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The horrific effects of cocaine eroding the roof of your mouth – leaving gaping holes

ABUSING cocaine can leave gaping holes in the roof of users’ mouths, with more and more dentists seeing the horrifying side-effects.

And if record levels of cocaine deaths aren’t enough to put you off the drug, these gruesome pictures of the Class A’s soft tissue damage just might be.

Holes in the palate are one of the most extreme side-effects of cocaine abuse
Facebook / Howard Farran DDS, MBA

It’s a lesser-known side-effect of taking the drug, but is similar to “coke nose”, celebrity dentist Dr Richard Marques told The Sun Online.

Cocaine deaths have increased five-fold in the last 10 years, as the purity and popularity of the drug has rocketed as the price has dropped.

In particular, more young people are trying the Class A – with the UK having the highest number of young cocaine users of any country in Europe.

That’s why The Sun launched the End Of The Line campaign, to highlight the devastating effects the drug can have.

These photos, all showing holes in the palate known as palatal perforation and taken from medical case reports, highlight yet another disturbing reality of regular coke abuse.

More and more doctors are seeing horrific mouth problems like this among people who use cocaine

Coke cuts off blood supply

Dr Marques explained the palate is the roof of the mouth, and separates it from the nasal cavity.

Cocaine can cut off the blood supply to the area, eventually causing it to die.

“This process is called vasoconstriction (closing off of blood vessels),” the Harley Street-based dentist said.

It means the vessels shrink, so oxygen can’t get to the palate in blood as it should.

“With low levels of oxygen, the palate begins to die and shrink away, leaving a hole in the roof of the mouth,” he explained.

The devastating injuries are caused when blood supply to the roof of the mouth is interrupted
Journal of Clinical and Experimental Dentistry

Infection risk

A hole between your mouth and nasal cavity is a “serious issue”, Dr Marques warned, affecting drinking, eating and even speech.

“The most profound and serious consequence is problems drinking,” he explained.

“The hole means liquid can travel through the palate and come out the nose.

“While it’s not generally life-threatening, it is embarrassing and unnatural.”

The defect will also mean a person struggles to taste – and eat – their food.

As well as looking horrific, the injury impacts everyday things for the sufferer – including being able to eat and talk normally
Journal of Clinical and Experimental Dentistry

The roof of your mouth contains many of your taste buds, and more serious problems arise if a piece of food gets stuck in the hole.

“Food can end up travelling into the cavity,” Dr Marques said. “It can cause nasty infections because it can go unnoticed.”

Thirdly, the palate is also vital when it comes to speaking.

Sounds like “s”, “t” and “h” become hard to say because they rely on the tongue coming into contact with the roof of the mouth.

Early warning signs

While a hole forming in the palette is an extreme side effect, Dr Marques said people will often ignore the problem, or may not even realise they have one.

“One of the earliest signs something is wrong is liquid coming out of your nose when you drink,” he said.

“But lots of people won’t seek treatment early one, because they may be embarrassed.

The official name for the side-effect is palatal perforation
Journal of Clinical and Experimental Dentistry

“In other cases it might not even be noticeable to the naked eyes so can be ignored.

“And obviously, regular drug users may suspect it is as a result of their use of illegal drugs and so won’t want to come forward.”

Treating these holes isn’t easy either, with a specialist surgeon needed.

‘Worrying trend as coke is normalised’

Dr Marques said dentists are on the front line and often see the earliest signs of this severe condition.

He warned more and more patients are displaying the nasty dental side effects of taking cocaine, as use surges and society “normalises the drug”.

“It’s a very worrying trend,” he said. “I am seeing more and more patients who are suffering the side effects.

“Typically, it’s the less serious and earlier warning signs.

“As well as snorting coke, users tend to rub it into their teeth and gums, so some of the earliest signs of abuse can show here.

“[Things like] black marks and ultimately it can lead to loose teeth, and tooth loss.”

Coke users may also suffer loose teeth and blackened gums as a result of rubbing the drug inside their mouths, while snorting can cause the nose to collapse
Journal of Clinical and Experimental Dentistry

Other common signs of coke use is neglecting to brush and floss regularly.

“People doing cocaine weekend after weekend will be up late and forget to brush their teeth,” he warned.

“When experiencing a comedown it’s unlikely users will take good care of their oral health.”

Where to go for help


Helpline open 24/7: 0300 123 6600


For help finding a service or to Instant chat


Help, support and advice for those affected by addiction

Change, Grow, Live

Help for anyone with drug and alcohol issues

Dedicated help for people under 25.


Mental health support line: 0300 304 7000

Action on Addiction

Rehab and community addiction treatment

0300 330 0659


Helpline open 9am-9pm, 7 days a week

0300 888 3853

Help for families affected by drugs and alcohol

From a health point of view, Dr Marques said it’s important to remember coke that’s sold on the streets is typically cut with unidentified powders, ranging from cow de-wormer that rots your skin to banned painkillers linked to cancer and local anaesthetics.

“When you take cocaine, the reality is you don’t know what you are inhaling or rubbing into your gums,” Dr Marques warned.

“The drug is cut with other chemicals, many of which could have nasty effects on your oral health.

“It does scare me how society appears to have normalised cocaine, this is a dangerous drug with very serious consequences for your health.”

Am I addicted to cocaine? The signs and symptoms of addiction

Cocaine is highly addictive and what can start out as a one-off can quickly turn into a habit.

Regular use of the drug changes the way the brain releases dopamine – a chemical in the brain that makes you feel happy.

But the high is short-lived so often users will take more to feel the desired effects again.

Over time, the body and brain can become too used to cocaine that it builds up a tolerance, which means you have to take more to feel the same high.

If you recognise any of the following behaviours in yourself, it might mean you’ve developed an addiction to cocaine:

  • You’re taking more of the drug to feel the effects
  • When you stop or reduce your dosage, you feel agitated, restless and depressed
  • You’re struggling to cut down or control how much you take, even if you try to
  • You spend a lot of time thinking about and trying to get cocaine
  • You’re disregarding family, friends and work in favour of taking cocaine
  • You know the damage it’s doing to you, but you can’t stop taking it

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