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  #1  
Old 08-10-06, 03:37 PM
wholeo wholeo is offline
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Talking ADDERAL & TOOTH DECAY?

I am 51. I was only dx'd w/ADHD about 2 yrs ago. After going thru various medications, i ended up on Adderal. my dr had me on 30 mg/day, but that was knocking me out. finally i quit. eventually my psychologist convinced me to give it a try again, only start w/a low amt and work my way back up. now i am back to 30mg/day, but it is broken down to 2-15mg (morn/aft).
My biggest problem lately has been my teeth. I think we started me back on Adderal about 1/06. anyway i went in last month for tooth pain, and my dentist asked me what has happened between last yr & now-he showed me the xray-it is like my teeth have been rotting away. so i am trying to find out if there is any info or if anyone has heard of Adderal & problems w/teeth?
My dentist isnt sure. My dr & pharmacist sd they havent heard anything. now before answering, 2 other things-i chew a lot of gum, but i have done so for many years and moreso in the last 4 yrs since quitting (by the grace of God) cigarettes. and i am also on methadone for my back problems (i jsut had a 3-level fusion w/titanium plate & 6 screws) in 12/04. I have been on this for some time but at a very low dose except for exacerbations. my dr originally had me up to 60mg/day but when i heard that junkies start at 70 i made myself wean down. I had tried to stop cold turkey but i went thru withdrawals so i had to do it the long way (this was prior to surgery). so now i am at 10-20 mg/day, sometimes just 10. bad days i have gone up to 30-40 depending on severity. i have been learning to live w/the pain.
in meantime my teeth, in particular my molars, have been rotting out one by one. i am on my last 2 on the bottom-in fact the right one was to have a root canal today to salvage it. unfortunately it just broke off in half about 1/2 hr ago (i see the dentist in 2 hrs) so i think the root canal is being changed to an extraction-which means i will have only 1 molar left on bottom. i have lost one of each of the uppers in the back.
so i am asking if anyone has heard of problems w/Adderal & teeth, b/c in my job i constantly see meth addicts with their teeth missing or rotted etc, and so that made me wonder about Adderal since it says methamphetamine salts (i've really been working on lowering my salt intake....thats a joke, ok?). my dr said its a different type or make up.
THAT'S MY QUESTION. Is there any connection between Adderral & tooth decay? It is quite possible that it may be the combo of the methadone & Adderral too, i dont know. or it could just simply be my teeth have simply given up the ghost. i appreciate any and all feedback. thanx.
ps-i will not be able to view any comments till later tonite. lunch break over & soon my dentist, pick up people for recovery meeting at church, then drop off after meeting, get mail, then...home! :-)
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Old 08-10-06, 03:54 PM
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Good question...

Yes, there is information concerning a connection between amphetamines and some other drugs accelerating tooth decay. I happen to read that there is also a connection to tooth decay from Fentanyl, and morphine which are both very similar to methadone.

The article I found was at medscape.com, and they will not allow me to link the article concerning this connection. If you go there and do a search, or do a search at http://scholar.google.com/ and you will find it there too.

PS Adderall does not contain any methamphetamine, but it does contain both dextro and levo amphetamine salts.
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Old 08-10-06, 05:57 PM
Hyperion Hyperion is offline
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Fentanyl, morphine, and methadone are opioids. While they all resemble each other both structurally and pharmacologically, none of them bear much resemblance to amphetamines.

It is possible that the tooth decay might also be due to grinding your teeth, as this is a common side effect from amphetamines. I've also heard speculation that a decrease in saliva could be partly responsible, but I'm not sure that a decrease in saliva would be sufficient on its own.

Methamphetamine addicts do often have bad teeth, but there are important things to consider there:

1. Many methamphetamine addicts smoke their methamphetamine, and drawing the methamphetamine plus countless impurities into their mouth could cause damage.

2. Hardcore drug addiction is often accompanied by poor hygeine and substandard or nonexistent medical and dental care, plus polydrug abuse is also common, as are infections from sharing drug paraphernalia and from poor hygeine and weakened immune systems.

With medicinal use, I'd be more likely to blame the tooth-grinding.
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Old 08-10-06, 07:08 PM
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Quote:
Originally Posted by Hyperion
Fentanyl, morphine, and methadone are opioids. While they all resemble each other both structurally and pharmacologically, none of them bear much resemblance to amphetamines.
I never said that Fentanyl, or morphine were in any way related to amphetamines, or that they resemble amphetamines. What I did say was that they are related to methadone which wholeo stated he has been using for back pain.

