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Cannabis is a genus of annual flowering plants found in temperate zones around the world, with a long history of use for industrial, recreational and medicinal purposes. The proportion of cannabis users has increased dramatically since the early s. One study reported that cannabis usage among older individuals rose from 2. Despite the increasing social and legal acceptance of cannabis over time, public health concerns remain due to the potential adverse effects associated with cannabis use, including impaired cognitive functioning, impairment in driving vehicles, blurred vision, cardiovascular effects e. From a neurotropic perspective, THC is considered the most important of the cannabinoids and it is the main active ingredient in marijuana, responsible for its psychoactive effects. When smoked, marijuana delivers average THC concentrations between 0. Cannabis can also be vaporized through a non-combustive heating process that releases psychoactive compounds such as THC, which are inhaled by the user. Several vaporizer models, including pen-sized and tabletop devices, are used for vaping cannabis herb, wax, or e-liquid. Cannabis can also be mixed into food substances, and numerous cannabis-derived food products are available for medicinal or recreational purposes, particularly in U. The neurological and behavioral effects of cannabis include a sense of well-being coupled with immediate cognitive and psychomotor impairment. Cannabis contains many of the same carcinogens as tobacco, and chronic smoking of marijuana is associated with similar respiratory pathologies as tobacco smoking, , 13, 21, 41, 55, although co-occurrence of tobacco and marijuana smoking complicates ascribing causality to cannabis. The evidence base for cannabis use as a therapeutic medication is in its infancy. Pharmaceutical administration in tablet or capsule form is more common among individuals who are not accustomed to smoking recreationally, 70 and most studies do not show a significant difference in effectiveness among modes of administration. More studies of cannabis-derived compounds in clinical trial settings are needed to assess safety and efficacy. The use of cannabis, particularly marijuana smoking, has been associated with poor quality of oral health, 3, 4, 16, 22, 73 but etiology has been complicated by the number of associated factors with frequent users, including: concomitant use of tobacco, alcohol, and other drugs; poor oral hygiene practices; and infrequent visits to dentists. Leukoedema is more common among cannabis users than non-users but it is unclear whether associated irritants, such as orally inhaled smoke, rather than cannabis itself, may be contributing causes. The immunosuppressive effects of cannabis may contribute as well to a higher prevalence of oral candidiasis compared to non-users. A number of studies have suggested a direct relationship between cannabis use and periodontal disease, , 16, 19, 85, 86 including several systematic reviews 77, 87, 88 and a rapid evidence review. A currently intoxicated i. Increased anxiety, paranoia and hyperactivity may heighten the stress experience of a dental visit. Effects of acute intoxication effects are reported to subside within 2 to 3 hours. The following dental findings may indicate a chronic recreational cannabis user: , 16, 54, , If the patient appears to be a cannabis user, it may be helpful to understand whether the use is medicinal, as this may suggest relevant comorbidities. When dental health care providers suspect cannabis use, recommendations for patient care include: 5, 16, Resolved, that that the ADA encourage the development of best practices for the management of patients and their caregivers, dentists, and dental team members who are under the influence of cannabis. American Society of Addiction Medicine. Content is neither intended to nor does it establish a standard of care or the official policy or position of the ADA; and is not a substitute for professional judgment, advice, diagnosis, or treatment. ADA is not responsible for information on external websites linked to this website. Cannabis: Oral Health Effects. Key Points. Cannabis smoking is associated with periodontal complications, xerostomia, and leukoplakia as well as potentially increased risk of developing mouth and neck cancer. Cannabis use has increased significantly in recent years due to expanding legalization of cannabis for medical and recreational use in various U. With growing use of cannabis and cannabis derivatives nationwide, dental professionals can expect to encounter more patients experiencing various side effects of cannabis use, including effects on the oral cavity e. Cannabinoids and Modes of Cannabis Use. Oral Effects of Cannabis Use. Dental Care Implications. Signs and symptoms of an active intoxicated cannabis user may include: 22, 54 Euphoria Hyperactivity Tachycardia Paranoia Delusions Hallucinations A currently intoxicated i. Emphasizing the importance of regular dental visits and oral care. Encouraging healthy, nutritious snacks over sweet, cariogenic