Does Cannabis Have a Negative Effect On Your Oral and Dental Health?

Are you curious about the impact of cannabis on your oral and dental health? It’s increasingly relevant as cannabis becomes more widely used for both medicinal and recreational purposes. While cannabis offers various benefits, from pain relief to anxiety reduction, its potential effects on oral health deserve more attention.

Smokable cannabis remains the leading intake method that many patients choose, but few people realize that it can have a detrimental impact on dental health. The way cannabis affects oral health can vary depending on how it’s consumed, i.e., prerolls versus electric herb vaporizers or water pipes.

Let’s discuss the nuances of smokable medical cannabis use and its impact on your smile and overall oral wellness.

Tobacco And Cannabis Smoke Are Equally Harmful To Dental Health

There may be substantially fewer carcinogens in cannabis smoke compared to tobacco smoke, but when it comes to your teeth, they are equally detrimental to dental health, introducing a range of harmful chemicals and toxins into the mouth. The oral health implications and risks are the same.

These substances can lead to dry mouth, staining, and increased plaque buildup. In both cases, the smoke reduces saliva production and oral mucosa, which are crucial for neutralizing acids and preventing tooth decay. The tar and residues from the smoke adhere to teeth, causing stubborn stains and fostering an environment where bacteria can thrive.

Additionally, the heat from smoking can irritate and damage gum tissues, making them more susceptible to infections and diseases like periodontitis. Both tobacco and cannabis smokers often face higher risks of oral health problems, including cancer, gum disease, and tooth loss.

Why Does Oral Health Matter? The Bigger Picture

The conditions can be very painful if you develop tooth decay or gum disease. Fixing these problems involves a treatment plan from a dentist, and it can be costly. However, protecting your oral health impacts more than just the appearance and function of your teeth.

Poor dental health can complicate many serious chronic diseases. Dental health is intricately connected to overall wellness for several important reasons. First and foremost, the mouth serves as the gateway to the body, and oral inflammation directly influences your overall health.

Poor dental health, particularly conditions like gum disease (periodontitis) and oral infections, can allow bacteria to enter the bloodstream, leading to chronic inflammation. This inflammation has been linked to various serious health conditions, such as cardiovascular disease, diabetes, and respiratory infections.

Furthermore, maintaining good dental health contributes to overall quality of life. Healthy teeth and gums enable proper chewing and digestion of food, which is crucial for adequate nutrition and overall health.

Poor oral health impacts social and psychological well-being by affecting speech, appearance, and self-confidence. Dental problems, such as toothaches or missing teeth, can impair daily activities and diminish quality of life.

Dental Problems Caused By Smoking Marijuana

While many people turn to smokable cannabis for the convenience of use and experience, it’s important to consider its potential impact on dental health. Just like tobacco, smoking cannabis can introduce harmful chemicals into your mouth, which may lead to oral health issues. These substances can cause dry mouth or xerostomia, a condition where saliva production decreases.

Saliva is essential for neutralizing acids and washing away food particles and bacteria, so with you, you’re at a higher risk for cavities and gum disease. Regular cannabis smokers might notice an increase in plaque and tartar buildup, which can further exacerbate these problems.

Xerostomia (Dry Mouth)

Cannabis use, particularly when smoked, can lead to xerostomia, commonly known as dry mouth. This condition occurs because cannabinoids, the active compounds in cannabis, interact with the endocannabinoid system, inhibiting the production of saliva.

When saliva flow is reduced, the natural defense mechanisms are compromised. Symptoms of xerostomia include a persistent dry or sticky feeling in the mouth, difficulty chewing or swallowing, and a rough tongue.

People who consume cannabis for medical and recreational use know the symptoms of dry mouth very well, and it is often referred to as having “cotton mouth” that isn’t easily resolved by drinking water to rehydrate.

