What Are Heroin Teeth?

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Heroin is classified as a Schedule I substance by the Drug Enforcement Administration,  meaning that it cannot be used for illicit or medical purposes within the United States. (1) Heroin use was reported in approximately 1.1 million individuals within a 12 month period. (2) Heroin is classified as an opioid drug, a class of substances that can aid with pain relief and cause feelings of sedation. Heroin and other opioids can lead to adverse health effects.

Heroin is known to cause various side effects, including: (3)

  • Collapsed veins due to intravenous injections
  • Heroin abscesses
  • Flushed skin
  • Extreme itchiness
  • Damages to the tissue within the nostrils
  • Dry mouth
  • Heart infection
  • Heroin teeth

Regardless of one’s understanding of substance use and their side effects, heroin teeth are not a commonly known phenomenon and some may wonder what are heroin teeth? Heroin teeth is the term coined to describe oral issues caused by heroin use. A research article found that, when compared to the rest of the population,  the oral health of those who engage in heroin use was significantly worse. (4)

With approximately 1.0 million individuals, 12 years of age or older, diagnosed with opioid use disorder, effective treatment options are crucial to aid with this public health crisis. (5) Here, at Guardian Recovery, we offer opioid and heroin specific detoxification services to help you or a loved one no longer depend on substance use. With therapeutic and medication assisted treatment options, we can help individuals develop healthy coping techniques to reach their sobriety goals. Seeking treatment may seem scary, but our professional staff will help you feel comfortable by working with you to identify the best treatment plan. Reach out today to start your road to recovery with Guardian Recovery.

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Visual Signs of Heroin Use on the Teeth

Heroin teeth are very similar to meth teeth, or tooth decay caused by engaging in meth use. Heroin teeth can be identified by stained, blackened, rotting, and crumbling teeth. With continued use, heroin can lead to oral hygiene issues that may lead to other serious health risks.

Mouth Sores

Mouth sores, also known as canker sores or mouth ulcers, are painful cuts in the mouth that can be identified visually. In some cases, mouth sores can heal on their own after a couple of days or weeks. However, chronic or excessive heroin use can lead to the continuous development of mouth sores. Depending on the severity of the sores, they can range in size and extend throughout the cheeks and throat.

Signs and symptoms of mouth sores due to heroin use include: (6)

  • Reddish sores with white patches in the center
  • Swollen gums
  • Painful chewing or swallowing
  • Bleeding ulcers
  • Pus within the mouth
  • A white or yellow film near the sore
  • Burning or pain when eating cold or hot foods

There are some home remedies that can be used to help treat mouth sores. These include gargling salt water, avoiding spicy foods, and avoiding alcohol or other substances. Continued heroin use may lead to mouth sores that need to be treated by a professional.

Damage to Tooth Enamel

Heroin is an acidic substance. (7) Acidic substances can cause symptoms of GERD or acid reflux, which introduce stomach acid into the mouth. This can highly damage the protective enamel around the tooth. Eroding tooth enamel can cause severe pain and lead to cavities.

Other Known Oral Side Effects of Heroin Use

Engaging in heroin use does not only cause the oral side effect of heroin teeth, but also causes other serious oral hygiene related problems. These may include tooth loss, gum disease, dry mouth, and grinding of the teeth.

Tooth Loss

The average individual, between the ages of 20 to 64, has approximately 25.5 teeth in their mouth. (8) Tooth loss is defined as a process that involves one or more teeth becoming loose and falling out of the mouth. Missing one or more teeth is also known as edentulism. (9) Tooth loss has been found to increase depression and reduce overall health. (10)

Gum Disease

Heroin can be ingested in various different ways. Methods of use in regards to heroin include intravenous injections, sniffing, snorting, and smoking. Smoking is one of the leading causes of gum disease throughout the United States. (11) Gum disease is caused by bacteria getting underneath the gums, causing an increase of plaque and tartar. (12)

Signs and symptoms associated with gum disease caused by heroin use include: (13)

  • Bad breath
  • Swollen or red gums
  • Sensitive teeth
  • Tender gums
  • Bleeding gums
  • Painful chewing
  • Loose or wiggly teeth
  • Painful cheeks
  • Gums that have pulled away from the teeth
  • Changes in the way that the teeth fit together

Certain gum diseases are not curable, however, they can be treated by dentists and oral surgeons to help reduce further infection or damage.

