ADA encourages development of best practices for managing patients under influence of marijuana

61% of dentists say they screen patients for marijuana use or vaping

by Mary Beth Versaci

December 06, 2021

In response to the increased legalization and use of marijuana, the American Dental Association House of Delegates passed a resolution in October to 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 marijuana.

Res. 96H: The Practice of Dentistry and Cannabis calls for more research by external stakeholders, as currently available data on this topic to support the development of clinical guidance are limited.

Dr. Mascarenhas

"The oral health effects associated with smoking cannabis that include periodontal complications, xerostomia and leukoplakia have always been a concern to dentists," said Ana Karina Mascarenhas, B.D.S., Dr.P.H., chair of the ADA Council on Scientific Affairs. "However, the rapidly growing number of states where the use of marijuana and cannabis-containing products is legal will increase the recreational and medical use of these products. Thus, the development of best practices for the management of those under the influence of cannabis is timely and in the best interest of our profession."

Research from the 2021 ADA Council on Communications Trend Report confirms the increased use of marijuana among dental patients and the growing need for more clinical guidance. In the report's March survey of 760 ADA member dentists who are part of the Advisory Circle research panel, 61% of participants said they screen patients for marijuana use or vaping, 57% reported increased marijuana/CBD use among their patients, and 24% said they have seen more issues related to marijuana use or vaping. Generally representative of overall ADA membership, the Advisory Circle research panel is made up of ADA members who participate in surveys typically focused on business-related topics.

The trend report's May survey of 1,000 consumers — with responses balanced to be representative of the U.S. population as a whole — found 67% of adults would be very or somewhat comfortable discussing their marijuana use with their dentists and about 50% could be substantially or moderately influenced not to use marijuana or vape if they learned of the negative effects on their oral health. More members of the public are aware of the oral health impact of vaping than marijuana use, with 57% of adults reporting they think vaping has a detrimental effect on oral health and 32% reporting the same for marijuana.

The ADA's Oral Health Topics page on cannabis discusses the oral effects of marijuana use, including periodontal complications, xerostomia and leukoplakia, as well as a possible increased risk of mouth and neck cancers. It also outlines signs a person could be under the influence of marijuana, such as euphoria, hyperactivity, tachycardia, paranoia, delusions and hallucinations.