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This report describes a case of a meth user with severe oral injury that demonstrates the necessity for prompt treatment when severe tongue biting occurs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>A 43\u2010year\u2010old meth\u2010using man with severe tongue biting was left untreated for more than 24\u00a0hours, resulting in extensive ischemic changes in the tongue and eventual extensive tissue necrosis. After debridement and deep suture repair in several layers, the wound healed. However, tongue dysfunction and a speech disorder remained because of tongue shortening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Meth may induce or aggravate severe oral self\u2010mutilation. Tongue biting with severe tissue damage may occur as oral self\u2010mutilation in meth users; however, among self\u2010mutilation behaviors, tongue biting is especially difficult to prevent. A withdrawal from meth and a behavioral approach may be necessary for fundamental prevention, but it is often difficult in high dependence users. When severe tongue biting occurs, prompt suture reconstruction must be performed before ischemic change occurs to prevent tissue necrosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/scd.12580","type":"journal-article","created":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T15:29:50Z","timestamp":1613748590000},"page":"431-436","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Extensive tissue necrosis of the tongue in a methamphetamine user: A case report"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6950-3181","authenticated-orcid":false,"given":"Atsushi","family":"Shudo","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Kishiwada Tokushukai Hospital  Osaka Japan"},{"name":"Department of Oral and Maxillofacial Surgery Hyogo College of Medicine  Hyogo 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