Effect of Frequent Cannabis Use on Periodontal Disease Clinical Parameters: A Systematic Review and Meta-Analysis

Journal Article

2025

Objectives: To verify if an association between marijuana use and periodontal disease exists.

Methods: Electronic searches performed on PubMed/MEDLINE, Embase, Scopus, and Cochrane Library databases yielded seven eligible observational studies, comprising six cohorts (N=13,221). The exposure group was defined as frequent/regular cannabis users and the control group as non-cannabis users. Several periodontal clinical parameters were set as outcomes to ensure a comprehensive and accurate diagnosis of periodontitis:

1. The Centers for Disease Control and Prevention/American Academy of Periodontology classification (Severe vs. No/Mild/Moderate);
2. Clinical Attachment Loss (CAL) as a continuous measure and as a categorical variable (yes/no) for sites with CAL ≥3, ≥4, ≥5mm;
3. Patient’s mean CAL; and
4. Proportion of sites with CAL ≥3 and ≥5mm.

The meta-analysis was performed using R Project (version 3.6.1), and pooled estimates of odds ratios (pooled-OR), prevalence ratios (pooled-PR), and mean differences (pooled-MD) were calculated.

Results: Frequent/regular cannabis users were significantly more likely to present with severe chronic periodontitis (pooled-OR=1.72, 95%CI=1.35-2.18, p<0.01; pooled-PR=1.28, 95%CI=1.03-1.59, p=0.03). Similarly, a higher mean CAL (pooled-MD=0.26mm, 95%CI=0.16-0.36, p<0.01); higher CAL for each of the selected thresholds (CAL ≥3mm: pooled-PR=1.18, 95%CI=1.05-1.32, p<0.01; CAL ≥4mm: pooled-OR=1.54, 95%CI=1.16-2.04, p<0.01; and CAL ≥5mm: pooled-OR=2.23, 95%CI=1.17-4.27, p=0.02); and a higher proportion of sites with CAL ≥3mm (pooled-MD=53.03%, 95%CI=44.48-61.59, p<0.01), and ≥5mm (pooled-MD=23.71%, 95%CI=10.62-36.81, p<0.01) were found in users compared to non-users.

Conclusions: This study demonstrated the detrimental effect of frequent cannabis smoking on periodontal health. Practitioners should be aware of this association when making therapeutic decisions in their patient population.

Keywords: Cannabis, Marijuana Use, Periodontal Diseases, Risk Factors, Systematic Review, Meta-Analysis.

• Publisher Name: Journal Hispanic Dental Association
• Publishing City: New York
• Volume Number: 3
• Issue Number: 2