Half of dentists surveyed report patients high during dental visits

Surveys show increased prevalence of marijuana use which can affect patients' oral health

More than half of dentists responding to a new ADA survey report seeing patients who are high on marijuana or another drug during dental visits.

The findings come at a time when recreational marijuana use is legal in 21 states and the District of Columbia, plus medicinal use is legal in 37 states and D.C.

The trend shown in the survey is concerning because being high for a dental appointment after recreational marijuana use can limit the care that a dentist can provide, said Tricia Quartey, D.M.D., an ADA spokesperson and general dentist in Brooklyn, New York.

“When talking through health histories, more patients tell me they use marijuana regularly because it is now legal,” said Dr. Quartey. “Unfortunately, sometimes having marijuana in your system results in needing an additional visit.”

An ADA online survey of 557 dentists found 56% reported limiting treatment to patients who were high and, because of how marijuana and anesthesia affect the central nervous system, 46% of surveyed dentists reported sometimes needing to increase anesthesia to treat patients who needed care.

“Marijuana can lead to increased anxiety, paranoia and hyperactivity, which could make the visit more stressful. It can also increase heart rate and has unwanted respiratory side effects, which increases the risk of using local anesthetics for pain control,” Dr. Quartey said. “Plus, the best treatment options are always ones a dentist and patient decide on together. A clear head is essential for that.”

And there are other oral health concerns dentists should be watching for in patients who use marijuana. Smoking marijuana is associated with periodontal disease, xerostomia and increased risk of mouth and neck cancers. Studies have shown regular marijuana users are more likely to have significantly more cavities than nonusers.

“The active ingredient in marijuana, THC, makes you hungry, and people don’t always make healthy food choices under its influence,” Dr. Quartey said. “Medically speaking, munchies are real.”

The ADA has called for additional research around marijuana and oral health and will continue to monitor the science to provide clinical recommendations for dentists and patients.

But an ADA survey of 1,006 consumers on marijuana and vaping use also has some good news: 67% of patients say they are comfortable talking to their dentist about marijuana. The ADA recommends dentists discuss marijuana use while reviewing health history during dental visits.

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

The consumer survey found nearly 4 in 10 (39%) patients reported using marijuana, with smoking the most common form of use. Separately, 25% of respondents said they vaped, and of those respondents, 51% vaped marijuana.

Dentists can make a positive impact on patients using marijuana by stressing the importance of brushing twice a day with fluoride toothpaste, cleaning between teeth daily, visiting the dentist regularly and making healthy snack choices.

For more information on the oral health effects of marijuana, visit ADA.org.