Marijuana

With the legalization of medicinal and recreational marijuana in Massachusetts, it is important for dentists and their patients to discuss any cannabis use. Those who consume cannabis should be aware of the potential oral health impacts and various dental treatment considerations.

Oral Health Impacts

According to a special report published in the Journal of the Massachusetts Dental Society, potential oral health impacts of cannabis use include:

  • Leukoedema
  • Dry socket
  • Xerostomia (dry mouth)
  • Green-gold staining
  • Malignancy
  • Periodontal disease

The long-term effects of cannabis are unknown, due to a lack of controlled studies. However, the main health concerns associated with cannabis are related to the act of inhaling smoke from burned plant material and contaminants, rather than secondhand exposure or oral consumption. 

Similar to tobacco smoke, marijuana smoke is associated with increased risk of cancer, lung damage, and oral health diseases—such as oral cancers, dental caries (cavities), and periodontitis, a serious gum infection that damages the soft tissue and destroys the bone that supports your teeth.

Marijuana users are also prone to oral infections, possibly due to its immunosuppressive effects.


Dental Treatment Considerations

If you consume cannabis, it is important to let your dentist know. A patient under the influence of medicinal or recreational marijuana presents unique implications for dental care:
  • Increased anxiety, paranoia, and hyperactivity may heighten the stress of a dental visit.
  • Increased heart rate and other cardiorespiratory effects of cannabis make the use of local anesthetics containing epinephrine or products containing alcohol potentially life-threatening.
  • Under general anesthesia, the use of cannabis has been shown to increase the likelihood of cardiac arrhythmias and respiratory depression. It is advised that cannabis use be ceased 72 hours prior to the use of general or regional anesthesia.
  • Smoking marijuana before or after surgical procedures could result in increased risk of dry socket, implant failure, pain, and infection, along with prolonged healing time.
  • Marijuana interacts with many common prescription and over-the-counter medications, herbs, and supplements. 
  • Marijuana may compromise the user’s judgment, short-term memory, and attention span, which could impact a patient’s communication with dental practitioners.
  • There may be legal implications regarding the validity of informed consent, especially with irreversible procedures such as tooth extractions.
Because of these concerns, dentists may refuse to treat a patient under the influence of marijuana or postpone non-emergency treatment for at least 24 hours.

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