By Donalee Moulton
In October 2018, Canada became only the second country in the world to legalize recreational cannabis. Despite the legal seal of approval, there are concerns that cannabis may harm your oral health.
“Anything you smoke has very negative consequences on the lips, teeth and gums,” says Dr. Aaron Burry, director of professional affairs with the Canadian Dental Association in Ottawa.
Many people are often smoking more than one substance, including tobacco, cannabis and e-cigarettes, he adds. “We don’t know the consequences of these chemicals combined, but we know they all contain cancer-causing components.”
It is also known that cannabis smoke can cause damage to the soft tissues lining the inside of the mouth, notes Dr. Robyn Ramsay, a dentist with the West Prince Dental Clinic in O’Leary, PEI. “This damage can be in form of white, grey or red lesions. Cannabis stomatitis is a term used to describe the damaged tissue, and these lesions can be precursors to oral cancer.”
She notes that there is also a higher incidence of oral candidiasis. Often called thrush, this is a fungal infection in the mouth caused by an increased proliferation of yeast colonies. “These colonies are normally present in the mouth, but the effects of cannabis in combination with poor oral hygiene can promote their growth.”
Studies also show a direct correlation between cannabis use and gum, or periodontal, disease. A higher rate has been observed among users with increased sites of gingival, or gum, tissue loss and gingival pocket depths in comparison to non-users, says
Smoking cannabis can also lead to a thickening of the soft tissue in the mouth as well as enlargement of the gums, she adds. “This can make maintaining good oral hygiene more difficult.”
It is well known that adverse changes to the gums occur with long-term tobacco use. “They thicken and recede and can hide underlying infections,” notes Dr. Burry. “Smoke will dry and damage tissue cells. That is where the cancer-generating properties start.”
It is not yet well known if such impacts will be experienced by cannabis users. “There is enough evidence, however, to suggest that there is an increased risk. It is the same process and the same chemicals,” says Dr. Burry. “As a general rule, you shouldn’t expose your mouth or lung to any toxic chemical.”
Aside from risks posed by inhaled chemicals, cannabis can have other effects on your mouth and your oral health. For example, cannabis causes xerostomia, more commonly known as dry mouth, due to a decrease in the flow of saliva. “This causes stickier conditions in the mouth that make it easier for cavities to develop,” says Dr. Ramsay.
As well, cannabis users may consume more snacks, especially, sugary snacks. Tetrahydrocannabinol (THC), the main psychotropic agent found in cannabis, stimulates the appetite. With increased consumption of food between meals and before brushing, comes an increased risk of cavities.
It’s important to let your dentist know if you smoke cannabis so that information can be factored in to your ongoing oral health care, says Dr. Burry.
Since the legalization of marijuana in Canada, those discussions have become much more commonplace, he notes. “Today patients are telling us much more often that they are using these products. When cannabis was illegal, they were much less likely to disclose. It is important to have the conversation.”
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