What you need to know
By Dr. Karla Bloomquist and Dr. Chiarina Iregui
With the growing prominence of cannabis products in many forms, you will likely see that dentists incorporate questions about patterns and types of cannabis use in your medical history. As oral health-care providers, we are very aware of the effects of cannabis on your oral and general health. We feel that you should be too.
Medicinal usage of marijuana is the main reason we have seen such an increase in cannabis options. In 2019, pharmaceutical cannabis held the leading revenue share of 71.9 percent. Severe medical conditions such as cancer, Alzheimer’s disease, neurologic conditions, arthritis and chronic pain are only a few medical conditions that are finding benefit from cannabis use.1
Despite what some feel are health benefits of regular marijuana use, a report published by the American Dental Association, updated July 12, 2019, raises concerns for oral health in those using cannabis. Significantly higher rates of periodontitis (gum disease) were observed among frequent users compared to non-users. These patients showed significantly higher numbers of gingival pocket depths (4+ millimeters in depth) as well as attachment loss and/or gum recession.2
The use of cannabis, particularly in the tobacco form, is associated with poor oral health that is complicated by associated factors such as tobacco use, alcohol consumption, other types of drug use, poor oral hygiene practices and infrequent visits to the dentists.
Cannabis use leads to dry mouth. When saliva production is decreased, the teeth are more prone to decay. THC, an appetite stimulant, often leads users to consume cariogenic (cavity-causing) snack foods. This, combined with decrease in saliva production and poor oral hygiene, is a recipe for dental disaster. Smoking marijuana is also associated with chronic inflammation of the oral tissues that can lead to red-and-white mixed lesions, ultimately resulting in malignancy. A synergistic effect between tobacco and cannabis smoke may increase the oral and neck cancer risk for people who smoke both. A currently intoxicated (“high”) user may present several difficulties for the dental practitioner. Increased anxiety, paranoia and hyperactivity may heighten the stress experience of a dental visit. Increased heart rate and other cardiorespiratory effects of cannabis make the use of epinephrine, which is a component of local anesthetic used by dentists, potentially life-threatening.
How does marijuana affect sleep? The verdict is still out as to whether marijuana is beneficial or detrimental as a sleep aid. There are people who use forms of cannabis in order to improve their ability to fall asleep. The issue with marijuana as a sleep aid is that the body does eventually become used to the dose it receives and will continue to require a higher dose for the same effect. Due to the many forms of cannabis, there has not been a substantial amount of studies done that can help the medical profession determine a concrete answer to the effect marijuana has on sleep quality. There is evidence that the quality of sleep is detrimentally affected due to the amount of time that a person will spend in deep sleep and/or REM. At this time, the American Academy of Sleep Medicine does not promote the use of marijuana for the purpose of sleep or for the treatment of sleep disorders.
Ref: Kelly John Walker, DOCS education, Science and Health Education and Economics, Cannabis and Dentistry, Part 1, July 27, 2020.
1. MaristPoll.Marist.edu/wp-content/uploads/2019/12/UPDATED_NPR_PBS- NewsHour_Marist-Poll_USA-NOS-and-Tables_1912131159.pdf#page=3
2. ADA.org/en/member-center/oral-health- topics/cannabis