snacks. Considering employing preventive measures, such as topical fluorides. Considering treatment for xerostomia, if necessary, while avoiding alcohol-containing products. Keeping advised of current changes in applicable laws on recreational or medicinal cannabis. Dentists are encouraged to be knowledgeable about substance use disorders—both active and in remission—in order to safely prescribe controlled substances and other medications to patients with these disorders. Dentists should draw upon their professional judgment in advising patients who are heavy drinkers to cut back, or the users of illegal drugs to stop. Dentists are urged to be current in their knowledge of pharmacology, including content related to drugs of abuse; recognition of contraindications to the delivery of epinephrine-containing local anesthetics; safe prescribing practices for patients with substance use disorders—both active and in remission—and management of patient emergencies that may result from unforeseen drug interactions. Dentists are obliged to protect patient confidentiality of substances abuse treatment information, in accordance with applicable state and federal law. The Practice of Dentistry and Cannabis Trans. Cannabinoids for medical use: a systematic review and meta-analysis. JAMA ; 24 From ancient Asian relics to contemporaneity: a review of historical and chemical aspects of cannabis. European Journal of Chemistry ;14 3 General and oral health implications of cannabis use. Aust Dent J ;50 2 Periodontal and oral manifestations of marijuana use. Journal of the Tennessee Dental Association ;92 2 Rechthand MM, Bashirelahi N. What every dentist needs to know about cannabis. Gen Dent ;64 1 Drug and Alcohol Dependence ; National Survey on Drug Use and Health, Accessed October 4, Trends in cannabis use among older adults in the United States, Cannabis: an emerging treatment for common symptoms in older adults. Journal of the American Geriatrics Society ;69 1 Trends in emergency department visits associated with cannabis use among older adults in California, — Journal of the American Geriatrics Society ;71 4 Chronic pain, cannabis legalisation, and cannabis use disorder among patients in the US Veterans Health Administration system, to a repeated, cross-sectional study. Lancet Psychiatry. Hall W, Lynskey M. Assessing the public health impacts of legalizing recreational cannabis use: the US experience. World Psychiatry ;19 2 Medical marijuana, recreational cannabis, and cardiovascular health: a scientific statement from the American Heart Association. Circulation ; 10 :ee Development over time of the population-attributable risk fraction for cannabis use disorder in schizophrenia in Denmark. JAMA Psychiatry ;78 9 The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe EU-GEI : a multicentre case-control study. The Lancet Psychiatry ;6 5 Joshi S, Ashley M. Cannabis: A joint problem for patients and the dental profession. Br Dent J ; 11 Molecular targets of the phytocannabinoids: a complex picture. Prog Chem Org Nat Prod ; Cannabinoids, phenolics, terpenes and alkaloids of cannabis. Molecules ;26 9. Relationship between frequent recreational cannabis marijuana and hashish use and periodontitis in adults in the United States: National Health and Nutrition Examination Survey to J Periodontol ;88 3 Cressey D. The cannabis experiment. Nature ; Bostwick JM. Blurred Boundaries: The therapeutics and politics of medical marijuana. Mayo Clinic Proceedings ;87 2 Dental treatment planning considerations for patients using cannabis: a case report. J Am Dent Assoc ; 5 Centers for Disease Control and Prevention. Accessed September 26, Delta-8 tetrahydrocannabinol: a scoping review and commentary. Addiction ; 6 The form and content of cannabis products in the United States. Journal of General Internal Medicine ;33 9 Uncomfortably high: testing reveals inflated THC potency on retail cannabis labels. PLoS one ;18 4 :e E-Cigarettes: a review of new trends in cannabis use. High school students' use of electronic cigarettes to vaporize cannabis. Pediatrics ; 4 Acute effects of smoked and vaporized cannabis in healthy adults who infrequently use cannabis: a crossover trial. Loflin M, Earleywine M. A new method of cannabis ingestion: the dangers of dabs? Addict Behav ;39 10 Forensic Sci Int ; Cannabis butane hash oil dabbing induced lung injury mimicking atypical pneumonia. Cureus ;12 2 :e Understanding dabs: contamination concerns of cannabis concentrates and cannabinoid transfer during the act of dabbing. J Toxicol Sci ;40 6 How four U. Int J Drug Policy ; Impact of cannabis-infused edibles on public safety and regulation. J Forensic Sci ;67 6 Food and Drug Administration. Accessed October 11, A review of recent advances in the therapeutic uses of secondary cannabinoids. Current Addiction Reports ;3 2 Systematic literature review of human studies assessing the efficacy of cannabidiol for social anxiety. Psychiatry Research Communications ;2 4 Labeling accuracy of cannabidiol extracts sold online. JAMA ; 17 Corroon J, Phillips JA. A cross-sectional study of cannabidiol users. Cannabis Cannabinoid Res ;3 