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Heng CK, Badner VM et al. N Y State Dent J 2008; August/September: 50–51

Despite the then anticipated 'crystal meth' epidemic not materialising in the UK, in 2007 the Government reclassified methamphetamine as a Class A Drug. Methamphetamine is 'easily manufactured from ordinary household chemicals, making it “cheap,” relative to other drugs, and it is highly psychologically addictive'. Its use may result in extensive and widespread caries, vernacularly referred to as 'meth mouth'. This is because this drug causes profound xerostomia, has 12 hour duration of action compared with 2 hours for cocaine, and 'users drink sugared soda to quench their thirst and satisfy their craving for sweets'. The dental management of the signs and symptoms caused by methamphetamine are described, particularly the use of adhesive dental materials to restore the 'so-called apple-core preps'. The authors remind the reader that methamphetamine can potentiate the sympathomimetic effects of adrenaline/epinephrine in local anaesthetics which could result in an hypertensive crisis or a cerebral vascular accident.