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Illustration by Alex Citrin

Weed: How Bad Is It?

In our “How Bad Is It?” series, we answer your cringing questions about whether something you’ve done, or do everyday, is bad for your oral health (or completely harmless).

By Tend

We all know that cigarette smoking is awful for oral (and overall) health—thank you, decades of PSAs from the American Dental Association and CDC. But what if what you’re smoking doesn’t contain tobacco? As the availability (and legality) of marijuana increases nationwide, it’s natural to wonder if cannabis use is as harmful for your mouth as smoking cigarettes.

To find out, we sat down with resident expert Dr. Marc Schlenoff, Tend’s Head of Clinical Development.

Smoking weed has been linked to gum issues

“There have been studies that show that marijuana can be a causative factor in periodontal disease,” says Dr. Schlenoff. Meaning, we’re less worried about the effect smoking marijuana has on your teeth, and more worried about the effect it can have on your gums. According to a 2017 study from Columbia University published in The Journal of Periodontology, “frequent recreational use of cannabis—including marijuana, hashish, and hash oil—increases the risk of gum disease.”

“You can tell a smoker by the way their gums look,” explains Dr. Schlenoff, “They’re sort of a grayish color because there’s not a lot of blood in there.” Researchers have long understood that the combination of nicotine—which constricts blood vessels—and heat in cigarettes can restrict blood flow to the gum tissue, which leaves it vulnerable to infection or gingivitis. And it seems the Columbia study has found the same link with marijuana, a nicotine-free substance.

Another one of the side effects of marijuana use that can affect your dental health? Dry mouth. The tetrahydrocannabinol (THC) in marijuana interacts with your body’s cannabinoid receptors, impeding the production of saliva and causing “cottonmouth,” a condition known medically as xerostomia.

Xerostomia can be uncomfortable; more critically, it can have serious oral health effects. Without saliva to help wash away bacteria buildup, you’re at an increased risk for tooth decay and, you guessed it: gum disease. (So what increases saliva flow? Believe it or not, chewing gum. Popping a piece of sugar free gum after you smoke weed can help reduce your risk for xerostomia.)

Vaping may be just as bad (or worse)

When it comes to the newest trends on the market, the research is less clear cut, since there hasn’t been enough time to conduct studies focusing on long-term effects. “We just don’t have that kind of data yet,” explains Dr. Schlenoff.

That said, you may have seen headlines warning about the effects of vaping on your teeth and gums. It’s not hard to imagine why: exposing your gums to heat restricts blood flow. Plus, most e-cigarette liquid typically does contain nicotine, which is a known oral health offender. The bottom line: when it comes to vaping, signs point to it being risky for your oral health—and, of course, your overall health, as vaping has been increasingly linked to severe and even fatal respiratory problems.

CBD results have been more positive

CBD, on the other hand, may be a different story. There is some preliminary research that suggests cannabidiol (the chemical name of CBD) may prevent bone loss, which would help keep your teeth stable and sturdy. However, it’s very preliminary: so far, it hasn’t even been tested on humans. And importantly, all studies involved CBD that was injected or consumed as edibles, not smoked. The bottom line: we can’t (yet) count on CBD as a way to prevent oral health issues.

All things in moderation

So is the occasional cannabis user or vaper doomed, then? Can marijuana users have good oral hygiene? When it comes to incidence of gum disease for smoking, at least, Dr. Schlenoff says that “it’s very clear that your risk is proportional to how much you smoke.”

The more you smoke, the higher the risk. The same is likely true of vaping. (For weed and CBD gummies, there’s currently too little research to know.) In the meantime, whether you smoke or not, one of the best ways to ensure excellent oral health is with excellent dental care. That means daily brushing and flossing, plus twice-yearly dental checkups.


Worried about your own habits?

Be frank with your dentist. Not comfortable talking to your dentist about this kind of thing? Maybe it’s time for a new dentist. This shouldn’t be an awkward conversation.

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