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CHICAGO, US: State legalisation of marijuana began to be introduced in 2012, and the use of personal and medical marijuana is on the increase in the US. However, in spite of its legal and social acceptance, marijuana use continues to fuel great controversy. For example, in a dental setting, marijuana has been shown to affect the oral health of users, and two new surveys conducted by the American Dental Association (ADA) have shown that it may also hinder dental treatment when patients arrive intoxicated for their appointments. In light of the findings, the ADA suggested that patients refrain from using marijuana before dental visits.
According to the Centers for Disease Control and Prevention, marijuana is the most commonly used federally illegal drug in the US. In 2019, an estimated 48.2 million people in the US were using it. Recreational marijuana use is currently legal in 21 states, two territories and the District of Columbia. Additionally, medicinal use is legal in 37 states, 3 territories and the District of Columbia. Given the high figures and as part of its trend research, the ADA investigated how marijuana use may affect the treatment of dental patients.
Marijuana use before a dental appointment
The first online survey included 557 dentists and found that 52% of the respondents had encountered situations where patients arrived for their appointments intoxicated by marijuana or another drug.
“When talking through health histories, more patients tell me they use marijuana regularly because it is now legal,” ADA spokesperson Dr Tricia Quartey, a dentist in New York, said in a press release. “Unfortunately, sometimes having marijuana in your system results in needing an additional visit,” she added.
“Marijuana can lead to increased anxiety, paranoia and hyperactivity, which could make the visit more stressful.”
According to the results, 56% of the surveyed dentists also reported having to limit treatment to intoxicated patients. Since marijuana and anaesthesia may also have an impact on the central nervous system, 46% of the surveyed dentists reported sometimes needing to increase anaesthesia to provide treatment.
“Marijuana can lead to increased anxiety, paranoia and hyperactivity, which could make the visit more stressful. It can also increase heart rate and has unwanted respiratory side effects, which increases the risk of using local anaesthetics for pain control,” Dr Quartey noted and added that patients must be able to think clearly to choose the best treatment.
Besides general health effects, marijuana use has also been linked with poor dental hygiene, including dental caries. “The active ingredient in marijuana, THC, makes you hungry, and people don’t always make healthy food choices under its influence,” Dr Quartey explained.
Marijuana and vaping
The second survey included 1,006 consumers that were questioned about marijuana and vaping use. It found that 39% of patients reported using marijuana and that smoking was the most common form of using the drug. Additionally, 25% of the total respondents said they vaped, out of which 51% vaped marijuana.
“Smoking marijuana is associated with gum disease and dry mouth, which can lead to many oral health issues,” Dr Quartey commented. “It also puts smokers at an increased risk of mouth and neck cancers,” she added.
According to the data, 67% of patients said that they are comfortable talking about marijuana with their dentist. Given the findings, the ADA recommends that dentists discuss marijuana use while reviewing patients’ health history during dental visits.
The organisation has also stated that it will continue its research around marijuana use and oral health in order to provide clinical recommendations for dentists and patients.