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An Introduction to Substance Use Disorders for Dental Professionals

Course Number: 545

Oral Implications of Marijuana Use/Abuse

Periodontal Disease: Smoking marijuana may contribute to periodontal disease in a way similar to tobacco smoking. A study of individuals who reported smoking cannabis at 18, 21, 26 and 32 years of age in New Zealand investigated the relationship between marijuana and oral health. When measurements of oral health between ages 26 and 32 in the group reporting high cannabis use were compared, there were 23.6% more sites with clinical attachment loss in the 32-year-old group compared with 11.2% in the 26-year-old group. After controlling for tobacco smoking, the authors concluded that cannabis smoking may be a risk factor for periodontal disease that is independent of the use of tobacco.30,59,65

Xerostomia: Heavy use of marijuana may cause xerostomia in the mouth and dryness in the throat, irritation of oral tissues, edema, and erythema of the uvula. As an added detriment, the xerostomia may increase the caries rate.20,30

Tissue Changes: The high temperature of the burning product on the oral tissues causes some tissue change and cellular disruption. Additionally, oral leukoplakia/erythroplakia, leukoedema and hyperkeratotic lesions have been documented. Candida has been reported to be higher in marijuana users compared with tobacco users.8,30

Bleeding: The use of synthetic cannabinoids has been connected with unexplained persistent bleeding which may impact surgical interventions such as extractions, grafting or periodontal therapy.30