As the regulations regarding marijuana use rapidly change across the United States, healthcare providers are seeing an increase among their patients in usage. Proponents of marijuana often argue that it is safer than tobacco, and in some ways that may be true. It is important to understand that it does have negative effects on health, and that includes the health of your mouth.In this article, we will highlight some of the most common problems we see in the oral health of marijuana users. Most of these effects apply to cannabis that is smoked, but some also apply to any type of THC ingestion (including edibles).
Xerostomia is the scientific term describing a dry mouth. Patients who frequently smoke marijuana have a high risk for this harmful oral condition. A dry mouth leads to an increase in the buildup of plaque and a change in its consistency. Xerostomia makes dental plaque more difficult to remove. Patients with a dry mouth have a much higher risk for cavities, gum disease, and frequent mouth sores.
According to the American Dental Association, “Smoking marijuana is associated with gingival enlargement, erythroplakia and chronic inflammation of the oral mucosa with hyperkeratosis and leukoplakia, sometimes referred to as “cannabis stomatitis,” which can develop into malignant neoplasias. It has been reported that a synergistic effect between tobacco and cannabis smoke may increase oral and neck cancer risk for people who smoke both.” This means that marijuana users have a higher risk for oral cancer, most likely due to the constant irritation of the oral soft tissues.
A common sign of heavy marijuana use is enlargement of the gum tissues and thickening or scarring of oral mucosa. Some users will notice a white appearance of the gums, while others have red areas of inflammation.
Commonly called thrush or candidiasis, this fungal infection is much more prevalent in cannabis users. This is a common side effect of dry mouth, and it appears to be particularly troublesome for those who smoke marijuana frequently.
This infection leads to an overgrowth of fungus on the tongue and roof of the mouth. It can also occur in the corners of the mouth (where the upper and lower lips meet). It often causes pain, burning or tingling on the soft tissues it affects.
Many THC users seem to have poor oral hygiene, leaving large volumes of dental plaque on the teeth, and thus increasing the risk for dental diseases like cavities and gum disease.
The source of the poor oral hygiene is unclear, but it could be the feeling of apathy that many people experience when “high” on marijuana. They simply don’t care.
The phenomenon of the “munchies” that people experience when high on THC leads many to seek out snacks that have a high cavity-causing potential. This includes sweets, like cookies, candies, cake and others. It also includes any simple carbohydrate, like crackers and chips.
These poor snack choices can lead to an increase in the risk for cavities. When you combine these dietary choices with a dry mouth and poor oral hygiene, the risk for cavities is extremely high (pun intended).
Marijuana users also have a higher risk for active gum disease, which includes worsening bone loss. The mechanism of how cannabis affects the tissues surrounding the teeth is unclear. Studies have shown a high rate of progressive periodontal disease in young people who frequently smoke marijuana. Like the risk for cavities, the risk for gum disease is at its worst when you combine it with a dry mouth and poor plaque control.
Because of the effects of marijuana, some people choose to use it prior to a visit with the dentist. This may be to counteract dental phobia or anxiety, or simply to relax them before a long procedure. Unfortunately, this is also risky for two important reasons.
Most dental procedures involve the administration of injected local anesthetic, which contains an ingredient called epinephrine. Epinephrine is a hormone that enacts a “fight or flight” type response. It increases the heart rate and blood pressure. Most people believe that marijuana relaxes you and calms you down, but it has some of the same “fight or flight” effects of the sympathetic nervous system.
Therefore, if you use marijuana prior to a dental visit, during which your dentist uses an epinephrine-containing local anesthetic, you risk experiencing an exaggerated sympathetic response with harmful cardiovascular effects.
Another important risk associated with using marijuana to help relax you prior to a dental visit is a negative impact on your ability to consent to dental treatment. For example, it makes sense to most people that you should not make any important decisions when intoxicated in any way. If you are high at your dental visit, you may be unable to make the right decision regarding dental treatment.
If your dentist is unaware of your condition (i.e. you do not divulge that you have taken marijuana prior to the visit), he or she cannot be held responsible for a poor decision that you make regarding your treatment during that visit.
Call Rockland Dental Specialists today to schedule a consultation with one of our periodontists. We can assess your current situation and help you make changes to improve your oral health. Call us at (845) 259-2500 or complete our online contact form today!