Half of dentists say patients come to appointments high

As marijuana legalization becomes mainstream, patients are showing up to their dentist appointments under the influence.

by Gianna Melillo | Nov. 07, 2022

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A new survey from the American Dental Association revealed the majority of dentists have had a patient attend an appointment while high.

Because marijuana can interact with anesthesia, dentists may have to adjust their care during the appointment.

Previous research has shown a link between marijuana use and poor oral health.

Fifty-two percent of dentists say patients have arrived to appointments high on marijuana or another drug, according to a new survey from the American Dental Association (ADA).

The findings come as more states permit recreational use of marijuana and several weigh decriminalizing psychedelic substances like psilocybin, the active ingredient in magic mushrooms.

However, dentists are raising concerns and suggest patients refrain from marijuana use prior to an appointment, as the drug could affect oral health and treatment.

Marijuana is currently legal in 19 states and Washington, D.C., while five more states are poised to vote on the issue Nov. 8.

“When talking through health histories, more patients tell me they use marijuana regularly because it is now legal,” said New York dentist and ADA spokesperson Tricia Quartey in a release.

“Unfortunately, sometimes having marijuana in your system results in needing an additional visit.”

Of the 557 dentists included in the online survey, 56 percent said they’ve limited treatment to patients who were high, while 46 percent reported needing to increase anesthesia to treat these patients due to the combined effects of marijuana and anesthesia on the central nervous system.

Because marijuana can increase anxiety, paranoia and hyperactivity, it can make visits to the dentist’s office more stressful, Quartey added.

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“It can also increase heart rate and has unwanted respiratory side effects, which increases the risk of using local anesthetics for pain control. Plus, the best treatment options are always ones a dentist and patient decide on together. A clear head is essential for that.”

Research has shown cannabis use is associated with poor oral health, with one study finding finding the drug’s use was linked with gum bleeding, loose teeth and gum disease.

“For dental practice, these results suggest that clinicians can expect a higher prevalence of poor oral health among cannabis-using patients and should consider cannabis use alongside tobacco use as modifiable risk factors central to managing oral health and key topics on which to advise patients,” authors wrote.

THC, the active ingredient in marijuana, also induces hunger. People under the influence may not always make healthy food choices, Quartey said, and this could factor into higher rates of cavities seen among marijuana users.

In a second survey, the ADA queried 1,006 consumers. Around 39 percent reported using marijuana, with smoking being the most popular form. A quarter of respondents said they vaped, while the majority of these patients vaped marijuana.

Although the science on oral health and marijuana is still emerging when it comes to topical or edible forms, “there are strong indications that smoking marijuana is harmful to oral and overall health,” the release reads.

Smoking marijuana has been linked with gum disease and dry mouth and puts tobacco smokers at an increased risk of mouth and neck cancers, Quartey said. Brushing twice a day with a fluoride toothpaste, cleaning between teeth daily and scheduling regular dentist visits can help marijuana users stay on top of their dental hygiene.

The majority of respondents reported being comfortable talking about marijuana with their dentists, while the ADA recommends dentists bring up the subject with patients while reviewing health history.

“If we ask, it’s because we’re here to keep you in the best health we can,” Quartey said. “If you use it medicinally, we can work with your prescribing physician as part of your personal healthcare team.”