My point being that both amphetamine, and the drugs Fentanyl and morphine have been shown to accelerate tooth decay by causing xerostomia in many who take them. I was implying that since Fentanyl, and morphine are so closely related to methadone (which he is taking) that there might be a connection with methadone causing this dry mouth too. Xerostomia is the cause of "meth mouth" where tooth decay can be very advanced among those who abuse meth. I hope wholeo does not think that I think he is abusing anything, I just wanted him to be aware that a link exist between these drugs and tooth decay since he asked if anyone knew anything.

I read all this in a published article at Medscape.com, but that site will not allow an active link to the article there. You have to go there and sign up to read it. I found the article by doing a search at Google scholar under "amphetamines and tooth decay." It was very easy to find, so I am sure you can find it by doing the same search.
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Old 08-11-06, 06:52 AM
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good point lars i keep an open mind on this one as well i keep an eye on it an see where things go.... thanks for asking the Q. dorm
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Old 08-11-06, 07:31 AM
mguffey31 mguffey31 is offline
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It's my opinion that the issue with meth users and tooth decay has more to do with vasoconstriction. The stimulants, especially in doses that meth users abuse, can cause profound peripheral vasoconstriction i.e. cold fingers, toes, genitalia, etc. Well, even though the teeth are in the mouth, the gums are technically on the surface. With stimulants, there action is primarily on the sympathetic nervous system. With increasing dosages vasoconstriction is more significant causing blood to be directed more to central, more important structures for fight/flight i.e. heart, lungs, brain, muscle. Reduced flow to the skin surface means reduced nutrient flow to tissues in the periphery, teeth included IMO. Other examples are diabetics or people with significant peripheral vascular disease. These are the people that end up having toes, feet, legs, amputated because there blood flow is compromised to the point where it can't support tissue life. Those are extreme examples I know but I think my theory is right on. I'm positive that this is also why some people on stimulants experience hair loss. Rogaine and some of the other hair regrowth products are vasodilators. Hence, regrowth caused by better blood flow. Minoxidil (rogaine) is even used in other aspects of medicine as a vasodilator. Reduced blood flow to scalp=less oxygen, protein, delivery and less carbon dioxide/waste remove from surface capillaries=Kojak. Add possible teeth grinding (which I do like a champ in my sleep) and poor or less than adequate hygiene to the mix and you have a great recipe for tooth decay. Sorry for the long post but my focalin just kicked in. You could ask for a lower dosage but that might affect your symptom control. My bet would be to ask for something that has fewer side effects on the cardiovascular system like focalin xr or something. I take it. It works really well and I can tolerate the side effects much better than I could on Adderall or concerta. P.S. It blows regular Focalin out of the water. That stuff is a waste of time unless you just need coverage for about 2-2.5hrs. Anyway, good luck.P.S.S. I can talk to you about the methadone too. I have my own pain clinic so I have experience with it. You can private message me if you like.

Last edited by mguffey31; 08-11-06 at 07:34 AM.. Reason: Forgot something else
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Old 08-11-06, 01:48 PM
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Interesting theory...

Quote:
Originally Posted by mguffey31
It's my opinion that the issue with meth users and tooth decay has more to do with vasoconstriction. The stimulants, especially in doses that meth users abuse, can cause profound peripheral vasoconstriction i.e. cold fingers, toes, genitalia, etc. Well, even though the teeth are in the mouth, the gums are technically on the surface. With stimulants, there action is primarily on the sympathetic nervous system. With increasing dosages vasoconstriction is more significant causing blood to be directed more to central, more important structures for fight/flight i.e. heart, lungs, brain, muscle. Reduced flow to the skin surface means reduced nutrient flow to tissues in the periphery, teeth included IMO. Other examples are diabetics or people with significant peripheral vascular disease. These are the people that end up having toes, feet, legs, amputated because there blood flow is compromised to the point where it can't support tissue life. Those are extreme examples I know but I think my theory is right on. I'm positive that this is also why some people on stimulants experience hair loss. Rogaine and some of the other hair regrowth products are vasodilators. Hence, regrowth caused by better blood flow. Minoxidil (rogaine) is even used in other aspects of medicine as a vasodilator. Reduced blood flow to scalp=less oxygen, protein, delivery and less carbon dioxide/waste remove from surface capillaries=Kojak. Add possible teeth grinding (which I do like a champ in my sleep) and poor or less than adequate hygiene to the mix and you have a great recipe for tooth decay. Sorry for the long post but my focalin just kicked in. You could ask for a lower dosage but that might affect your symptom control. My bet would be to ask for something that has fewer side effects on the cardiovascular system like focalin xr or something. I take it. It works really well and I can tolerate the side effects much better than I could on Adderall or concerta. P.S. It blows regular Focalin out of the water. That stuff is a waste of time unless you just need coverage for about 2-2.5hrs. Anyway, good luck.P.S.S. I can talk to you about the methadone too. I have my own pain clinic so I have experience with it. You can private message me if you like.
I enjoyed reading your theory, however tooth decay is not caused, or accelerated by vasoconstriction. Your teeth are hard calcified objects with nerves (soft tissue) in their cores. The surface of our teeth (were tooth decay begins) is formed from enamel and dentin that are both very dense, and are actually not vascular at all. Tooth enamel is the hardest tissue found in the human body.

