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I have several friends that go to a methadone clinic that have had severe problems with tooth decay because of the methadone.  I don't know why this is but my friends say that the dr. at the clinic told them that tooth decay is a possible side effect.  By the way they take it in liquid form.

adding to the pizzicato's third point, sometimes people that abuse one drug may also abuse other drugs that have significant risk for tooth decay, such as meth. 

but on the dry mouth issue, see: http://www.archi.net.au/e-library/health_awards/awards06/effectiveness/methadone

My friends that attend a meth clinic are very particular about their teeth.  Take very good care of theirs.  Never had any problems until about 2nd year in clinic.  Then started having EXTREME decay and even some teeth even breaking.

I have been on high doses of Methadone (180 mg) for over five years now and although it's true, it causes dry mouth, I have a 32 oz cup I carry with Pepsi in it, which I sip all day.  Now I know what everyone says (including my wife and dentist) that it isn't good for you, I am able to help the dry mouth.  I just can't do the water thing.  I have just dropped my daily dose down to 120 mg per day, my PM doc said she felt I was at too high of a dose for my age.  She is lowering it by 20 mg per month.

When I first started, I was drinking regular Pepsi, but have since switched to diet, with just a small amount of regular, for the flavor.  This past year when I went for my check up last earlier this month, I had no cavities.  I did have two with cracks that had to be replaced, but I had no new ones.  When I was drinking regular Pepsi, I think I had four or five the first year.  Because I had Periodontal gum disease several years ago and had sugery to correct the problem, I now have to go in every four months for a cleaning.  Every other one is with my Periodontist, who does a deep cleaning every six months.  I'm sure this has helped with keeping my dental problems to a minimum.

I do have two other medications that also cause dry mouth, so I really do get it, hence the drink I carry. 

If they are attending the clinic everyday for their dose, they cannot be abusing it because they are getting the same dose every day.... let me re-phrase that because they could abuse by telling the doc that they need alot more than they do to be comfortable(as in 60 mg a day is holding them but they take 150) but not in they way we are talkin about it consenring tooth decay.... Also, I was on the methadone clinic for almost 3 years, and my teeth are not decaying.  I guess you could call me a 'junkie' because I was a heroin addict but I also never stoped personal hygine and taking care of myself(i.e. brushing my teeth).  I'm not sure how much sugar the methaondone has, but it doesn't taste bad, I'm sure it has some.  But anyway, I detoxed from my daily dose of 120mg to 30mg and have switched over to suboxone and hope to be finished with that soon too.

Fact 1:  My friends go to a meth clinic.

Fact 2:  Since starting have had tooth decay

Fact 3:  Dr told them that it was a "possible" side effect.

I am sure that their are a ton of other contributing factors to it though because I know of others that have not had tooth decay.  Maybe because they started eatin alot of very sweet food since started clinic has something to do with it as well.