Exploring Associations Between Frequency and Methods of Cannabis Use and Tooth Loss.

Merrill R. · Oral health & preventive dentistry · 2026

**Background & Methods** This cross-sectional study analyzed data from 577,848 adults participating in the Behavioral Risk Factor Surveillance System (BRFSS) surveys across 2016, 2022, and 2024 to examine associations between cannabis use frequency, consumption methods, and tooth loss. Multinomial logistic regression was used to evaluate past 30-day cannabis use and tooth loss outcomes, with adjustment for age, sex, race/ethnicity, survey year, tobacco smoking status, and 10 chronic conditions. **Key Findings** • Daily or near-daily cannabis use remained significantly associated with greater odds of tooth loss after adjusting for multiple confounding variables, whereas infrequent use (6.5% of participants) showed no statistically significant association. Daily or near-daily users comprised 5.8% of the sample and demonstrated the strongest relationship with adverse dental outcomes. • Smoking was the predominant consumption method, particularly among frequent users, and adults who smoked cannabis had significantly higher prevalence of tooth loss compared to those using alternative consumption routes (e.g., edibles, vaporization). • Cannabis use prevalence was 12.3% overall, with higher rates among younger adults, men, non-Hispanic Black and multiracial populations, and current or former tobacco smokers. Tooth loss was strongly associated with chronic diseases including arthritis, depression, asthma, and diabetes, with daily or near-daily cannabis users showing stronger associations with some conditions. **Dosage & Administration** Not reported. The study classified users as infrequent (past 30-day use) versus daily or near-daily, without quantifying specific cannabis doses or THC/CBD content. **Safety & Adverse Effects** Tooth loss was identified as the primary adverse outcome. The mechanism underlying cannabis-associated tooth loss was not explicitly discussed, though smoking as a consumption method showed the strongest associations with dental loss, suggesting combustion-related damage may contribute. **Evidence Quality** This study represents moderate quality evidence with limitations including cross-sectional design (precluding causal inference), self-reported cannabis use (potential for misclassification bias), and lack of data on consumption quantity, potency, or specific oral hygiene practices. The large sample size and adjustment for multiple confounders strengthen findings. However, the inability to distinguish between cannabis-specific effects and smoking-related effects limits mechanistic conclusions.

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