Grafton Sarah Essek, Huang Po Ning, Vieira Alexandre R
J Am Dent Assoc. 2016 May;147(5):354-61. doi: 10.1016/j.adaj.2015.11.019. Epub 2016 Jan 6.
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.
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.
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.
对于治疗使用大麻用于医疗或娱乐目的的牙科患者所涉及的潜在风险,临床研究存在不足。本病例报告的目的是说明口腔保健专业人员需要接受更多教育,以便他们能够了解各种各样的大麻产品及其对牙科治疗的潜在影响。
一名27岁男性到牙科诊所就诊,有一颗无法修复的磨牙需要拔除。在询问病史时,患者报告在预约就诊前约5小时吸食了“一小口”大麻。由于患者承认近期使用过非法药物,因此未进行任何治疗。患者被安排了第二天的预约,但他以对其使用大麻存在偏见为由拒绝了。
使用大麻的美国人数量正在迅速增加。23个州和哥伦比亚特区在某种程度上已将大麻合法化,阿拉斯加、科罗拉多、俄勒冈和华盛顿已将娱乐用大麻合法化。这种可获得性和使用率的急剧上升将要求牙医应对大麻对牙科诊疗的可能影响。牙科护理人员必须基于有关大麻药理和心理作用的科学证据做出临床决策,而不是基于与非法药物使用相关的社会污名。牙医应熟悉常见的给药系统,并了解各种大麻产品之间的差异。可能需要制定临床指南,以帮助医护人员评估患者的认知障碍程度。牙医应该能够就这种习惯对患者口腔健康的潜在后果向患者提供建议。