Saliva plays a crucial role in maintaining oral health by neutralizing acids produced by bacteria, washing away food particles, and providing disease-fighting substances. Without adequate saliva, bacteria and food particles linger in the mouth, increasing the risk of dental infections and decay. This environment can lead to plaque buildup, cavities, gum disease, and bad breath.

Leukoedema

Leukoedema is a benign oral condition characterized by a white, filmy appearance of the mucous membranes inside the mouth, often seen on the cheeks. While it is more commonly associated with tobacco use, cannabis smoke can also contribute to its development. The exact cause of leukoedema is not entirely understood, but it is believed that the irritation from smoke, whether from tobacco or cannabis, plays a significant role.

Cannabis smoke contains a variety of chemicals and heat that can irritate the oral mucosa, leading to cellular changes. This irritation prompts the mucous membranes to thicken as a protective response, resulting in leukoedema’s characteristic white, opalescent appearance. Although leukoedema itself is typically harmless and asymptomatic, it can sometimes be mistaken for more severe conditions.

Oral Candidiasis

Oral candidiasis, also known as thrush, is a fungal infection in the mouth caused by an overgrowth of the Candida species, commonly Candida albicans. Regular use of smokable cannabis can contribute to or exacerbate this condition.

Cannabis smoke impacts the oral environment by reducing saliva production and altering the natural balance of microorganisms in the mouth. This reduction in saliva, a condition known as xerostomia, creates a dry and less acidic environment that favors the growth of Candida.

Moreover, cannabis smoke introduces various irritants and chemicals that can weaken the mucosal barrier, making it easier for the fungus to colonize. Symptoms of oral candidiasis include creamy white lesions on the tongue, inner cheeks, and sometimes the roof of the mouth, gums, and tonsils. These lesions may be painful and can bleed when scraped.

Managing this condition involves antifungal treatments prescribed by a healthcare provider, maintaining good oral hygiene, and reducing or eliminating the use of smokable cannabis to protect the mouth’s natural defenses.

Early Onset Periodontal Disease

Early onset periodontal disease, a severe form of gum disease affecting young individuals, can be significantly caused or exacerbated by regular use of smokable cannabis. This condition arises from the inflammation and infection of the gums and supporting structures of the teeth.

Cannabis smoke contains harmful chemicals and toxins that irritate the gums, leading to an inflammatory response. This chronic inflammation can damage gum tissue, making it easier for bacteria to invade and multiply.

Cannabis-induced dry mouth further contributes to this problem by reducing saliva production, which normally helps cleanse the mouth and neutralize harmful acids produced by bacteria. Without adequate saliva, bacterial plaque builds up more easily along the gum line, leading to gingivitis, the early stage of gum disease. If left untreated, this can quickly progress to periodontal disease, characterized by deep pockets between the teeth and gums, bone loss, and eventually tooth loss.

Stomatitis

Stomatitis, an inflammation of the mucous membranes in the mouth, can be caused or worsened by regular use of smokable cannabis. This condition manifests as painful sores, redness, and swelling inside the mouth, affecting the inner cheeks, gums, tongue, and lips. Cannabis smoke contains various irritants and toxic substances that can directly inflame the delicate oral tissues, triggering stomatitis.

The high temperatures of the smoke further exacerbate this issue, causing thermal irritation and damaging the mucosal lining. Additionally, cannabis-induced dry mouth (xerostomia) reduces saliva production, which normally helps to protect and heal oral tissues by maintaining a balanced microbial environment and washing away food particles and bacteria. The combination of chemical irritation, heat, and a dry mouth environment promotes the development and persistence of stomatitis.

Managing stomatitis involves reducing or eliminating smokable cannabis use, maintaining good oral hygiene, staying hydrated, and seeking medical or dental advice for appropriate treatments such as mouth rinses and topical medications to alleviate symptoms and promote healing.

Alveolar Bone Loss

Alveolar bone loss refers to the deterioration of the bone surrounding and supporting the teeth, a condition that the regular use of smokable cannabis can significantly influence. This type of bone loss is a severe aspect of periodontal disease, where inflammation and infection of the gums extend to the bone, gradually causing it to break down. Cannabis smoke introduces a range of harmful chemicals and irritants into the mouth, promoting chronic inflammation of the gums (gingivitis), which can progress to periodontitis.

