Cannabinoids and theDental Patient Dr. Mark Donaldson is a clinical professor in the Department of Pharmacy at the University of Montana inMissoula, clinical associate professor in the School of Dentistry at the Oregon Health and Sciences University in Portland, and adjunct professor at the Faculty of Dentistry at the University of British Columbia. Dr. Donaldson currently serves as associate principal pharmacy advisory solutions for Vizient. Dr. Mark Donaldson likes to discuss the bigger picture before getting into the smaller details of how societal-level changes can affect dentistry. “Cannabis use is common, even more so in Canada after it was legalized in 2018,” he says. “One in three Canadian adults use cannabis regularly, so we know that it will influence the health of many patients we see in the chair.” Like many other drugs or medications, cannabis use affects people’s oral health and influences the efficacy and safety of some dental treatments. “About 85% of cannabis users are under age 45, so when we are treating teenagers and younger adults, cannabis use will be something that we should talk about with our patients,” he says. Smoking is still the most common way to consume cannabis, with vaping the next most popular method. Dr. Donaldson says that patients often believe that vaping cannabinoids has fewer health implications than smoking, but the evidence is not yet clear on the subject, because vaping is relatively new. He says there are health costs associated with both behaviours. “Smoking is associated with a high incidence of periodontal complications, xerostomia, leukoplakia and an increased risk of developing head and mouth cancers,” says Dr. Donaldson. Regular cannabis smokers also sometimes present with gingival enlargement, hyperplasia and oral candidiasis. “In addition, hydrocarbons present in cannabis provide an energy source for Candida albicans,” he says. 32 | 2024 | Issue 4
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