The increasing social and legal acceptance of marijuana for medical and recreational use in the United States raises an important question for dentists: What are the oral health implications of increased cannabis use, a practice that often involves smoking?

In General Dentistry’s cover story for the January/February 2016 edition, Moshe M. Rechthand, a postgraduate student at the University of Maryland School of Dentistry, and Nasir Bashirelahi, PhD, a professor of biochemistry at the School of Dentistry - with a joint appointment at the University of Maryland School of Medicine - provide some elucidation on the matter.

Cannabis, according to the article, has its pros and cons with regard to oral health and general health.

“As the prevalence of marijuana use rises along with its legalization, it has become increasingly important for dentists and other health care providers to understand the potential benefits and risks of marijuana use,” the article says.

It goes on to note that cannabis was first used in India for ceremonial purposes, gaining recreational popularity in the 20th century and in more recent years being used medically as an appetite stimulant, antiemetic, and pain reliever.

With specific regard to dentistry, the article says, “At optimal concentrations, cannabis could provide a novel therapeutic modality against autoimmune and inflammatory diseases” including periodontitis.

The article goes on to point out, however, “marijuana cannot accurately be called a ‘safe’ drug, as there are legitimate concerns regarding marijuana’s acute and chronic effects, such as brain damage and cardiovascular disease.”

Among the “changes to the oral environment” noted in the article is Xerostomia, or dry mouth, which can lead to, among other problems, caries, periodontal disease and bad breath, as well as difficulty chewing and swallowing.

Moreover, cannabis smoke is comparable to tobacco smoke and tobacco use is “associated with increased incidence of oral cancer, and it might be expected that cannabis use would result in similar consequences,” the article says.‌

The article concludes that “it is instrumental for dentists, in their expanded role as oral physicians, to stay current regarding cannabis and its legal status, therapeutic potential, and global effects on the body and oral cavity.”