Methamphetamine (meth) is a drug traditionally sought by groups living on the fringes of society. But now, it has entered the mainstream. Over the last five years, meth has seen a surge in abuse, media coverage and attention from law enforcement officers. Meth mouth is characterized by rampant caries, typically on the smooth surfaces of dentition. This article gives a history of meth use and abuse. It describes the condition of meth mouth and its etiology. Treatment options and other dental considerations are discussed.