Dry Mouth

Xerostomia, also known as dry mouth, is a condition in which the mouth cannot stay wet due to a lack of saliva. (14) Saliva helps fight against tooth decay and bacterial growth.

Signs and symptoms associated with dry mouth due to heroin use include: (15)

  • Poor mouth odor
  • Thick saliva
  • Feelings of stickiness in the mouth
  • Dry tongue
  • Sore throat
  • Cracked lips
  • Difficulties talking, swallowing, or chewing
  • Impairment or changes in one’s sense of taste

Clenching & Grinding of Teeth

Teeth grinding, also known as bruxism, is when an individual grinds, clenches, or grate their teeth together. (16) Teeth grinding is often unconscious and can happen when an individual is awake or asleep.

Signs and symptoms related to teeth grinding due to heroin use include: (17)

  • Headache
  • You or your partner being awoken throughout the night due to loud grinding
  • Flattened, chipped, or fractured teeth
  • Damage to the tooth enamel
  • Tooth pain
  • Sensitive teeth
  • Tight jaw muscles or locked jaw
  • Pain in the neck, cheeks, or face

It is important to see a dentist if you or a loved one experience any of the above symptoms to help maintain good oral hygiene.

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Effects of Depressants on the Mouth

Depressants are substances that slow down the central nervous system, which consists of the brain and spinal cord. (18) Depressants can calm and relax body muscles. Depressants can also cause cloudy or foggy mental states, which may increase the chances of an individual neglecting their oral health. Dry mouth is a common side effect of multiple depressant substances.

Is Mouth Damage From Heroin Permanent?

Heroin teeth and other mouth damage caused by heroin use is often irreversible. Depending on the severity of an individual’s heroin teeth, extraction or tooth removal may be necessary. Many gum diseases have permanent effects, such as receding gums, which leads to the gums no longer being able to grow back.

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Luckily, heroin use treatment is available. Here at Guardian Recovery, we are dedicated to helping individuals who find it hard to control their substance use receive comprehensive care. We can provide you with psychoeducation regarding substance use and life skills training to help you maintain sobriety. Contact us to receive a consultation and a free, no obligation insurance benefits check. Begin your recovery journey today with Guardian Recovery.


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

  1. https://www.dea.gov/drug-information/drug-scheduling#:~:text=Schedule%20I%20drugs%2C%20substances%2C%20or
  2. https://nida.nih.gov/publications/research-reports/heroin/scope-heroin-use-in-united-states
  3. https://nida.nih.gov/publications/drugfacts/heroin
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3560821/
  5. https://nida.nih.gov/publications/research-reports/heroin/scope-heroin-use-in-united-states
  6. https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/eating-problems/mouth-sores.html
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5152678/
  8. https://www.nidcr.nih.gov/research/data-statistics/tooth-loss/adults
  9. https://www.icoi.org/glossary/edentulism/
  10. https://www.cambridge.org/core/journals/epidemiology-and-psychiatric-sciences/article/causal-effect-of-tooth-loss-on-depression-evidence-from-a-populationwide-natural-experiment-in-the-usa/F1A5E8C5DD64EB51E3AB408A9B6B2755
  11. https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html#:~:text=In%20severe%20cases%2C%20it%20can,disease%20in%20the%20United%20States.&text=Gum%20disease%20starts%20with%20bacteria,tartar%20(hardened%20plaque)%20develop.
  12. https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html#:~:text=In%20severe%20cases%2C%20it%20can,disease%20in%20the%20United%20States.&text=Gum%20disease%20starts%20with%20bacteria,tartar%20(hardened%20plaque)%20develop.
  13. https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html
  14. https://www.nidcr.nih.gov/health-info/dry-mouth
  15. https://www.nidcr.nih.gov/health-info/dry-mouth
  16. https://www.nhs.uk/conditions/teeth-grinding/
  17. https://www.nhs.uk/conditions/teeth-grinding/
  18. https://kidshealth.org/en/teens/depressants.html

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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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