Cannabinoids – high expectations?

Sir, health stores have been rolling up sales following a relatively recent addition of CBD products onto their shelves due to their implication in several health benefits. This raises the question: are there any potential dental uses for cannabinoids in the pipeline?

In the last few years, CBD has been incorporated into multiple products ranging from face creams and teabags to pure CBD oil taken sublingually for its muscle relaxant and anxiolytic effects. It has also been found to be antimicrobial against gram-negative and gram-positive bacteria.¹

These findings have potential implications within dentistry, as there is little research currently available on the efficacy of cannabinoid molecules in targeting oral commensal bacteria found in dental plaque. Incorporation of cannabinols into dentifrices may have positive outcomes on prevention of periodontal disease. Studies conducted recently had small sample sizes and lacked reproducibility; thus, more research is needed in this area.

The current legal status of healthcare products containing cannabinoids stands that any cannabis-derived product with more than 0.01% THC (psychoactive component of cannabis) has to be prescribed by a specialist doctor. Over-the-counter cannabinoid products may be sold without a ‘hemp licence,’ if the THC component is not detected (0.01% as verified by accredited ISO lab).

As outlined in a paper published in the BDJ in 2016,²smoking cannabis with tobacco can have detrimental effects in the oral cavity. Namely, lasting xerostomia post-oral cannabis use, cariogenic foods consumed after use, higher DMFT scores in cannabis users compared to non-cannabis smokers, risk of thermal injuries to soft tissues, higher risk of oral candidiasis and potentially a greater risk of oral cancer compared to non-cannabis smokers. More research is needed on the impact of non-smoking-related oral use of cannabinoids, such as in toothpaste or mouthwash.

Larger studies should be conducted to ascertain whether there are beneficial outcomes for patients with high plaque levels. Research thus far has shown similar bacteriocidal efficacy to the gold standard chlorhexidine digluconate without the detrimental staining potential.³ However, the authors of the study were found to have conflicts of interests as they are financially invested in cannabinoid production. It would be interesting to explore the dental potential of cannabinoids in future unbiased studies.