Cannabis and oral health

There are a number of short-term and long-term health effects associated with cannabis use. One often less focused on, is the effects of regular cannabis use on oral health.

Regular cannabis users have poorer oral health than non-users, which is evidenced by higher rates of decay, missing and filled teeth, higher plaque scores and less healthy gums.

What is the damage?

Saliva is the mouth’s own, effective cleaning system – it dilutes and washes away food particles and acids that cause erosion. Erosion occurs when enamel is dissolved from tooth surfaces, and teeth may appear shorter and have visibly worn surfaces, making them sensitive. Both cannabis and tobacco reduce saliva production leading to a dry mouth. If a person often has a dry mouth, erosion may damage their teeth more quickly.

Periodontal (gum) disease is one of the most common chronic diseases among adults and is linked to saliva production. The inflammation associated with the disease causes a breakdown in supporting connective tissue and bone, leading to tooth loss. Smoking cannabis and tobacco can cause damage to teeth, gums and other soft tissues in the mouth. Soft tissues include lips, tongue, gums, cheeks and the roof of the mouth.

Even small changes in how much saliva is produced can cause bad breath, a sore or burning mouth, and make it harder to chew, swallow and speak.

Cannabis smoking (and eating) causes changes in the lining of the mouth called cannabis stomatitis. In the long-term, this leads to chronic inflammation which is a risk factor for oral cancers.

What does the research say?

• A large general population study has shown that the degree of tooth loss at age 32 years is related to the level of cannabis use, irrespective of tobacco smoking.
• Animal studies suggest that cannabis smoke can decrease bone development around titanium implants.

What do dentists advise?

• Avoid smoking/using cannabis.
• Cannabis smokers should not use alcohol-based mouth rinses due to their dry mouth.
• Due to the effects on heart rate and blood vessels, cannabis should be avoided for at least one week prior to a dental procedure as the use of epinephrine (especially where there are high THC levels), combined with anxiety, can be life threatening.
• Dental implants may not be appropriate for regular cannabis smokers where there is an increased risk of them failing due to the effects on new bone development.