When I came up here I was shocked to see so many of the Pennsylvanian's had missing and rotten teeth? Originally I thought, maybe it was b/c the water doesn't have flouride like in New York. Last night I was watching a show about a place in Missouri with an out of control Meth problem and they had this young guy with horrible missing and decayed teeth. The dentist commented that he saw a lot of these types of cases and that it was a direct result of the Meth problem.
 
Do you encounter a lot of Meth dental decay up here?  
 
The show talked about how rampant it was in areas that are agricultural b/c they have easy access to the fertilizers etc which are the ingredients to make the drugs.

I personally have seen no confirmed cases of meth mouth.  The reason I say confirmed is because, unless the person confesses to using the drug, the clinical manifestations are similar to bruxism, rampant decay or other causes.  It's not as easy to say "this mouth is caused be meth" as it is to say "meth caused this mouth"...does that make sense?  You can attribute many clinical manifestations to it with hindsight, but it's very difficult to contribute it to without knowing.  There are other oral manifestations that are easier to diagnose with foresight, for example bulimia.  Hope that helped.

Fabi:
 
It's been my observation and experience that there is no more meth abuse in the Poconos than other areas of the nation.  But, there are several reasons for your observations regarding tooth decay in our region:
 
1.  Many local people do not have, nor can afford, proper dental insurance or care. 
 
2.  Diet - many people do not eat properly and as healthy as they should. 
 
3.  For years, a lot of guys that I know in the Poconos chew tobacco which can contribute toward tooth decay. 
 
4.  You may be correct.  The lack of flouride in the water may be another reason. 
 
5.  Improper hygienic habits including infrequent or inadequate brushing habits.
 
Trust me, it's not as bad as it used to be.  But, there are a lot of dirt poor people here that are struggling, so proper dental care is not at the top of the priority totem pole. 
 
Len
 
 

What Lenven states may be true in general, but is not specific to the Poconos or even low income patients.  A stronger indicator than money is priorities. 
1.  I have had many "well off patients" who let their teeth rot. 
2.  & 5.  go hand in hand, usually not one or the other.
3.  Chew, yes
4.  Lack of Fluoride in the water is wide spread, but is usually set off by fluoride vitamins that a pediatrician should be prescribing. 
 
People don't realize that the better they take care of your teeth, the less they will cost you.  Patients would spend far less money if people would just listen to us

Winebrat:  I see your point and mostly agree.  However, all I can say is that growing up here, I noticed that the people who seemed to have the nicest sets of teeth usually had more resources to take care of them.  I can show you dozens of pictures of people from long ago, mostly of poor farming people, who lost their teeth. 
 
Yes, it is a matter of priorities - no question!.  But, having more money (and insurance) allows the more "well off" to be in a position to address those priorities - whereas the poor cannot as easily address this priority without considerable sacrifice.
 
Years ago, the poor people, mostly older farmers, didn't need to make a good impression because they worked on or around the farm all day.  They really didn't have to care.  On the other hand, people in business, who usually had more money, had to make a better impressions with people, so they often cared for their teeth better.
 
Len

The original topic of this thread was the correlation between meth and missing/rotten teeth.  Hopefully that has been addressed to Fabi's satisfaction, if not, please PM me...

The "new" topic has become the reason people in this region seem to have less that wonderful teeth. 
"dozens of pictures from long ago..." 
Dentistry has changed dramatically in the past 100 years.  Do you realize the first Hygienist (which is a far cry from today's standards) wasn't until 1906?  The first Northeast Regional Board Exam (part of what we currently do for licensure) wasn't until 1950?  Dentistry itself has changed from Drill & Fill to Prevention.  You can't fault "poor people years ago" for bad teeth.  Dentistry is constantly evolving with better and new techniques and concepts.

Currently, there are many reasons people have bad teeth across the country and to go into all the reasons would mean writing a paper for publication.  Yes, money is a part of it but I don't agree, seeing it first hand, that it is a main reason.

Let me share with you what Dr. Jess PM'd me and I post here with her permission...
 
Dr. Jess said that although she's seen many cases resembling the destruction of 'meth mouth' there has only been one case so far that she truly believed was, and that could not be confirmed.