Two years ago, Dr. Lowell Dawson was wrapping up his career as a pediatric dentist when an opportunity to start a new oral health program for the poor and uninsured arose.

He jumped in with both feet at the Community Health Center of Central Wyoming and was shocked.

"I was ignorant of real life," Dawson said.

He choked up as he talked about his experience with "meth mouth" at Wednesday's 3rd Annual Methamphetamine Awareness Conference in Casper.

Meth use and the lifestyle that goes with it are hell on teeth, gums and the jawbone, he said.

For those who smoke meth, the chemicals eat away at teeth. The cravings for sweets and pop only exacerbate dental problems. Often, methamphetamine users aren't too concerned with brushing and flossing, and they don't have the money for dental care.

Dawson displayed examples of "meth mouth," showing pictures of rotted, rubbery teeth and gums. In many cases, a patient who visits the clinic have teeth that are too damaged to save, and the dentist can't do anything but pull them.

"It's a nightmare for a dentist, for his assistant, and you can imagine what it's like for the patient," he said. "The normal pain medication usually will not even approach the amount of pain. It's horrible for them."

Dawson said he saw as many as two or three "meth mouth" patients a day for difficult, expensive treatment that many adults who use the drug can't afford.

State-provided insurance for poor children includes dental care, but only provides adults with two extractions per year, Dawson said, and doesn't pay for fillings or dentures, he said. A person with rotting or no teeth has a much harder time finding work, and may go back to using drugs, he said.

"There is very little sympathy, very little understanding for the adult," he said.

Adult dental care has become too expensive for the Community Health Center to subsidize, he said. Since opening in 2003, the center has written off two-thirds of all dental treatment, according to the Community Health Center's website.

"I can only see so many patients and do it for nothing," Dawson said. "The City of Casper needs to be paying something into the CHC. The CHC cannot do it on their own. We need $200,000 right now to continue the same level of care we've been doing."

Because adults aren't well-insured, the center has had to cut back on dental services to them. Adults used to make up 95 percent of the dentists' clients, but now make up just a quarter, Dawson said.

Beth Eveland, CHC administrator, confirmed the problem after the talk.

"I don't think people are really aware of the crisis situation for adults," she said. "It just hit us so hard and fast, like we ran into a brick wall."

While they continue to do emergency and catastrophic care, it's too heavy a financial burden to care for every adult who needs help, she said. "It's very expensive for the patient, even on a sliding fee scale."

Susan Cummings with the Casper Re-Entry Center, a Casper treatment center for incarcerated drug addicts, was at the talk, and told Dawson that her program, too, exhausted its dental budget. One inmate, scheduled to graduate from the program next week, has an abscessed tooth. Cummings said she is checking with the state prison at Rawlins to see if he can be helped there.

"That's what we look at every day," she said.

Reach Barbara Nordby at (307) 266-0633 or at barbara.nordby@casperstartribune.net.