Gum Disease

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Smoking marijuana linked to gum disease

Updated Tue. Feb. 5 2008 4:39 PM ET

CTV.ca News Staff

Smoking a lot of pot can cause plenty of problems. Now a new study has found a new health risk: gum disease.

Researchers studied a group of more than 900 New Zealanders who smoked marijuana more than 40 times a year. They found that smoking that much pot regularly from the age of 18 greatly increased the chance of developing periodontal disease by age 32.

The study is published in the Journal of the American Medical Association.

It's well known that smoking tobacco can lead to gum disease, but no one had ever looked at whether marijuana has the same effect. The study measured how much gums receded at three sites on each tooth at ages 26 and again at 32.

The researchers found that those who reported the highest use of marijuana had triple the risk for severe gum disease and a 60 per cent higher risk for a milder form of it compared to people who had never smoked pot.

Even those who reported smoking pot fewer than 41 times a year were more likely to have mild and severe gum disease than people who never used the drug.

Most of the heavy pot users also smoked tobacco, but the researchers say they controlled for that statistically. When they focused on study participants who were not tobacco-users, they still found a link between marijuana use and gum disease.

The authors say the study adds to the understanding of the health effects of smoking marijuana.

"Heavy cannabis use has been linked to greater risks of developing respiratory disease and some psychiatric conditions," said Terrie Moffit, a Duke University professor of psychology and neuroscience who participated in the study.

"Gum disease should be added to that list of known hazards."

Gum disease is an infection of the tissues surrounding the teeth that causes the gums to shrink. In advanced stages, the gums and bone that support the teeth can become seriously damaged and the teeth can become loose and fall out.

It's not known exactly how smoking pot can lead to gum disease, but the researchers believe it interferes with immune function, inflammatory response and blood flow in the gums, just as tobacco does.

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Cannabis Smoking Linked To Gum Disease


Medical News Today
06 Feb 2008

Scientists studying young adults in New Zealand have revealed that smoking cannabis (marijuana), independent of tobacco, is a potential risk factor for gum disease.

The study is published in the 6th February issue of the Journal of the American Medical Association (JAMA) and was the work of researchers based at the Dunedin School of Medicine in New Zealand; King's College London, England; Duke University, Durham, North Carolina, USA; and the University of North Carolina, Chapel Hill, also in the USA.

Inflammation associated with periodontal disease (disease of the bone, gum or ligaments that anchor and support the teeth) can extend deep into dental tissue, weakening its supportive structure and resulting in loose teeth and eventually tooth loss as well.

Periodontal disease is one of the most chronic diseases in adults, wrote the researchers.

Scientists already knew that smoking tobacco was significantly linked to increased risk of periodontal disease, but there was no information on how cannabis smoking, with our without tobacco smoking, may or may not have the same connections.

In this study Dr Murray Thomson, of the Dunedin School of Medicine, and colleagues, put together a prospective cohort representative of the general population and examined cannabis use at ages 18, 21, 26 and 32 years.

They also did dental checks at ages 26 and 32 years, for which the most recent were completed in June 2005. The 1,015 participants were born in Dunedin, New Zealand, between 1972 and 1973. From these 903 (89 per cent) completed records were obtained for the duration of the study and used in the analysis.

The main outcome measure the researchers looked for was periodontal disease status at age 32 (including changes that had occurred since the previous exam at age 26). This was assessed from a measure known as periodontal CAL (combined attachment loss) which indicates how well or poorly the periodontal tissue is holding onto its teeth.

They defined cannabis exposure in three categories: no exposure, some exposure, and high exposure. No exposure was defined as not using cannabis during the period assessed, some exposure was defined as using cannabis on average between 1 and 40 times, and high exposure was 41 or more times.

<span class=postbold>The analysis showed that</span>:
<ul class=postlist><li>293, or 32.3 percent of participants fell into the no exposure group.</li>

<li>428, or 47.4 per cent of the participants had had some exposure.</li>

<li>And 182, or 20.2 per cent of the participants had had high exposure.</li>

<li>At the age of 32 years, 29.3 per cent (265) of the participants had one or more sites with 4 mm or greater amount of CAL, and 12.3 per cent (111) had one or more sites with 5 mm or more CAL.</li>

<li>New CAL that appeared between the ages of 26 and 32 went up in line with cannabis exposure (ie higher cannabis exposure linked to worse gum disease).</li>

<li>The no cannabis exposure group had an average of 6.5 per cent of new CAL.</li>