Not having a proper amount of salivia to help dissolve away many things that collect on the surface enamel will accelerate tooth decay, which is exactly what happens when one has xerostomia (dry mouth), aka "meth mouth." Xerostomia is usually a problem with people who abuse meth, but can also happen with marijuana use. In fact, anything that causes one to experience chronic xerostomia will accelerate tooth decay. The reason you do not see marijuana users with similar tooth decay problems is because they seldom neglect to drink enough liquids (or eat enough for that matter ) which helps them to counter the dry mouth. People abusing meth do not want to even think about eating or drinking anything unless they absolutely have too due to the anorectic effect of the methamphetamine at such high chronic doses that they consume.
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Old 08-11-06, 02:05 PM
Veighen Veighen is offline
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This is all really interesting, I also read somewhere that tooth decay has alot to do with the amount of saliva in ones mouth.

As for the hair loss.. how often does that happen? I am on Ritalin, and have very long hair, I obviously dont want to start losing it.

Does hair start to fall out after a prolonged period of stimulant use.. or when it becomes almost abusive in nature?

Sorry, if it is off topic,.. any information regarding this would be great, either with links or responses.

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Old 08-11-06, 04:56 PM
mguffey31 mguffey31 is offline
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I stand corrected Lars. That's very interesting. Those poor meth addicts can get to looking pretty bad. Thanks for the info. and reading my theory. It's a shame to wonder how many of those guys are like us and just need some meds and a fresh start.
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Old 08-11-06, 08:21 PM
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Great post Lars. You explained it quite well. I just started on Adderall a couple days ago and the first day was hell with the nasty taste followed by the dry mouth. I've never taken any drugs, legal or illegal, that cause that so it was definetly a new experience.

There are ways to counteract the problems with tooth decay associated with dry mouth and that is to chew sugarless gum or suck on sugarless candy (sugerless being the key to good dental health here). Both my psychiatrist and my pharmacist told me about this when I was getting my initial dose. I'm surprised nobody told you wholeo.

So that evening of my first day on the drug I went out and got a bunch or Orbit gum. Works great. The minty flavor of the gum and the chewing really get the saliva glands going again and with any luck my teeth won't suffer as a result. The only negative side effect being...if your not a regular gum chewer...look out for a nasty case of sore jaw until your jaw muscles get used to their new found exercise. :-)


I also put a call into my dentist to see if she has any recommendations on particular types of gum or if there's any additional pre-emptive actions I can take.
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Old 08-11-06, 09:12 PM
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Quote:
Originally Posted by crichton
I'm surprised nobody told you wholeo.
I have found that Dr's & phamacist usually only tell us about the potential major side effects, and even then I am not so surprised when they overlook something. It has been my experience that Dr.'s are just like any other profession in the sense that some really know their stuff very well, and others simply don't.

I am glad you liked my post, but my intention was just to make wholeo aware that Adderall may not be the only cause of his dry mouth. He stated that he is taking methadone, and one of the side effects of chronic narcotic therapy is dry mouth. I'm not sure if it's as severe a side effect with methadone as it is with other narcotics like Fentanyl, and morphine, but since those are both schedule II controlled opiates, I assumed it must be very close to being the same.

That's a wonderful suggestion about using sugar free gum & candy. There are also some really good mouthwashes that are on the market that are made for treating dry mouth too. I know of one called "Oasis," but I would think there are others out there.
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