Cannabis: A joint problem for patients and the dental profession

Abstract

Cannabis is one of the most commonly abused drugs in the UK. The debate about its legality has grown in recent times but the health implication of cannabis use is an issue of today. It is a drug commonly described as being 'soft' but its use has profound effects on many of the body's systems, including the oral cavity. This is of particular importance to the dental clinician. This paper aims to discuss the oral implications of cannabis use and provide advice on ways in which dental professionals can approach this sensitive topic and provide support.

Oral manifestations of illicit drug use

“…It is established that smoking cannabis is associated with xerostomia and therefore an increased risk of caries, with users having higher decayed, missing and filled teeth scores compared to non‐users . A study that aimed to determine the effects of cannabis smoking on oral soft tissues showed that 69.6% of users experienced xerostomia almost immediately following administration of cannabis .…”

“…Cannabis smoking is also associated with an increased risk of oral cancer, as cannabis and marijuana smoke contain a variety of carcinogens including phenols, vinyl chloride and aromatic hydrocarbons and others . Marijuana smoke contains 50% more carcinogenic hydrocarbons compared to tobacco smoke, and Zhang et al described that one marijuana cigarette deposits approximately four times as much tar in the respiratory tract compared to a single filtered tobacco cigarette of approximately the same weight .…”

A systematic review and meta‐analysis of the association between poor oral health and substance abuse

“…The precise dental consequences vary by substance and route of administration. For instance, cannabis use is associated with significant xerostomia , increased caries , and possibly increased oral cancers . People who use amphetamines present with accelerated tooth wear as a result of associated bruxism, in addition to advanced caries, severe xerostomia and an overall dental status that is significantly poor for their age .…”

“…The reality is that these substances are rarely used alone . A large majority of patients report using two or more of illicit substances .…”

“…The indirect effects and life‐styles associated with SU include a lack of priority of oral health and poor oral hygiene. Furthermore, issues regarding to the access of dental care can also contribute to oral diseases . This is compounded by neglected oral hygiene, malnutrition, high sugar diets and sporadic dental appointment patterns.…”