This is MORNING EDITION from NPR News. I'm Linda Wertheimer in for Renee Montagne. She's on vacation.


I'm Steve Inskeep.

Here's the story of one small problem that shows the widespread cost of methamphetamines. Meth addiction first gained attention in farm towns and has now spread to suburbs, even inner cities, and the cost of cracking down has strained law enforcement. Now you can see the effect in state prisons. As more addicts end up behind bars, prisons have to manage their medical problems, including this one: The drug destroys their teeth, and the repair is costing a fortune. NPR's Laura Sullivan reports.

(Soundbite of prison doors closing)


The prison dentist's office at the St. Cloud Correctional Facility in Minnesota is hidden down a long metal staircase in the basement.

(Soundbite of door closing)

SULLIVAN: It's a cave-like room with stone walls, no windows and a group of prisoners on a cement bench waiting patiently for their turn.

(Soundbite of dental tool)

SULLIVAN: Most of them are here for a lot more than a checkup.

(Soundbite of plastic gloves)

Dr. CHRIS HERRINGLAKE(ph) (Dentist): We'll just put some gloves on here and take a look.

SULLIVAN: Dr. Chris Herringlake leans over the open mouth of inmate James Clecatsky(ph). Most of his teeth are missing. Others are black and rotting.

Dr. HERRINGLAKE: As we're looking through the mouth, we can look at some of the areas here that we've taken the teeth out already that he had come in with some abscesses. They were swelling and painful.

SULLIVAN: Herringlake and other prison dentists have a name for this condition. It's called meth mouth. Blackened teeth ground into little nubs or brown holes in the gums where teeth used to be, all from smoking methamphetamine.

Dr. HERRINGLAKE: Got some areas that still are very extensive cavities, as we can see here. The tooth is just mostly gone or portions thereof.

SULLIVAN: Herringlake first saw meth mouth eight years ago. His dental colleagues on the outside were unable to imagine what he was describing. Now the dentist works on meth mouth every day.

Mr. JAMES CLECATSKY (Inmate): Dr. Chris is a great, great dentist. He's a craftsman at what he does.

SULLIVAN: Patients, like inmate James Clecatsky, hope Herringlake will be able to save even five or six of their teeth. Clecatsky is serving a two-year sentence for meth possession. He started smoking the drug three or four years ago. It wasn't long before he noticed something was wrong with his teeth.

Mr. CLECATSKY: They started falling out of my face. You know, you notice one break and then all of a sudden they're all going to hell. I mean, it's--if you're doping, you're not going to the dentist.

(Soundbite of background dental office noise)

SULLIVAN: The drug's impact on teeth is twofold. Meth is made out of hydrochloric acid. Dr. Herringlake says tooth enamel is no match.

Dr. HERRINGLAKE: And they are just literally dissolving the surface. It would be like pouring battery acid on your car fender and then wondering why your fender is starting to fall off.

(Soundbite of background dental office noise)

SULLIVAN: And meth users, like Clecatsky, say the drug makes you dehydrated and craving sweets.

Mr. CLECATSKY: Sugar seems to be one of the needs for amphetamine users. It is for me. I love chocolate, and soda pop is just--I mean, that's a gift from God.

(Soundbite of background dental office noise)

SULLIVAN: And the drink of choice for meth users, Mountain Dew, with twice the sugar and almost twice the caffeine of other drinks.

Dr. HERRINGLAKE: Each 12-ounce can contains 11 teaspoons of sugar. One fellow was even drinking 48 cans of Mountain Dew a day.

Mr. CLECATSKY: And you're constantly quenching that thirst from your drug use, and Mountain Dew's the one. Yes, indeed, good stuff.

Dr. HERRINGLAKE: Well, my motto is: `Don't Do the Dew.'

Mr. CLECATSKY: But it's so tasty.

(Soundbite of background dental office noise)

SULLIVAN: With tooth enamel gone, constant sugar and no brushing, the results are dramatic. Dr. Herringlake's next patient, inmate George Nichols(ph), flies into the rickety old dentist chair to wait for his exam.

Mr. GEORGE NICHOLS (Inmate): I'm 30, from Minneapolis, and I'm here on a second-degree controlled substance of methamphetamines.

