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Big Sky Dentistry

Big Sky DentistrySchool of Dental Medicine graduate Ryan Smart, whose research brought attention to the phenomenon of "meth mouth," is honored by the chance to help his community.

Boston [05.29.07] When Ryan Smart embarked a few years ago on the study of "meth mouth," the rapid and horrific tooth decay that often befalls people addicted to methamphetamine, he knew it was about more than just medicine. It was about lives.

"For the health care provider, it's important to realize that these patients need help on multiple levels," says the 2007 Tufts School of Dental Medicine graduate.

In the case of many addicts, meth takes over their lives almost without them realizing it. Smart has seen those affected come from surprising backgrounds: a lawyer, a single mom, a teenage athlete. "They need not be judged about their destructive behavior," he says. "What might have started out as a relatively minor use just got out of hand."

Putting people first is what drives Smart. After he graduated from Carroll College in his native Montana in 2001, he joined Americorps and was assigned to work with the Montana Department of Public Health and Human Services. There, he ended up on a task force set up to examine methamphetamine abuse, which was becoming a growing problem in the state.

The drug is inexpensive and easy to manufacture, using products found at home and over-the-counter at the drug store. "Federal reports estimate that 1.5 million Americans use methamphetamines regularly," Tufts Dental Medicine reported in winter 2006. "According to a 2003 survey, the number of Americans who had tried the drug at least once was up 40 percent since 2000 and up 156 percent since 1996."

The causes of "meth mouth," an accelerated and extensive form of decay and wear that leaves teeth soft, discolored and misshapen, are uncertain. Experts say that poor oral hygiene combined with teeth-grinding and the consumption of sugary snacks contribute to the phenomenon, and recent research shows that dry mouth caused by meth use could facilitate bacterial growth that leads to the decay.

Noting a lack of research into the oral health consequences of methamphetamine abuse, the summer before he came to Tufts Smart connected with Tufts' Dr. Morton Rosenberg (D'74), a professor of oral and maxillofacial surgery and head of anesthesia and pain control at Tufts School of Dental Medicine. Their work resulted in an article in the summer 2005 issue of the Journal of the Massachusetts Dental Society that discussed the growing epidemic and the need for dental professionals to be able to identify methamphetamine abusers and refer them to treatment.

"Here's a student who became interested in a topic and pursued it," Rosenberg told Tufts Dental Medicine. "It was a joy to mentor him on a project that he was excited about and is also important to dentistry. He's very motivated and altruistic and wants to make a difference."

Smart is surprised at the impact his research has had. He notes an e-mail he received from a resident at Brigham and Women's Hospital in Boston, saying she had been referred to Smart and his research on meth mouth from a student at Boston University.

"I never dreamed that people would have this access to this information and work I've done," he says, and he credits Tufts for helping facilitate that access.

"The university and the people I've been involved with have been overwhelmingly helpful," says Smart. "I don't think I would have been able to put this issue into the spotlight had I not had their support and their interest."

Smart's work has gained much acclaim and netted him several honors. In January, Smart received the prestigious American College of Dentists Senior Dental Student Award. This spring, the graduate received several additional parting honors, including the American Academy of Oral Medicine Senior Dental Student award for excellence and achievement in oral medicine and the Horace Wells Senior Student Award from the American Dental Society of Anesthesiology.

Smart was also nominated by his class for the Senior Class Award for Outstanding Peer Support and Leadership and the Joshua O’Dette Award for Leadership and Creativity.

Smart, who will now enter a six-year postgraduate program in oral and maxillofacial surgery at Harvard and Massachusetts General Hospital, looks at his training at Tufts and beyond as a means through which he can repay a community that has given him so much. Growing up, when he had medical issues that could have placed a financial burden on his family, his community banded together with donations that helped him get the health care he needed.

It was also a hometown dentist and family friend who got Smart interested in a career in dentistry. (That dentist is now, independent of Smart's research, doing his own work concerning methamphetamine abuse in Montana.) Now, Smart's "soft spot" for his native Montana has him eyeing opportunities to return.

He hopes to help fill the oral surgeon shortage in the state by working with underserved rural and Native American populations there. The task, he says, would be an "honor."

"What I see is really an opportunity to do something great for people and use my knowledge and education," explains Smart. "It's not just that I went and worked really hard, but without a community to bestow that sort of recognition, it would be all for naught."


Profile by Georgiana Cohen, Tufts Web Communications

Some reporting from the story "Public Health Scourge," originally published in the Winter 2006 edition of Tufts Dental Medicine and written by Jacqueline Mitchell, was used in this story.

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