J Am Dent Assoc. 2016 Jan 5. pii: S0002-8177(15)01149-6. doi: 10.1016/j.adaj.2015.11.019. [Epub ahead of print]
Abstract
BACKGROUND AND OVERVIEW:
There
is a deficit in clinical research on the potential risks involved in
treating dental patients who use cannabis for either medicinal or
recreational purposes. The aim of this case report is to illustrate the
need for additional education for oral health care professionals so they
can understand the wide variety of available cannabis options and their
potential effects on dental treatment.
CASE DESCRIPTION:
A
27-year-old man sought care at the dental clinic with a nonrestorable
molar requiring extraction. During the review of his medical history,
the patient reported taking a "dab" of marijuana approximately 5 hours
before his appointment. Because of the admission of recent illicit drug
use, no treatment was rendered. The patient was offered an appointment
the next day but he refused, citing bias in regard to his cannabis use.
CONCLUSIONS AND PRACTICAL IMPLICATIONS:
The
number of Americans using marijuana is increasing rapidly. Twenty-three
states and the District of Columbia have laws legalizing cannabis to
some degree, and Alaska, Colorado, Oregon, and Washington have legalized
marijuana for recreational use. This drastic upswing in availability
and usage will require dentists to address the possible effects of
cannabis on dental practices. It is imperative that dental care
providers make clinical decisions based on scientific evidence regarding
the pharmacologic and psychological effects of marijuana, not on the
societal stigma associated with illegal drug use. Dentists should be
familiar with popular delivery systems and understand the differences
between various marijuana options. Clinical guidelines may need to be
developed to help providers assess the patient's degree of cognitive
impairment. Dentists should be able to advise patients on the potential
consequences of this habit on their oral health.
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