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Cannabis and dental health: what dentists should know

With the legalization of cannabis in Canada, dentists should be aware of the impact recreational or medical cannabis use may have on the oral health of patients.

Confirming patients’ medical history

Despite cannabis being legal, some patients may still be hesitant to inform dentists about cannabis use. As part of providing safe dental care, dentists must ensure that all necessary medical information is obtained prior to initiating treatment.

For patients who list cannabis use on their medical history, asking these questions may provide helpful information:

Do you use cannabis? Yes  No 
If yes, for what purpose do you use cannabis? Medical  Recreational  Both
For what medical condition do you use cannabis?
Medical condition:

How do you usually take cannabis? Smoke Vape Ingest
Have you had any side effects with your cannabis use? If yes, what type of side effects? Yes No N/A
When did you last use cannabis? Answer:
In addition to cannabis, do you use other recreational drugs? Answer:

The possible impacts of cannabis on oral health

Cannabis use has been associated with the following oral health complications:
  • poor quality of oral health, potentially complicated by a number of factors such as tobacco, alcohol and other drug use, poor oral hygiene practices and infrequent dental visits
  • periodontal disease
  • xerostomia (dry mouth), which can contribute to a number of problems, including an increase in the incidence of caries
  • exposure to a number of carcinogens (particularly with smoking), which may lead to dysplastic changes and pre-malignant lesions within the oral mucosa
  • an increased likelihood of post-surgical dry socket, in patients who smoke cannabis

Key points to communicate with patients who use cannabis

If a patient has communicated that they use cannabis, there a few things that dentists may want to consider discussing with the patient.

  • Because the side effects of cannabis are highly variable, it may be appropriate to delay dental treatment for a period of time following cannabis use. Cannabis has been associated with:
    • impaired decision-making that can potentially affect a patient’s ability to provide informed consent for dental treatment
    • behavioural changes, which may affect a patient’s cooperation during dental procedures
    • compromised responsibility for such activities as driving or returning home from the dental office unescorted
    • tachycardia, which may influence the choice of anesthetic modality indicated for certain dental procedures

For your staff and yourself

Dentists, like all regulated health care professionals, have a duty to understand the implications of all relevant medicinals, including cannabis, prescription drugs, over-the-counter medications and herbal remedies used by their patients, in order to ensure these patients receive safe dental treatment at all times.