Cannabis use and oral health effects: What the data shows

Dental Tribune International

Tue. 8. September 2026

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NEW YORK, US: As cannabis use becomes more common internationally, it may have important implications for oral health and dental treatment. A recent systematic literature review has examined the available evidence on the relationship between cannabis use and adverse oral health outcomes and identified common oral health trends among cannabis users that may help inform patient counselling and treatment planning.

The review included 23 studies identified in the literature up to 31 May 2024. The studies reported on periodontitis, caries, xerostomia, head and neck cancer, and anaesthesia requirements and efficacy.

Frequent or long-term cannabis use was associated with deeper periodontal pockets, greater clinical attachment loss and increased tooth loss. However, some studies found no significant association, including one that found no direct biological relationship between cannabis use and periodontitis. Overall, the authors considered periodontal disease the oral health outcome most consistently associated with cannabis use and suggested that cannabis use should be considered when assessing periodontal risk, particularly in frequent or long-term users.

The review also identified possible associations with xerostomia and caries. Frequent cannabis use was associated with subjective symptoms of a dry mouth, although objective measures of salivary flow were inconsistent. Some studies reported greater caries experience among cannabis users, but these relationships were weakened or disappeared after accounting for confounding factors. The findings suggest that behavioural factors, including frequent consumption of sugary drinks and snacks and poorer oral hygiene practices, and socio-economic factors, tobacco use and access to dental care may contribute more to the observed difference in dental health between cannabis users and non-users.

Evidence concerning head and neck cancer was inconsistent. Some studies found no relationship between these cancers and cannabis use. Although one study associated cannabis use with human papillomavirus-positive head and neck cancer but not human papillomavirus-negative disease, a later study did not corroborate this.

The findings concerning anaesthesia differed according to the type of anaesthesia. One study suggested that cannabis users undergoing deep sedation or general anaesthesia may require higher doses of propofol, midazolam, ketamine and fentanyl. Local anaesthetic efficacy, however, did not appear to differ significantly. The authors therefore suggested that cannabis use should be taken into consideration when planning deep sedation or general anaesthesia.

One possible biological mechanism proposed for an association between periodontal disease and cannabis use is alteration of the oral microbiome. Supporting this possibility, recent research found that cannabis use was associated with distinct oral bacterial profiles and that some potentially pathogenic bacteria were resistant to the antimicrobial effects of cannabidiol, a cannabis-derived compound, potentially allowing them to be favoured over more susceptible bacteria.

Overall, the review suggests that cannabis use is most consistently associated with poorer periodontal health, whereas evidence concerning several other oral health outcomes remains unclear. The authors thus recommended that dental professionals routinely assess and document cannabis use, including its frequency, duration and route, as well as the date of last use, when evaluating patients and planning treatment. However, the current body of evidence is limited, and considerable clinical and methodological heterogeneity does not allow robust conclusions to be drawn regarding whether adverse oral health outcomes are associated with specific patterns of use or cumulative exposure, or whether particular routes of consumption carry greater risk.

The article, titled “Cannabis use and risk of periodontitis and adverse oral health outcomes: A systematic literature review”, was published online on 18 August 2026 in Cureus.