Cannabis-induced dry mouth (xerostomia) exacerbates this issue by decreasing saliva production. Saliva plays a crucial role in neutralizing harmful acids and bacteria, thus protecting oral tissues and bones. Without sufficient saliva, bacterial plaque and tartar buildup increase, leading to more severe gum inflammation and infection. This persistent inflammation triggers the body’s immune response, inadvertently breaking down the alveolar bone while attempting to fight the infection.

Preventing alveolar bone loss involves excellent oral hygiene, regular dental check-ups, and managing or eliminating the use of smokable cannabis to reduce exposure to harmful substances that contribute to gum disease and subsequent bone loss.

Increased Oral And Neck Cancer Risk

Regular use of smokable cannabis can significantly increase the risk of developing oral and neck cancers. Cannabis smoke contains carcinogenic compounds similar to those found in tobacco smoke, such as polycyclic aromatic hydrocarbons and acetaldehyde.

Substances in cannabis and tobacco smoke can damage the DNA in cells lining the mouth, throat, and neck, leading to mutations that can result in cancer. The heat from the smoke also irritates and inflames these tissues, further contributing to cellular damage and increasing cancer risk.

Without adequate saliva, the oral environment becomes more conducive to the proliferation of carcinogens and the development of lesions that can turn malignant. Symptoms of oral and neck cancers may include persistent sores, lumps, difficulty swallowing, and unexplained bleeding.

Do Other Cannabis Intake Methods Pose The Same Risks?

Other methods of cannabis intake, such as edibles, tinctures, and vaporizers, generally pose fewer risks to dental health compared to smokable cannabis. Smoking cannabis introduces harmful chemicals and irritants directly into the mouth, contributing to gum disease, dry mouth, and other oral health issues. However, the effects on dental health vary depending on the method of intake.

Edibles and Tinctures

Consuming cannabis through edibles or tinctures avoids the direct exposure of the mouth to smoke and its associated chemicals. However, sugary edibles can contribute to tooth decay if proper oral hygiene is not maintained. Edibles do not cause dry mouth as severely as smoking, but they can still lead to some reduction in saliva production, mainly if they contain ingredients that promote dry mouth.

Vaporizing

Vaporizing cannabis is generally considered less harmful to dental health than smoking, as it produces fewer toxic byproducts. However, it can still cause dry mouth and may contain some irritants at lower levels than smoke. Regular use of vaporizers can still lead to minor oral health issues, but the risk of gum disease is significantly reduced compared to smoking.

Topicals

Cannabis topicals, such as creams and ointments, pose no risk to dental health as they are applied to the skin and do not involve oral intake. Topical creams do not contribute to or exacerbate dental health problems.

While alternative cannabis intake methods reduce the risk of gum disease and other dental health issues associated with sitting, it’s still essential to maintain good oral hygiene practices and monitor any changes in oral health. Regular dental check-ups are essential for ensuring that any potential problems are addressed early, regardless of how cannabis is consumed.

Dr. Jack Rothman

Dr. Rothman is a diplomate of the American Board of Obstetrics and Gynecology.  He has received multiple special awards and recognitions, including Physician of the Year, from the Pinellas County Medical Association (2014 – 2015) and the President’s Service Award from the Pinellas County Medical Society.

He attended medical school at State University of New York Upstate Medical Center in Syracuse, New York, where he also completed his Obstetrics and Gynecology residency. In addition to practicing medicine, Dr. Rothman’s professional career includes being an Assistant Professor at the University of South Florida and Clinical Instructor at the University of Tampa’s College of Nursing.

Dr. Rothman received his Florida Medical Marijuana Physicians Certification in 2016 and was one of the first recommending physicians through DocMJ in the state and is loved by many of those early patients today.