Dentists may be seeing more patients with oral health complications because of increasing rates of marijuana use. According to the National Institute of Drug Abuse, 22.2 million people in the United States have used marijuana in the past 30 days, and the rate of marijuana use is increasing as the stigma attached to using the drug is decreasing.
Recreational marijuana use is currently legal in eight states and the District of Columbia, and the medical use of the drug is now legal in 28 states.
The risk of oral health complications increases with marijuana use because the drug negatively impacts gum tissue and causes periodontal disease- just like smoking cigarettes. Periodontal disease, which begins as an irritation and redness of the gums known as gingivitis, can progress to a more serious condition and lead to tooth loss. Severe periodontal disease can even cause cardiac health complications.
Smokers of marijuana and tobacco tend to have increased rates of periodontal disease because smoking kills off the epithelial cells in the mouth, Epithelial cells serve as the body’s first line of defense against bacteria that cause inflammation and tooth decay.
Without these cells to fight off bacterial invaders, the body is at risk for developing gum infections. Smokers tend to also have deeper gum pockets that surround the teeth. These pockets harbor the bacteria and make gum disease harder to treat.
Treatments for periodontal disease involve deep scaling and root planing to physically remove bacteria from below the gums. Oral antibiotic therapy is also a standard treatment for patients with periodontal disease.
“Patients with periodontal disease that occurs because of smoking- tobacco or marijuana- risk losing their teeth because of their habits,” Dr. Stefania Caracioni, D.D.S., L.V.I.F, said.
Caracioni is a Topeka, Kansas, dentist.
Many marijuana and other drug users tend to avoid going to the dentist to not be identified as a drug user. Avoiding the dentist is detrimental to overall oral health.
“When patients avoid going for regular dental checkups and cleanings, bad things begin to happen,” Caracioni said.
Things like cavities and decay. When these things go unchecked or untreated, patients can end up in pain or with severe complications like loss of teeth, gum tissue and even bone.
“Patients that avoid going to the dentist for regular checkups tend to also not practice good dental hygiene,” Caracioni said.
Good dental hygiene practices involve brushing at least two times a day and flossing at least once per day, as recommended by the American Dental Association. Patients who do not practice good oral hygiene also are at risk of decay, infection and tooth loss.
Other concerns that many dentists have regarding their patients who use marijuana or other drugs, is over the interactions between drugs and anesthesia during procedures. The effects of anesthesia can be heightened by certain drugs.
On the other hand, some patients become immune to anesthesia because of their drug use, making it hard to treat them without pain. Marijuana is stronger today than in previous years, due to higher levels of tetrahydrocannabinol, or THC, the active ingredient of the drug. Other drugs, like cocaine and methamphetamine, raise the blood pressure of users, too, making it dangerous for dentists to use anesthesia if they are high during a dental procedure.
Drug users frequently also have poor diets and crave sugary foods and beverages. These foods and drinks can cause tooth decay and enamel erosion if left on the teeth when patients do not brush them away.
“There are a lot of overall oral health complications that stem from using drugs- whether legally or illegally,” Caracioni said.
Patients who use marijuana should visit their dentists regularly for routine checkups and monitoring to ensure gums and teeth are healthy.