakens the gums.
Additionally, vasoconstrictive effects reduce blood flow to the gums, decreasing oxygen and nutrient supply, thereby accelerating tissue necrosis. Neglect of oral hygiene, malnutrition, teeth grinding due to anxiety, and compulsive behaviors amplify the damage. Altogether, these mechanisms often lead to progressive tooth loss and severe oral health problems among users.
Is Prevention Possible Against This Scourge?
Dentists and doctors, particularly ENT specialists (otorhinolaryngologists — doctors specializing in ear, nose, and throat disorders, as well as nearby head and neck structures), struggle to control the situation because they are fighting chemical effects that can only be neutralized through detoxification and abstinence.
Discussing prevention in these situations is almost a challenge, as most affected individuals are already caught in a difficult addiction cycle. Prevention can only be effective if it occurs long before regular use begins — at a time when consumption is still perceived as harmless. Once addiction is established, preventive messages lose much of their impact, replaced by the necessity of medical, psychological, and social support.
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