Chemical dependency induces bone demineralization often resulting in (but not limited to) degraded oral health status. The omission of dental status assessment in chemical dependency, when initially evaluating the patient for needed treatment referrals, constitutes disregard of one of the many possible reasons for relapse . Also, chemical dependency results in increased sensitivity to pain. Pain, frequently associated with dental infection can lead to medication-seeking behaviors and abuse of opioid medication (and medication classes). Advanced dental disease, and poor general health outcomes results in poor social outcomes. Poor social outcomes include: 1) return to substance abuse due to persistent anhedonia 2) negative outcomes of job-seeking as a result of cultural values and prejudice toward obvious lack of dental care in the form of missing, broken and rotting teeth, and finally, 3) possible death as a result of advanced dental infection. This writing explores substance-specific dental diseases, provides a dental assessment tool for triaging symptom presentation, and suggests treatment and policy changes to improve standard of care.