Cocaine can have detrimental effects on your whole body, including your oral health.

Cocaine use, especially when rubbed on the gums or smoked as crack cocaine, can erode the gums and teeth over time.

Here’s what to know about how cocaine use can affect your teeth and mouth.

Cocaine can damage overall oral health. Regular cocaine use can lead to:

Some people also rub cocaine on their teeth or gums, which can erode tooth enamel. It increases the risk of tooth decay and cavities.

A small 2021 study including 106 people who used crack cocaine and 106 people who did not found those who used crack cocaine:

Researchers also found that people who used crack cocaine visited the dentist less often than people in the control group.

Cocaine use also appears to damage the gums.

The 2021 study mentioned above also notes that smoking crack cocaine can potentially cause gum disease. Gum disease can lead to the breakdown of the gums, teeth, and surrounding bone tissues.

In a 2008 research review covering anecdotal reports on cocaine and oral health, results found that consuming cocaine orally caused ulcerated lesions on the gums where the cocaine touched, usually near the front teeth.

People who used cocaine this way reported painful and receding gums. One person also had severe bone loss. Researchers theorized it could be due to the drug’s vasoconstrictive properties.

After stopping cocaine use, the gum lesions disappeared completely within 2 weeks to 18 months.

You’re not alone

If you want to change your relationship with cocaine, you don’t have to go through it alone. When you’re ready, you can consider seeking support from a drug treatment program.

You can ask a doctor for resources or reach out to the U.S. government’s Substance Abuse and Mental Health Services Administration (SAMHSA).

You can find programs in your area with SAMHSA’s online treatment locator or call SAMSHA at 800-662-HELP (4357).

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Other oral issues that may develop from cocaine use include:

Headaches, jaw pain, and other oral health issues

Some people who use cocaine have described orofacial pain similar to cluster headaches. Cocaine use seems to trigger pain near the front upper jaw, which can spread to other parts of the face.

Doctors sometimes prescribe medications to reduce cocaine withdrawal symptoms, such as antidepressants, lithium, and levodopa. These medications can cause dry mouth, alter taste perception, or cause involuntary facial movements.

Palate and nasal cavity deterioration

Chronic cocaine use is associated with perforations, or holes, in the nasal cavity or hard palate (the roof of the mouth).

In severe cases, it can cause breathing or eating difficulties.

Dental anesthetic issues

Cocaine use may also have severe consequences when combined with dental anesthetics during dental procedures.

Cocaine blocks nerve activity, similar to how local dental anesthetics like lidocaine, xylocaine, and antiacne work.

When a local anesthetic is used in a dental procedure soon after cocaine use, it can cause a spike in blood pressure. This likely happens due to the drug’s vasoconstrictive properties, which amplify the body’s response to the adrenaline released by dental anesthetics.

Researchers have found that during teeth extraction surgery, people who used cocaine or crack cocaine experienced extreme variations in blood pressure.

Experiments on animals also showed that combining cocaine with a local anesthetic can be potentially fatal. Combining cocaine with lidocaine can also raise the risk of convulsions.

Before any dental procedures, always tell your dentist about any substance use, including illegal drugs, prescribed medications, and supplements.

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Treatment can significantly improve oral health issues from cocaine use. In some cases, treatment can even reverse any problems.

You can start by finding a dentist you trust and telling them about your substance use. Due to doctor-patient confidentiality, it’s safe to disclose information about substance use. You will not get into legal trouble.

Together, you can find a treatment regimen that works for you. This may include:

You can also follow general preventive care steps for oral health, such as:

  • stopping substance use
  • quitting smoking, if you smoke
  • avoiding or limiting alcohol
  • avoiding or limiting acidic, sugary drinks, like soda or energy drinks
  • avoiding or limiting foods high in sugar
  • staying hydrated and limiting caffeine
  • brushing teeth twice a day and flossing at least once a day

Cocaine use can lead to several oral health issues over time. These issues can be corrected with restorative dental treatments and starting treatment for substance use disorders.

Limiting or avoiding high sugar foods and drinks as well as brushing and flossing every day can also prevent dental issues down the road.