Cannabis use linked to caries and severe tooth loss

Dental Tribune International

Tue. 18. March 2025

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BUFFALO, N.Y., US: Research has shown that smoking cannabis can be detrimental to overall health and can have adverse effects on the lungs, heart and brain. Just recently, a study conducted by researchers from the University at Buffalo has provided evidence that frequent recreational cannabis use is also associated with dental caries and severe tooth loss. The findings underscore the need for dental professionals to address cannabis use with patients and offer personalised preventive care to reduce potential risks.

According to the US National Center for Drug Abuse Statistics, 45% of Americans have tried marijuana at least once in their lives, and 17% of adults in the US currently use marijuana. Given its popularity and increasing legality, research is needed to determine its effects on the body, including teeth.

The University at Buffalo study sought to investigate the association of untreated coronal caries, untreated root surface caries and severe tooth loss with frequent recreational cannabis use, which was defined as self-reported use at least once per month for the past 12 months. The cross-sectional study analysed data obtained from 5,656 people aged 18–59 years who had participated in the National Health and Nutrition Examination Survey from 2015 to 2018.

The findings showed that 29.34% of the participants reported frequent recreational marijuana use. Compared with non-users, marijuana users were found to exhibit higher rates of untreated dental issues: 27.64% (vs. 20.18% of non-users) had untreated coronal caries, 16.44% (vs. 9.03%) had untreated root caries and 6.50% (vs. 4.23%) had severe tooth loss.

After adjusting for socio-demographic factors, alcohol consumption and other covariates, the researchers found that marijuana users had an increased probability of untreated coronal caries (17%), untreated root surface caries (55%) and severe tooth loss (41%). The authors suggested that these cannabis-related oral health issues may result from multiple factors. These include a decreased saliva buffering capacity, dietary changes linked to cannabis-induced appetite stimulation and chronic oral inflammation caused by chemicals in cannabis smoke, which can contribute to periodontitis and mucosal lesions.

Although smoking cannabis can give rise to oral health issues, the researchers emphasised that it was not their intention to suggest that the drug is inherently harmful or that patients should avoid it. Lead author Dr Ellyce Clonan, a clinical assistant professor in the Department of Pediatric and Community Dentistry at the University at Buffalo, highlighted its therapeutic potential for treating cancer and anxiety. She said in a press release: “Yes, we want to educate our patients about the dangers of smoking, but we want to treat their use with kindness and understanding.” She also explained that the results of the survey point to the need for personalised guidance.

The researchers believe that integrating questions related to cannabis use into patient intake forms could help dental professionals improve care. Dr Clonan commented: “Knowledgeable providers will be better equipped to identify and address the adverse outcomes associated with frequent recreational cannabis use, and in turn, give better advice to their patients.”

“This recent study was just a snapshot in time, so we can’t completely determine cause and effect of the cannabis use and the caries and tooth loss,” Dr Clonan explained. She concluded: “More research is definitely needed.” To that end, the researchers aim to conduct a longitudinal study incorporating additional surveys and patient interviews to assess the long-term impact of cannabis use on oral health.

The study, titled “Frequent recreational cannabis use and its association with caries and severe tooth loss”, was published online in the January 2025 issue of the Journal of the American Dental Association.