Gum Disease Is More Common In Smokers – Even For Cannabis

Philip Ghezelbash July 25, 2019 0 comments

Smokers of cannabis elevate their risk of gum disease. Yet when you use other methods of consumption, the risk lowers.

Why is gum disease in smokers – specifically cannabis smokers – so prevalent? Cannabis is becoming more and more popular as legalization becomes a reality, and with all the claims about its benefits many get the impression it’s a cure-all. However, cannabis consumption does have its downsides and it seems that gum disease in smokers might be one of them.

Cannabis Smoking And Gum Disease

One study looked to see if recreational cannabis consumption could lead to any health problems. The longitudinal study included over 1000 participants and linked smoking cannabis to poor periodontal health. Researchers saw a decline in periodontal health from 26 years old onwards. Other health issues, including inflammation and metabolic health, showed no negative effects from long-term cannabis smoking. In fact, some of the health measures actually improved. 

Periodontitis is also referred to as gum disease, and is actually one of the most common dental conditions. Periodontitis attacks the periodontal tissues of the mouth, like the gums and bone support of the teeth. It occurs when bacteria called plaque starts to build up on your teeth. It is first seen as gingivitis (inflammation of the gums) before it moves through to structures like the periodontal ligament and alveolar bone. Early symptoms include swollen gums, and serious cases can result in bone damage and tooth loss. Furthermore, severe periodontitis is a risk factor for heart and lung disease.  

The study linked people who had smoked cannabis long-term to declining periodontal health. Symptoms include attachment loss, which involves damaged or destroyed connective tissue, and tooth loss. 

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Other Evidence Connecting Smoking Cannabis and Gum Disease 

Other research seems to back up the link between smoking cannabis and gum disease. One literature review, with over 13,000 participants from separate studies, found that 19 percent of participants showed a connection between cannabis smoking and higher levels of periodontitis. 

Another review found similar results, concluding that cannabis smokers had a 1.12 times greater chance of developing periodontal disease than those who abstain.

Another study found that “regular exposure to cannabis smoke was strongly associated with the prevalence and incidence of periodontal attachment loss by age 32.” The researchers controlled for tobacco use and other indicators of periodontal disease. They still found that cannabis is detrimental to periodontal health, and that reducing cannabis consumption might result in improved oral health.

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How To Treat Periodontal Disease 

A review of one woman who smoked cannabis regularly for a three-year period found that she had gingival inflammation, significant gingival enlargement (when your gums start to creep over your teeth), and severe chronic periodontitis in her mandibular anterior teeth.

The patient required both non-surgical and surgical treatment over a 6-month period to show improvement. 

Treatments included:

  • Convincing her to stop smoking cannabis
  • Scaling and root planing (deep cleaning)
  • Osseous surgery, a procedure that reconstructs damaged periodontal bone

Tobacco And Cannabis Have A Similar Effect 

One answer to why periodontal risk occurs could lie in what we know about tobacco smoke. Cigarettes have a similar effect on periodontal health and are thought to damage periodontal tissue through increasing inflammation and vasoconstriction. We know that cannabis doesn’t appear to cause inflammation of the gums. However, there is evidence to indicate that cannabis smoking could cause vasoconstriction in the mouth. 

Contradictory Evidence: Cannabinoids Help Prevent Gum Disease

Confusingly, there is also evidence that cannabinoids may actually improve the conditions that otherwise lead to periodontal disease. 

Cannabis is made up of active cannabinoids that induce effects within the body by interacting with cannabinoid receptors, non-cannabinoid receptors, and by modulating receptor pathways. Studies have actually shown that cannabinoids may be able to improve periodontitis. One study concluded that the endocannabinoid anandamide was able to reduce inflammation in rats with periodontitis through cannabinoid receptors. 

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The cannabinoid receptor CB2 was also shown to induce “anti-inflammatory, osteoprotective, and pro-homeostatic effects” in the oral tissue of rats with periodontitis when activated with the HU-308 agonist. 

Researchers have also demonstrated that the cannabinoid CBD reduces alveolar bone loss in rats with periodontal disease. Moreover, both CBD and THC have antibacterial properties, which is key to fighting the bacteria that can cause periodontitis. 

So Is Cannabis Good Or Bad For Gum Health?

With contradictory evidence surrounding cannabis and oral health, it’s easy to misunderstand. However, one important distinction between the negative and positive research around cannabis and periodontal health is the delivery of cannabis. The prevalence of gum disease in smokers does not appear to apply to non-smoking cannabis patients.

The studies that found a link between cannabis and an increased risk of periodontal disease all reviewed participants who smoked cannabis. Meanwhile the studies that found that cannabinoids improved periodontal health all used patients who took cannabinoid extracts. We know that smoking tobacco leads to a higher risk of periodontal disease. Now it seems that taking cannabis in the same way (smoking) does too. 

Author avatar

Philip Ghezelbash
Philip Ghezelbash is an ex-personal trainer with a science background who currently operates New Zealand's only health specialized writing studio. He is passionate about presenting complex science in an easy to digest manner and is a firm believer that cannabis has substantial potential to be used as a medicine for degenerative disease.