Methamphetamine is a potent central nervous system stimulant with limited therapeutic effects. This drug produces prolonged euphoria and is relatively inexpensive to purchase and easy to make and distribute. Methamphetamine changes normal physiologic processing of several centrally acting neurotransmitters and ultimately leads to neurotoxicity and neurodegeneration from chronic use. Chronic methamphetamine use has been associated with severe oral health effects; rampant caries is the most notable of these. Dental professionals must recognize patients who are involved with methamphetamine use and understand the risk factors associated with its deleterious oral effects so that preventive and treatment strategies may be implemented for patients who use this drug.