(Soundbite of background dental office noise)

SULLIVAN: Nichols is missing most of his back teeth. Since coming to prison, he's been brushing and flossing, hoping to save his front teeth. But it hasn't been easy. Just four days earlier while out in the yard, one of his better teeth, one that hadn't turned entirely black, snapped in half.

Mr. NICHOLS: When it cracked, everyone around me turned and looked. It was like (snaps fingers)--Pow!--you know. I put my hand up to my mouth and it felt like my whole tooth was missing, but it was paper thin with a sharp hook on the bottom. And when that happened, it was, `Oh, man.'

SULLIVAN: It took Dr. Herringlake three and a half hours of intensive dental work to rebuild the tooth. This kind of dental work doesn't come cheap, inside or outside prison. Since 2001, the cost of dental care alone in Minnesota's prisons has almost doubled to $2 million a year. Prison officials say the amount of time and money they're spending fixing prisoners' teeth has wreaked havoc on their budgets, cutting into money they used to spend on health care, staffing or even just giving inmates yearly dental checkups.

(Soundbite of cafeteria noise)

SULLIVAN: Daniel Olmshank(ph) makes his way past a line of prisoners waiting for lunch in the cafeteria next to his office.

(Soundbite of doors swinging closed)

SULLIVAN: As the prison health administrator, his records show a virtual onslaught of prisoners needing emergency dental work and a problem that is getting worse by the month.

(Soundbite of file cabinet doors being opened)

SULLIVAN: He pulls papers from a file cabinet that show that in the first quarter of 2004, about 690 prisoners went to the dentist, mostly with meth-related problems.

(Soundbite of papers being shuffled)

Mr. DANIEL OLMSHANK (Prison Health Administrator): This is the first quarter of 2005 and here we are at 1,238. It's not going to go away.

SULLIVAN: On top of the costs of dental work, prosthetic teeth can cost $2,000 per inmate, and though officials make the prisoners wait two years for them, it makes little difference. They either spend the money on new teeth or spend it on special liquid food and dietary supplements.

And the problem isn't just in Minnesota. Prison systems across the country, from Missouri to South Dakota to Georgia, say the cost of dental care has exploded. Dentist Dr. Herringlake.

Dr. HERRINGLAKE: I really think this is like a giant train locomotive that's just going to be gaining steam and going down the track unless something's done about it.

SULLIVAN: Even as their teeth became the consistency of cantaloupe, meth addicts say when they were high, they didn't care and they didn't feel the pain. Inmates like George Nichols say nothing felt better.

Mr. NICHOLS: At first, it felt like being almost like Superman. I mean, I just--I had incredible amounts of energy, and the--I was just on top of the world. And, you know, I thought I could do anything and I thought I could do everything.

SULLIVAN: After a while, he says he used meth just to keep from the unavoidable comedown. Today he keeps the teeth he's lost in a plastic case, lined up just the way they used to be in his mouth, a reminder to himself that when he gets out, he never wants to use meth again.

Mr. NICHOLS: They symbolize a lot of things to me. There is the pain that went along with them. There's the fact that you only get one set, you know, just like wh--you only get one life. You look at a person when they smile and, you know, you see their teeth. When I smile a lot and I look in the mirror I see my teeth. They're a very physical way of showing how I destroyed myself. You look at that, and it's like seeing a skeleton of yourself.

SULLIVAN: But in a sign of just what corrections officials are up against, that message isn't reaching everybody.

Dr. HERRINGLAKE: We still have more to do.

(Soundbite of background dental office noise)

SULLIVAN: For other inmates, like James Clecatsky, the addiction to meth is just too strong. Even as he learns on this day that he will have to lose several more teeth, Clecatsky says there is no doubt that he will use meth again when he gets out in a year. He's just not going to smoke it anymore.

Mr. CLECATSKY: I have a ball using drugs. I'll always be a drug addict, and that's just the way it is.

(Soundbite of background dental office noise)

Mr. CLECATSKY: It's just like getting up in the morning and brushing your teeth.

SULLIVAN: Or in his case, not brushing. As the fiscal year draws to a close, prison officials in Minnesota say they're expecting to set another new record this year in dental costs. Laura Sullivan, NPR News.

INSKEEP: Over the years, Dr. Herringlake has kept a collection of photos from his patients, and you can find examples if you like at

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