1 Scully C. Cannabis; adverse effects from an oromucosal spray. Br Dent J ; 6 :E12; discussion Adverse health effects of marijuana use. N Engl J Med ; 23 At the tip of an iceberg: prenatal marijuana and its possible relation to neuropsychiatric outcome in the offspring. Biological Psychiatry ;79 7 :ee Marijuana use in the immediate 5-year premorbid period is associated with increased risk of onset of schizophrenia and related psychotic disorders. Schizophrenia research ; 1 Iversen L. Cannabis and the brain. Brain ; 6 National Academies of Sciences Engineering and Medicine. Cannabis use and psychosis: a review of reviews. Eur Arch Psychiatry Clin Neurosci ; 4 National Institute on Drug Abuse. Is there a link between marijuana use and psychiatric disorders? May 8, Accessed October 6, A systematic review: adolescent cannabis use and suicide. Associations between prenatal cannabis exposure and childhood outcomes: results from the ABCD study. JAMA Psychiatry ;78 1 The association between regular cannabis use, with and without tobacco co-use, and adverse cardiovascular outcomes: cannabis may have a greater impact in non-tobacco smokers. Am J Drug Alcohol Abuse ;46 4 Recent cannabis use and myocardial infarction in young adults: a cross-sectional study. Stroke in young cannabis users years : national trends in hospitalizations and outcomes. Int J Stroke ;15 5 Common substances and medications of abuse. In: O'Neil M, editor. Role of cannabis in cardiovascular disorders. J Thorac Dis ;9 7 Wolff V, Jouanjus E. Strokes are possible complications of cannabinoids use. Epilepsy Behav ;70 Pt B Cardiovascular complications of marijuana and related substances: a review. Cardiol Ther ;7 1 Alshaarawy O, Elbaz HA. J Hypertens ;34 8 Effect of cannabis smoking on lung function and respiratory symptoms: a structured literature review. Impact of Cannabis sativa marijuana smoke on alveolar bone loss: a histometric study in rats. Journal of Periodontology ;82 11 Marijuana use and increased risk of squamous cell carcinoma of the head and neck. Cancer Epidemiology and Prevention Biomarkers ;8 12 Adverse effects of medical cannabinoids: a systematic review. Mechoulam R, Hanus L. The cannabinoids: an overview. Therapeutic implications in vomiting and nausea after cancer chemotherapy, in appetite promotion, in multiple sclerosis and in neuroprotection. Pain Research and Management ;6 2 Medical marijuana and chronic pain: a review of basic science and clinical evidence. Current Pain and Headache Reports ;19 10 Robson P. Therapeutic aspects of cannabis and cannabinoids. The British Journal of Psychiatry ; 2 The effects of cannabis among adults with chronic pain and an overview of general harms: a systematic review. Ann Intern Med ; 5 Cannabis and orofacial pain: A systematic review. British Journal of Oral and Maxillofacial Surgery ;60 5 :ee Prod ;71 8 Cannabidiol in dentistry: a scoping review. Dent J Basel ;10 Clinical trials of medicinal cannabis for appetite-related symptoms from advanced cancer: a survey of preferences, attitudes and beliefs among patients willing to consider participation. Internal Medicine Journal ;46 11 Accessed October 25, Medical cannabis or cannabinoids for chronic pain: a clinical practice guideline. BMJ ;n Effect of cannabis usage on the oral environment: a review. Int J Dent Hyg ;6 4 The co-occurring use and misuse of cannabis and tobacco: a review. Addiction ; 7 Clinical practice guidelines for cannabis and cannabinoid-based medicines in the management of chronic pain and co-occurring conditions. Cannabis and Cannabinoid Research. Jager G, Witkamp RF. The endocannabinoid system and appetite: relevance for food reward. Nutrition Research Reviews ;27 1 Dental caries and periodontal disease among people who use drugs: a systematic review and meta-analysis. BMC Oral Health ;20 1 Cannabinoids drugs and oral health—from recreational side-effects to medicinal purposes: a systematic review. International Journal of Molecular Sciences ;22 15 Cannabis and caries--does regular cannabis use increase the risk of caries in cigarette smokers? Oral human papillomavirus infection: differences in prevalence between sexes and concordance with genital human papillomavirus infection, NHANES to Ann Intern Med ; 10 Guy GP, Jr. Vital signs: changes in opioid prescribing in the United States, Accessed October 24, Insufficient evidence to support or refute the association between head and neck cancer and marijuana use. J Evid Based Dent Pract ;16 2 Head and neck cancer among marijuana users: a meta-analysis of matched case-control studies. Arch Oral Biol ;60 12 A microbiome assessment of medical marijuana. Clin Microbiol Infect ;23 4 Substance use and periodontal disease among Australian Aboriginal young adults. Addiction ; 4 A critical review of cannabis in medicine and dentistry: A look back and the path forward. Clin Exp Dent Res ;8 3 Is the use of cannabis associated with periodontitis? A systematic review and meta-analysis. J Periodontal Res ;54 4 Periodontal status in cannabis smokers. A systematic review. J Int Acad Periodontol ;23 2 Oral health implications of cannabis smoking: