Why Meth Use Can Cause Mouth Ulcers and How to Treat Them

Meth-induced mouth ulcers may resemble other types of mouth ulcers.

Ulcers, by definition, only occur inside your mouth. They typically appear:

• in the inner lining of your cheeks and lips
• on the floor of your mouth under your tongue
• on your gums and tongue

Rarely, they may appear on the roof of your mouth.

Mouth ulcers often begin as white or yellow bumps, then collapse within a few days into shallow wounds. The tissue around the spot may become red, veiny, or swollen.

Most mouth ulcers are under 5 millimeters in diameter, or smaller than the eraser on a pencil. They form in clusters of one to five sores. If you have an oval ulcer larger than a centimeter, the tissue in your mouth may be dying — which means you need prompt medical attention.

Mouth ulcers of any size can be fairly painful. Even a day or two before you notice the sore, you might feel a stinging or burning sensation whenever your teeth or tongue brush against the ulcer. This can cause issues with eating, drinking, and talking.

Meth use can lead to mouth ulcers in a few different ways.

Dry mouth

Around 72% of people who use meth will experience dry mouth.

Whether you smoke, snort, or inject meth, the drug will rev up your sympathetic nervous system. This tells your body it’s fight or flight time, not feeding time. Your body recognizes that you likely won’t eat anytime soon, and your salivary glands stop producing as much saliva, which leads to dry mouth.

Saliva doesn’t just help keep your mouth moist. It also protects your tissues by neutralizing acidic substances. With dry mouth, there’s nothing to stop the acids in everyday foods and beverages from damaging your mouth. If you smoke meth, the acidic chemicals in the drug can also create ulcers.

What’s more, meth can lower the pH value of your spit. This means the little saliva you still produce won’t work as well as regular saliva to neutralize acids.

Infection

When your sympathetic nervous system is active, your body has fewer resources for its immune system. As such, chronic meth use can weaken your mouth’s defenses against disease.

Oral thrush is one common infection you might develop when using meth. This infection happens when a yeast called Candida albicans sets up shop in your mouth, leaving sores and fuzzy white patches on your tongue and cheeks.

Burns

When you smoke meth, you inhale hot chemical vapors directly into your mouth. This heat can easily burn the sensitive tissues in your mouth and leave behind sores. A still-hot pipe can also burn ulcers into your mouth, especially around the lip area.

Friction

When using meth, you might notice you tend to grind your teeth and move your tongue around more than you usually would. You may also accidentally chew the lining of your cheeks raw and cause an ulcer that way.

And since meth use can constrict the blood vessels in your mouth, this damage may take much longer to heal.

Ulcers may heal differently depending on what caused them:

• Small sores from burns, friction, or dry mouth may heal on their own within 10 to 14 days.
• Large sores can last up to 6 weeks and may require medical treatment.
• Sores caused by oral thrush usually heal after 1 to 2 weeks of treatment with antifungal medication. Untreated ulcers may take longer to disappear.

However, regular meth use can slow down the healing process, not to mention cause additional ulcers that replace the ones that heal. The only surefire way to get rid of meth-related mouth ulcers is to stop using meth.

Easing your dry mouth symptoms can do a lot to prevent further ulcers — and you may notice improvement in your mouth shortly after you stop using the drug.

For example, a small 2022 study suggests that saliva production and pH values may improve significantly after 4 days following withdrawal from meth use, and improve even more by the 30-day mark.

When treating mouth sores, your doctor may recommend some or all of the following medications:

• Topical anesthetics: You can buy over-the-counter (OTC) pain relievers like benzocaine (Orajel). They come in gels or sprays you put directly on the ulcer to numb the pain.
• Topical steroids: If anesthetics don’t make much difference, you can also use steroid tablets or pastes. These medications may help reduce inflammation and soreness around the ulcer.
• Antimicrobial rinse: Rinses can help fight off potential infection. You can buy some products over the counter, while others need a prescription.
• Oral moisturizers: If dry mouth causes your ulcers, you can use artificial saliva to temporarily supplement your own spit. You can buy these over the counter too.
• Saliva stimulators: The prescription drug pilocarpine (Salagen) can stimulate your saliva glands so you secrete more spit. For meth-induced dry mouth, you may need to take tablets 2 to 6 times a day. The healthcare professional who prescribes the medication will give you specific directions to follow.

Severe ulcers may require more intensive treatment to heal. For example, your doctor may suggest cauterizing the ulcer — burning it shut, in other words — or physically “gluing” it closed with nontoxic adhesives.

Home remedies

Outside of medical treatment, there are a few things you can try at home to help your ulcers heal:

• Avoid acidic foods and drinks. They can agitate the ulcers.
• Drink plenty of water each day so you have enough hydration to produce spit.
• Rinse your mouth with a saltwater rinse. You can make this at home or buy a saline solution at the pharmacy.
• Apply a wet bag of chamomile tea as a compress on your sore. Leave it on the sore for a few minutes to help reduce inflammation.

The doctor or dentist who treats your mouth ulcers will likely encourage you to stop using meth.

If you’d like to stop using meth, you don’t have to do it alone. Options for professional support and treatment include:

• Medically managed treatment: During meth withdrawal, issues like dry mouth or teeth grinding may get temporarily worse. During this treatment, sometimes called detoxification or “detox,” medical professionals can monitor your symptoms and help you manage withdrawal.
• Therapy: If you live with depression or other mental health conditions, behavioral therapy can help you address these symptoms along with meth use.
• Support groups: Support groups provide the opportunity to meet with other people who are quitting meth, or have already quit meth, and share advice.
• Inpatient treatment: Inpatient rehabilitation, or rehab, may involve staying at a treatment center for several days. Your care program will likely include a mix of withdrawal treatment, therapy, and support groups.

Need help finding support? You can find local support for meth use disorder by using the Substance Abuse and Mental Health Services Administration’s behavioral health treatment locator.

Meth use can decrease your saliva output, lower your immune system defenses, and cause direct damage to your mouth. Any of these issues can create painful mouth ulcers that make it hard to swallow or talk.

Medications can help these ulcers heal, but the best way to keep mouth ulcers from coming back is to stop using meth.

Emily Swaim is a freelance health writer and editor who specializes in psychology. She has a BA in English from Kenyon College and an MFA in writing from California College of the Arts. In 2021, she received her Board of Editors in Life Sciences (BELS) certification. You can find more of her work on GoodTherapy, Verywell, Investopedia, Vox, and Insider. Find her on Twitter and LinkedIn.