Once marijuana is legalized in Canada on Oct. 17, dentists don’t expect to see a significant increase in pot smokers in their chair, but they do want their patients to tell them if they smoke or eat the drug.
“A lot of patients are a little embarrassed. When you think about it, if you are nervous about dental work, it might be a time you consider using it and not telling your dentist,” Allan Hovan of the BC Cancer Foundation said.
“It is important to tell your dentist, especially if you’re having invasive procedures that involve either IV sedation of drugs or local anesthetic.”
Last fall, Hovan wrote an article for the BC dental journal about vaping and smoking marijuana. He found that while smoking marijuana is not as bad as smoking cigarettes, there’s still cause for concern in the oral health field.
“Like cigarette smoke, it has a harmful effect on tissues over time,” he said. “People aren’t smoking 20 joints a day like they are with cigarettes, so the frequency of exposure, the time of exposure is dramatically less. But marijuana smoking, like cigarette smoking, over time, does lead to more dry mouth which can lead to more dental cavities, more gum disease, staining of teeth.”
For dentists, the main concern is when patients come to their offices high. Most people smoking pot will experience a calming effect, Hovan said, but for some, they can become agitated — increasing their heart rate and causing them to bleed more during procedures. On the flip side, people who are relaxed after smoking marijuana might become too relaxed.
“Sedation effects can be exaggerated so that they achieve — unintentionally — a deeper state of sedation than the dentist or the patient wanted,” Hovan said.
He expects many patients will use edibles before a visit to the dentist’s because it can’t be smelled on their breath like smoke can. Edibles, while much less likely to cause cancer, are less predictable when the effect will start, and many patients don’t use the right dose, Hovan said.
The other big question is how smoking marijuana may cause cancer.
“Does it put you at an increased risk for oral cancer? Yes, if you use it a lot. But certainly not edibles,” Hovan said.
If you’re diagnosed with stage 3, stage 4 oral cancer, your likelihood of being alive in five years is less than 20 per cent. If you get oral cancer instead diagnosed at stage 1 or stage 2 before it starts to be treated, there’s an 80-plus per cent chance that you’ll still be alive in five years.
Early detection, Hovan said, is vital, especially since oral cancer is most commonly found at the base of the tongue near the tonsils, where it’s harder to see. Symptoms people should watch out for include canker sores or cold sores that don’t go away after more than two weeks, nosebleeds, persistent sore throat or voice change.
“It’s in your best interest about your recreational drug use as well as your smoking and drinking history,” Hovan said.