The occurrence of toothwear in users of Ecstasy (3,4-Methylene-DioxyMethAmphetamine)

Ecstasy users have reported that dry mouth, jaw tension and tooth grinding were common side effects of its use although the influence of these effects upon toothwear have not been previously investigated. Objective: This stud y aimed to compare incisal and occlusal toothwear in Ecstasy users and a gr oup of non-users of Ecstasy but users of other drugs. Methods: Groups were established by a snowball peer information network from visitors to the "dr op-in" Maryland centre in Liverpool. Volunteers completed a questionnaire a bout social life, drug use and diet. Clinical examination for wear on the i ncisal edges and on canine tips was conducted with a mirror and probe, wher eas occlusal wear was recorded in impressions and subsequently scored from stone replica casts. The degree of toothwear was scored according to the cr iteria of the Tooth Wear Index (Smith & Knight, Br Dent J 1984;157:16). Res ults: Ecstasy users (n = 30) were compared with non-users (n = 28). Toothwe ar through the enamel into the underlying dentine occurred in 18 (60%) Ecst asy users but in only three (11%) non-users. The overall mean toothwear sco re in Ecstasy users was 0.63 compared with 0.16 in non-users (t = 4.34, P < 0.001). Dry mouth was reported by 93% of Ecstasy users whilst 89% stated t hat they clenched or ground their teeth after taking the drug. Tooth grindi ng commonly continued into the following morning. Carbonated (acidic) bever ages were consumed by 93% of the users with a mean of three cans per "trip" . Conclusion: The severity of toothwear and the number of teeth affected we re greater in Ecstasy users than in a group of non-users. The occlusal surf aces were more commonly affected than the incisal, which may indicate jaw c lenching rather than grinding as a feature of Ecstasy-induced muscle hypera ctivity.