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Cannabis Use and Periodontal Health

Posted: June 8, 2016

Recreational cannabis use is increasing in the United States and will continue to get higher with further policy changes at the state and federal levels. Tobacco use is an established major risk factor associated with declining periodontal health but what about cannabis use?

A recently published 20-year longitudinal study [Associations Between Cannabis Use and Physical Health Problems in Early Midlife: A Longitudinal Comparison of Persistent Cannabis vs Tobacco Users. Meier MH, et al. JAMA Psychiatry. Published online June 01, 2016. doi:10.1001/jamapsychiatry.2016.0637] followed a representative birth cohort of 1037 individuals born in Dunedin, New Zealand in 1972 and 1973 and followed to age 38 years with 95% retention. The frequency of cannabis use and cannabis dependence at ages 18, 21, 26, 32, and 38 years was assessed.

Even after controlling for tobacco use, socioeconomic status and childhood health “cannabis use was associated with poorer periodontal health at age 38 years and within-individual decline in periodontal health from ages 26 to 38 years”. Although ”tobacco use was associated with worse lung function, systemic inflammation, and metabolic health at age 38 years”, “cannabis use was unrelated to other physical health problems”.

The bottom line: Cannabis use for up to 20 years is associated with periodontal disease.

What about cannabis use and gingival recession risk? Yes, there is an association. For your cannabis using patients, use Gingival Recession Checklist: quickly determine if they are susceptible and if there are modifiable factors for which to develop treatment plans for better management and prevention.

Clinical Tip: Keep a Perio Access Checklist card in each operatory for quick and easy reference.

George K. Merijohn, DDS

San Francisco periodontist George K. Merijohn practiced 28 years and is associate professor in postdoctoral periodontics at UC San Francisco and U Washington. He is appointed special expert to the California Dental Board; serves as a consultant to dental schools, clinicians, and the legal profession; and is on the editorial board of the Journal of Evidence-Based Dental Practice. Dr. Merijohn leads seminars and workshops at major dental conferences and is published in peer-reviewed journals with articles on mucogingival clinical decision-making, risk assessment, and the evidence-based approach. More about George >