Cannabis: Oral Health Effects
- Cannabis smoking is associated with periodontal complications, xerostomia, and leukoplakia as well as increased risk of mouth and neck cancers.
- Historically, cannabis has been smoked as marijuana, but is increasingly available in other forms, including edible and topically applied products.
- Cannabis use is increasing, along with state legalization, although it remains federally banned.
The use of cannabis, particularly marijuana smoking, has been associated with poor quality of oral health but etiology has been complicated by the number of associated factors with frequent users, including high tobacco, alcohol, and other drug use; poor oral hygiene practices; and infrequent visits to dentists. It also leads to xerostomia (dry mouth), which can contribute to a number of oral health conditions. Further, the main psychotropic agent, THC, is an appetite stimulant, which often leads users to consume cariogenic snack foods. Regular cannabis users are known to have significantly higher numbers of caries than nonusers particularly on normally easy-to-reach smooth surfaces.
The proportion of users has increased dramatically since the early 1970s; in a 2016 Gallup poll, about 44% of Americans said they had at least tried marijuana. Since 2012, many U.S. states have begun legalizing the substance for medical and/or recreational usage, and as of 2016, only six states have not reduced legal restrictions. Notwithstanding the gain in the social and legal acceptance of cannabis, public health concerns remain.
A number of studies have suggested a direct relationship between cannabis use and periodontal disease. Recent studies have tested the relationship between periodontitis and frequent cannabis use and adjusted for confounding factors such as cigarette smoking, alcohol use, social status and other health issues. Significantly higher rates of periodontitis were observed among the frequent users compared to non-users, with significantly higher numbers of sites with high pocket depths (≥4mm) and attachment loss. Further, periodontitis may occur at an earlier age in marijuana users than the general population with chronic periodontitis.