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Prospective, Longitudinal Study in New Zealand Shows an Association between Long-Term Cannabis Smoking and Development of Periodontal Disease

June 01, 2016 Following major changes to policy regulating medicinal and recreational cannabis use in the U.S., health-care professionals, policymakers, and the general public have sought information about the potential association of habitual cannabis use with development of subsequent health problems; however, data have been limited.1, 2  A recent report evaluating data from the “Dunedin Multidisciplinary Health and Development Study,” a prospective, longitudinal study of approximately 1,000 individuals in New Zealand, showed that up to a 20-year history of “persistent” cannabis smoking was associated with periodontal disease, but not other physical health problems, in early midlife.3

The Dunedin Multidisciplinary Health and Development Study followed a cohort of New Zealanders (n=1,037) from birth (in 1972-1973) to age 38 years.  Researchers assessed frequency of cannabis use and cannabis dependence at ages 18, 21, 26, 32, and 38 years and obtained laboratory measures of physical health (i.e., periodontal health, lung function, systemic inflammation, and metabolic health), as well as self-reported physical health, at ages 26 and 38 years. A similar study was done in the cohort to test associations between tobacco smoking and problems with physical health.

Approximately half of the study participants were male (n=535; 51.6%), 484 had ever used tobacco daily and 675 had ever used cannabis. Cannabis use was associated with poorer periodontal health (measured by loss of attachment) at age 38 years and within-individual decline in periodontal health from ages 26 to 38 years, even after controlling for tobacco use; however, cannabis use was not related to other physical health problems. Tobacco use was associated with worse lung function, systemic inflammation (including poor periodontal health), and metabolic health at age 38 years, as well as within-individual decline in health from ages 26 to 38 years.  The authors acknowledged limitations of their analysis, including basing cannabis use data on self-report rather than any laboratory measures, and the challenges with “disentangling cannabis use and tobacco use.”

A review and case report of dental treatment planning considerations for patients using cannabis was reported in the May 2016 issue of JADA.4 The paper acknowledges the “drastic upswing in availability and usage” of a variety of cannabis-containing products, including edible and “vape”-based products.  The authors encourage dental care providers to make clinical decisions “based on scientific evidence regarding the pharmacologic and psychological effects of marijuana, not on the societal stigma associated with illegal drug use,” but also to consider the effects of cannabis on potentially impairing the ability of patients to provide informed consent for dental procedures.
 

References

  1. Hall W. What has research over the past two decades revealed about the adverse health effects of recreational cannabis use? Addiction 2015;110(1):19-35.
  2. Volkow ND, Baler RD, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med 2014;370(23):2219-27.
  3. Meier MH, Caspi A, Cerda M, et al. Associations Between Cannabis Use and Physical Health Problems in Early Midlife: A Longitudinal Comparison of Persistent Cannabis vs Tobacco Users. JAMA Psychiatry 2016.
  4. Grafton SE, Huang PN, Vieira AR. Dental treatment planning considerations for patients using cannabis: A case report. J Am Dent Assoc 2016;147(5):354-61.

Prepared by: Center for Scientific Information, ADA Science Institute

About Science in the News

Science in the News is a service by the American Dental Association (ADA) to its members to present current information about science topics in the news. The ADA is a professional association of dentists committed to the public's oral health, ethics, science and professional advancement; leading a unified profession through initiatives in advocacy, education, research and the development of standards. As a science-based organization, the ADA's evaluation of the scientific evidence may change as more information becomes available. Your thoughts would be greatly appreciated.