Cannabis Use and Risk of Periodontitis and Adverse Oral Health Outcomes: A Systematic Literature Review.

Son J.; Bramswig B.; Orlowski C.; Shor A. · Cureus · 2026

**Background & Methods** This systematic literature review searched PubMed, EMBASE, and Cochrane databases from inception through May 31, 2024, to evaluate the association between cannabis use and oral health outcomes, particularly periodontitis, among current or former adult users compared with never users. After screening 6,535 records, 23 articles were included and underwent critical appraisal using the Crowe Critical Appraisal Tool; eligible studies encompassed randomized controlled trials, quasi-RCTs, cohort studies, case-control studies, and cross-sectional surveys. **Key Findings** • Cannabis use was associated with increased risk of periodontitis, the most prevalent condition evaluated across 11 included studies, with 9 of 11 studies identifying a negative relationship between cannabis use and periodontal health. • Beyond periodontitis, cannabis use was linked to multiple adverse oral health outcomes including xerostomia (dry mouth), dental caries, gingivitis, and potentially altered anesthesia requirements during dental procedures. • The findings underscore the importance of patient screening for cannabis use in dental practice, as these oral health complications may complicate dental care and treatment management. **Dosage & Administration** Not reported. The review examined cannabis through multiple consumption methods including smoking, vaping, and edibles but did not standardize or specify dosage parameters across included studies. **Safety & Adverse Effects** The primary adverse effects identified were related to oral health outcomes rather than systemic toxicity. Documented oral complications included periodontitis, xerostomia, dental caries, gingivitis, and potentially altered anesthesia response during dental procedures. These effects were noted to complicate dental care and management of oral health disorders. **Evidence Quality** This systematic review is limited by substantial variability in study methodologies and reported outcomes across the 23 included articles, which restricts definitive conclusions. The review excluded studies involving synthetic cannabinoids and non-English language publications, potentially limiting generalizability. While the methodological rigor was enhanced through dual independent reviewers and formal protocol registration (PROSPERO: CRD42024558418), the heterogeneity of study designs and outcome measures prevented meta-analysis. Evidence quality remains moderate, with most contributing studies representing observational designs rather than high-level RCT evidence, necessitating further standardized research.

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