<li>For the some exposure group this figure was 11.2 per cent.</li>

<li>For the high exposure group it was 23.6 per cent.</li>

<li>After controlling for tobacco smoking (using pack-years), gender, irregular attendance at the dentist, and amount of dental plaque, the high cannabis exposure group had a 60 per cent increased risk of having one or more CAL sites of 4 mm or more, a 3.1 times greater risk of one or more 5 mm CAL sites, and a 2.2 times greater risk of new CAL.</li>

<li>Tobacco smoking was strongly linked to periodontal disease, but there was no interaction between cannabis use and tobacco smoking in predicting the condition's occurrence. </li></ul><span class=postbold>The researchers concluded that:</span><ul class=postlist><li>"Cannabis smoking may be a risk factor for periodontal disease that is independent of the use of tobacco."</li></ul><span class=postbold>They suggested that</span>:<ul class=postlist><li>"The study's demonstration of a strong association between cannabis use and periodontitis experience by age 32 years indicates that long-term smoking of cannabis is detrimental to the periodontal tissues and that public health measures to reduce the prevalence of cannabis smoking may have periodontal benefits for the population."</li></ul>Shoud these findings be comfirmed by other studies, they suggested that health authorities and practitioners start raising awareness that cannabis use damages teeth and gums.

<i>"Cannabis Smoking and Periodontal Disease Among Young Adults."</i>
W. Murray Thomson; Richie Poulton; Jonathan M. Broadbent; Terrie E. Moffitt; Avshalom Caspi; James D. Beck; David Welch; Robert J. Hancox.
JAMA. 2008;299(5):525-531.
Vol. 299 No. 5, February 6, 2008.

Click here for Article.

Sources: JAMA article and press release.

Written by: Catharine Paddock, PhD
Copyright: Medical News Today

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Study finds link between marijuana use and gum disease

The Marquette Tribune (Marquette U.)
By: Sarah Milnar
Posted: 2/15/08

MILWAUKEE (U-WIRE) - Marijuana smoking may be a risk factor for gum disease that is independent of tobacco use, according to a study in last week's Journal of the American Medical Association.

Murray Thomson, professor of dental epidemiology and public health at University of Otago in New Zealand, is the author of the study. He said researchers knew about the gum-damaging mechanisms of tobacco smoke but wanted to test the effects of cannabis, or marijuana.

"We know there is an emerging body of evidence that gum disease is associated with and is a contributing cause to coronary artery disease, premature heart disease and stroke," Thomson said. "But don't know enough about relationship yet."

The more than 500 toxic substances found in the smoke take over the spot in the hemoglobin molecule reserved for carrying oxygen in the blood, Thomson said.

While cigarette smokers inhale and exhale frequently, cannabis smokers suck in deeply and hold the smoke in order to achieve the desired high, Thomson said. This allows the toxins to be absorbed more readily into the bloodstream, he said.

Smoke is absorbed through the lungs and affects the body's ability to deal with gum disease, he said.

Teeth are anchored in the bone and are attached by periodontal tissue, or gum tissue. If not cleaned properly, more than 500 types of bacteria form plaque on the tooth. These bacteria produce toxins that diffuse into the gums, causing an inflammatory reaction, Thomson said.

The absorption of the drug into the bloodstream weakens the gum's ability to protect against the bacteria and can lead to tooth loss, he said.

Thomson is involved in conducting a cohort study including about 1,000 participants born between 1972 and 1973 in Dunedin, New Zealand. The participants are assessed for various medical conditions every few years.

For this study, cannabis use of the participants was determined at 18, 21, 26 and 32 years of age. Dental examinations were conducted at ages 26 and 32.

By the age of 32, 20.2 percent of individuals had high exposure to cannabis, 47.4 percent had some exposure and 32.3 percent had no exposure. Gum loss in the high, some and no exposure groups were 23.6 percent, 11.2 percent and 6.5 percent, respectively.

Although smoking marijuana is illegal in New Zealand, Thomson said authorities often "turn a blind eye" to its usage. From a dental perspective, Thomson said he cautioned against smoking both tobacco and marijuana.

"The No. 1 thing to do if you want to do something for your gums that is going to make a difference is to stop smoking," he said.

Denis Lynch, Marquette professor of oral and maxillofacial pathology, said there is nothing dentists can find clinically when they examine a patient that would indicate cannabis usage.

But if patients show signs of gum disease, doctors may ask about tobacco or cannabis use when conducting patient history exams, Lynch said.

Lynch said the study did not greatly surprise him. He said doctors have supposed a link between cannabis use and gum disease, but have not had a definitive study to prove it until now.

"It's a validation of what people had suspected for some time," Lynch said

Sources agree that if patients, especially cannabis smokers, are concerned about periodontal health, they should brush at least twice a day and floss a minimum of three times per week.
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