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Methamphetamine is not a new drug. It has a long and storied history of legitimate clinical use and recreational abuse. Unfortunately, abuse of methamphetamine is increasing with alarming frequency in the United States and leads to appalling destruction of dentition. The pathognomonic effects of methamphetamine abuse on teeth have led to the term "meth mouth." This term, while descriptive of the clinical appearance of patients, is a misnomer. A review of available information on methamphetamine abuse is presented and discussed. A clinical case is documented to help clinicians recognize and manage patients who may be abusing methamphetamines.

Early dentifrices contained natural ingredients, mostly in coarse particle form, and were quite abrasive. Salts, either sodium chloride, sodium bicarbonate, or a mixture of both, have also been used for tooth cleaning because of their ready availability and low cost. Because of both their relatively low intrinsic hardness and their high solubility, another advantage is low abrasivity. Their biggest disadvantage is a salty, unpalatable taste. Many modern dentifrices that contain sodium bicarbonate, either as the sole abrasive or one of several, disguise the saltiness with flavoring and sweetening agents. An almost inverse relationship exists between the percentage of baking soda in a dentifrice and its abrasivity. Sodium bicarbonate has no anticaries activity per se but is compatible with fluoride. In high concentrations, sodium bicarbonate is bactericidal against most periodontal pathogens. Most clinical studies have not found significant differences in periodontal response to baking soda as compared with other commercial dentifrices, probably because of its rapid clearance from the gingival sulcus. Sodium bicarbonate may not be the "magic bullet" for curing dental diseases, but its safety (if ingested), low abrasivity, low cost, and compatibility with fluoride make it a consummate dentifrice ingredient.

This is the report of the Laboratory Abrasion Committee of the American Dental Association (ADA) Dentifrice Program relative to specific methods to measure the in vitro abrasivity of dentifrices. This method was used in two collaborative studies with six participating laboratories. These studies were designed by the ADA Dentifrice Program Statistical Committee and their interpretations form a basis for recommendations on the use of the method. This laboratory method is recommended for use in dentifrice development and may provide some basis for expectations in normal dentifrice use.