Marijuana is being recognized for its benefits to both physical and mental health, but that doesn’t mean the drug is completely safe. A recent study from Columbia University offers evidence that recreational pot use increases the risk of gum disease and tooth loss.

The study determined that frequent recreational use of the cannabis plant can double users’ risk of periodontal disease, a condition characterized by an inflammation of the gums in response to a bacterial infection below the gum line. If left untreated, this condition can cause receding gums and eventually tooth loss. This risk is associated with smoking marijuana as well as using hashish and hash oil.

“It is well known that frequent tobacco use can increase the risk of periodontal disease, but it was surprising to see that recreational cannabis users may also be at risk,” said lead research Jaffer Shariff in a statement. “The recent spate of new recreational and medical marijuana laws could spell the beginning of a growing oral public health problem.”

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For the study, the team looked at the occurrence of periodontal disease among 1,938 study participants who were recreational cannabis users. Even when the team controlled for factors such as cigarette smoking, frequent cannabis users were still more likely to have gum disease.

According to the American Academy of Periodontology (AAP), gum disease is a result of toxins produced by bacteria in the plaque irritating the gums. This causes inflammation, which in itself can cause the gums to separate from the teeth, forming pockets that in turn can become infected. As the disease further progresses, the pockets of infection get deeper and more gum tissue is destroyed. Eventually, this can lead to loosening of the teeth to the point where they either have to be removed or fall out on their own. While smoking can increase the risk of developing this condition, there are also other factors such as genetics, age, and overall diet that determine whether you'll develop periodontitis.

The point of the study was not to demonize marijuana and those who use it, but the team argue that it’s important to fully understand possible health consequences as marijuana becomes more widely used for both medical and recreational reasons,

“While more research is needed to determine if medical marijuana has a similar impact on oral health, our study findings suggest that dental care providers should ask their patients about cannabis habits,” added Shariff.

Of course, gum disease can be prevented and lessened with proper oral hygiene. According to the AAP, for example, brushing your teeth will remove plaque trapped in between the teeth and gums that could potentially lead to an infection. Flossing and using mouthwash can also help to prevent this same risk.

Source: Shariff J. While more research is needed to determine if medical marijuana has a similar impact on oral health, our study findings suggest that dental care providers should ask their patients about cannabis habits. Journal of Periodontology. 2017

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