How does methamphetamine use cause painful mouth sores to form?

Originally Published: October 31, 2003 - Last Updated / Reviewed On: December 28, 2009
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Dear Alice,

First things first, I love your website. I really like the format and especially love getting Alice in my e-mail box! My question is regarding smoking ice (methamphetamine). Sometimes, but not always, after I've smoked a lot, I get white sores on my tongue, especially, but all over in my mouth. I have a theory about this, and I'd appreciate any info you could supply. I think it is a sort of chemical burn from the iodine in the ice. I know it makes you get dehydrated, and I think this is part of why it burns (if it is a burn). You don't have normal amounts of saliva to naturally flush things out of your mouth. I also think that's a contributing factor in why it is so damaging to the teeth. I'm sorry, I'm babbling. My mouth is in so much pain! It looks like little patches of something growing and is especially bad where my tongue rubs against the back of my molars. Thanks in advance for the help!

Dear Reader,

Ouch! Smoking methamphetamine does cause painful mouth sores to develop, as you've noticed yourself, although they can form in many other ways. How mouth sores are formed by meth use may include the following possible culprits:

Chemical burn Some of the chemicals used to manufacture methamphetamine are caustic, meaning they burn skin. Similarly, when meth is vaporized and inhaled, the hot vapor irritates and burns soft tissue in the mouth, exacerbating dry mouth.

Stimulants, including methamphetamine, deplete salivary secretions and raise body temperature to a much higher level than normal. Based on these effects, long-term use of stimulants leads to dehydration, which worsens dry mouth. Without saliva to protect the mouth, teeth, and gums by acting as a neutralizing agent against acidic substances, such as some of the ingredients found in meth, an extended state of dry mouth can cause sores or ulcers to form in the mouth. Dry mouth also promotes tooth decay.

Tissue damage
Constriction of blood vessels in the mouth harms tissues initially, but after recurrent episodes, can cause tissues to die.

Skinned raw
Continuous friction between the tongue and the inside of the mouth while on meth can cause skin to become raw and irritated, which could lead to infection.

It's not clear in your letter if you've seen your primary health care provider or a dentist about the sores in your mouth; if not, make an appointment to have the sores examined and evaluated. It may be embarrassing to you to disclose the possible causes of your sores, but it is an important element in helping discover their source. This way, treatment may be identified and/or prescribed that can allow you to find some relief sooner rather than later. If the mouth sores are found to be caused by or related to smoking ice, then in order for treatment to be effective, you'll need to not smoke meth until the mouth sores heal completely. It also might be smart to think about the reasons you smoke ice, what it offers you, and what your life would be like without it. If you continue to use the drug, you may find that the only successful, long-lasting treatment for the sores, if they're caused by smoking meth, is to quit the substance altogether.