a rapid evidence review. J Can Dent Assoc ;k2. Cannabis smoking and periodontal disease among young adults. JAMA ; 5 Duane B. Further evidence that periodontal bone loss increases with smoking and age. Evid Based Dent ;15 3 Associations between cannabis use and physical health problems in early midlife: a longitudinal comparison of persistent cannabis vs tobacco users. JAMA Psychiatry Reexamining the association between smoking and periodontitis in the Dunedin study with an enhanced analytical approach. J Periodontol ;85 10 Cannabis use and destructive periodontal diseases among adolescents. Journal of clinical periodontology ;36 3 Int Immunopharmacol ;9 2 Protective effects of cannabidiol on lesion-induced intervertebral disc degeneration. PLoS One ;9 Schulte D. Dealing with patients who have been using marijuana. The Journal of the Michigan Dental Association ;97 1 Cannabis users require more anesthetic agents for general anesthesia in ambulatory oral and maxillofacial surgery procedures. Journal of Oral and Maxillofacial Surgery Momen-Heravi F, Kang P. Management of cannabis-induced periodontitis via resective surgical therapy. The Journal of the American Dental Association; 3 Effects of cannabis use on oral health and systemic effects relevant for oral health professions report prepared for the Office of the Chief Dental Officer. Ottawa: Public Health Agency of Canada; Hujoel PP. Destructive periodontal disease and tobacco and cannabis smoking. Managing xerostomia and salivary gland hypofunction: executive summary of a report from the American Dental Association Council on Scientific Affairs. The Journal of the American Dental Association ; 8 ADA Resources. Other Resources. Last Updated: October 26, Oral Health. Prevention and education.

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Share sensitive information only on official, secure websites. People who have cannabis use disorder may also be at a higher risk of other negative consequences, such as problems with attention, memory, and learning. Some people who have cannabis use disorder may need to use more and more cannabis or greater concentrations of cannabis over time to experience a 'high. Researchers do not yet know the full extent of the consequences when the body and brain are exposed to high concentrations of THC or how recent increases in concentrations affect the risk of someone developing cannabis use disorder. Cannabis—which can also be called marijuana —is the most commonly used federally illegal drug in the United States. Skip directly to site content Skip directly to search. An official website of the United States government. Official websites use. Key points. Some people who use cannabis will develop cannabis use disorder, meaning that they are unable to stop using cannabis even though it's causing health and social problems in their lives. The risk of developing cannabis use disorder is greater in people who start using cannabis during youth or adolescence and who use cannabis more frequently. Signs of cannabis use disorder Fast Statistics Approximately 3 in 10 people who use cannabis have cannabis use disorder. Cannabis use disorder and increased THC concentration Some people who have cannabis use disorder may need to use more and more cannabis or greater concentrations of cannabis over time to experience a 'high. Sources Print Share. Facebook LinkedIn Twitter Syndicate. Content Source:. Prevalence of marijuana use disorders in the United States between and JAMA Psychiatry. Drug Alcohol Depend. Likelihood of developing an alcohol and cannabis use disorder during youth: association with recent use and age. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 5th ed. Washington, DC; Freeman T, Winstock A. Examining the profile of high-potency cannabis and its association with severity of cannabis dependence. Psychol Med. Exploring cannabis concentrates on the legal market: User profiles, product strength, and health-related outcomes. Addict Behav Rep. Weinstein LC, Worster B. Medical Cannabis: A guide to the clinical and legal landscapes. J Fam Pract. New trends in cannabis potency in USA and Europe during the last decade Eur Arch Psychiatry Clin Neurosci. Mapping cannabis potency in medical and recreational programs in the United States. PloS One. Understanding dabs: contamination concerns of cannabis concentrates and cannabinoid transfer during the act of dabbing. The Journal of Toxicological Sciences. Doi: Potter BA. Terpenes: The Magic in Cannabis. Ronin Publishing; Changing landscape of cannabis: novel products, formulations, and methods of administration. Curr Opin Psychol. Association of high-potency cannabis use With mental health and substance use in adolescence. Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study. Lancet Psychiatry. The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe EU-GEI : A multicentre case-control study. Cannabis and Public Health Cannabis—which can also be called marijuana —is the most commonly used federally illegal drug in the United States. View All. Sign up for Email Updates.

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