Now that cannabis is legal for adults age 21 and older in Connecticut, cannabis usage has increased significantly. With that comes some trickle-down effects that might not have been on the forefront during initial discussions by lawmakers. An unintended ramification that is especially near and dear to my heart, of course, is the impact of cannabis on the oral cavity and repercussions on dental procedures.
Because most methods of ingestion of cannabis involve the oral cavity, there are obviously effects on the soft and hard tissues of the mouth. Adolescents using cannabis have been shown to have increased oral lesions, increased consumption of sugary foods and drinks that lead to decay, and increased bruxism (grinding of the teeth).
Studies have shown that these issues can become persistent and extend well into midlife. For example, a Dutch study found that use of cannabis joints led to increased periodontitis (loss of the levels of bone “holding the teeth in”) 20 years later.[i] Periodontitis can lead to early tooth loss and should be avoided at all costs.
Cannabis smoke is a carcinogen and leads to dysplastic changes in the cells of the oral mucosa (abnormal growth or changes in cells that could lead to cancer).[ii] People that use cannabis are also more likely to experience oral infections. The reason for this is not known, but it’s thought to be because marijuana can lead to immunosuppression.
In addition, regular use of cannabis affects the body’s response to anesthesia.[iii] Not only has cannabis been shown to increase the risk of cardiovascular and respiratory complications during surgery, it has also been shown to reduce the efficacy of sedatives during medical surgeries and dental procedures. This means that when the dentist is trying to numb your tooth, or a medical surgeon is trying to sedate you for surgery, it may be very difficult to do so, as the use of cannabis makes sedative agents less effective. Regular cannabis users often have problems with pos-operative pain control as well, while they are healing after their surgery.
What does this mean for you and your child? Even though a substance may be legal, it may still have negative consequences that can be far reaching. The risk of tooth decay, periodontitis, early tooth loss, bruxism/grinding, difficulty in using sedative agents, and increase in neoplastic changes in the oral mucosa, may outweigh the temporary enjoyment of temporary recreational euphoria.
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[i] JAMA Psychiatry. 2016 Jul 1;73(7):731-40. doi: 10.1001/jamapsychiatry.2016.0637. Associations Between Cannabis Use and Physical Health Problems in Early Midlife: A Longitudinal Comparison of Persistent Cannabis vs Tobacco Users
Madeline H Meier 1, Avshalom Caspi 2, Magdalena Cerdá 3, Robert J Hancox 4, HonaLee Harrington 5, Renate Houts 5, Richie Poulton 6, Sandhya Ramrakha 6, W Murray Thomson 7, Terrie E Moffitt 2
[ii] Australian Dental Journal . 2005 Jun;50(2):70-4. General and oral health implications of cannabis use C M Cho 1, R Hirsch, S Johnstone
[iii] Current Opinions in Anaesthesiology. 2020 Jun;33(3):318-326. Cannabis, e-cigarettes and anesthesia Rachael S Rzasa Lynn 1, Jeffrey L Galinkin 2
1 Int J Environ Res Public Health. 2022 Nov 18;19(22):15261 Associations between Oral Health
and Cannabis Use among Adolescents and Young Adults: Implications for Orthodontists Austin
Le 1 2 , Edmund Khoo 3 4 , Joseph J Palamar 1
2 JAMA Psychiatry. 2016 Jul 1;73(7):731-40. doi: 10.1001/jamapsychiatry.2016.0637.
Associations Between Cannabis Use and Physical Health Problems in Early Midlife: A
Longitudinal Comparison of Persistent Cannabis vs Tobacco Users
Madeline H Meier 1 , Avshalom Caspi 2 , Magdalena Cerdá 3 , Robert J Hancox 4 , HonaLee
Harrington 5 , Renate Houts 5 , Richie Poulton 6 , Sandhya Ramrakha 6 , W Murray Thomson 7 , Terrie
E Moffitt 2
3 Australian Dental Journal . 2005 Jun;50(2):70-4. General and oral health implications of
cannabis use C M Cho 1 , R Hirsch, S Johnstone
4 Current Opinions in Anesthesiology. 2020 Jun;33(3):318-326. Cannabis, e-cigarettes and
anesthesia Rachael S Rzasa Lynn 1 , Jeffrey L Galinkin 2
