“Meth mouth”

To the Editor: Single case reports of “meth mouth”, similar to that recently published in the Journal,1 exaggerate the dental problems surrounding the use of methamphetamines. Evidence that methamphetamines cause grinding and wear of teeth,2 xerostomia,3 and cravings for sweet drinks is weak. The drug use reported by Shetty was intravenous or intranasal, not oral. While systemic effects may contribute to dental problems, local oral effects associated with acidity of methamphetamines would be minimal with intravenous or intranasal drug use.