Chaffee Benjamin W
Associate professor of oral epidemiology and dental public health at the University of California, San Francisco, School of Dentistry.
J Calif Dent Assoc. 2021 Aug;49(8):493-501.
Cannabis use is common and increasing among adults. Evidence connects cannabis use to poor periodontal health, but few prospective studies exist of adults in the United States.
This investigation examined associations between cannabis use and self-reported adverse oral health conditions among participants (N = 18,872) in the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative cohort. Survey-weighted regression modeling estimated associations between cannabis use and seven self-reported measures of oral health status, adjusted for tobacco use and other disease risk factors.
Reporting past-30-days cannabis use in any of PATH Waves 1-3 was positively and statistically significantly associated at Wave 4 with multiple periodontal disease sequalae and with self-rated fair or poor overall oral health (adjusted odds ratio versus never-users: 1.75; 95% confidence interval: 1.52, 2.01).
These findings provide further evidence that cannabis use is an independent risk factor for poor oral health, although study limitations (self-reported outcomes, limited information on cannabis use frequency and modality) must be considered.
Dental professionals should engage patients in clear, nonjudgmental dialogue about cannabis use to address oral health risks and avoid potential patient safety issues in care delivery. General recommendations for addressing cannabis use in dental practice are presented.
大麻使用在成年人中很常见且呈上升趋势。有证据表明大麻使用与牙周健康不佳有关，但美国针对成年人的前瞻性研究较少。
本调查在具有全国代表性的队列研究“烟草与健康人口评估”（PATH）研究的参与者（N = 18,872）中，考察了大麻使用与自我报告的不良口腔健康状况之间的关联。采用调查加权回归模型估计大麻使用与七种自我报告的口腔健康状况指标之间的关联，并对烟草使用和其他疾病风险因素进行了调整。
在PATH研究的第1 - 3轮中报告过去30天内使用过大麻的参与者，在第4轮时与多种牙周疾病后遗症以及自我评定的整体口腔健康状况为一般或较差呈正相关且具有统计学意义（与从未使用者相比，调整后的优势比：1.75；95%置信区间：1.52，2.01）。
这些发现进一步证明大麻使用是口腔健康不佳的独立风险因素，不过必须考虑研究的局限性（自我报告的结果、关于大麻使用频率和方式的信息有限）。
牙科专业人员应与患者就大麻使用进行清晰、无偏见的对话，以解决口腔健康风险并避免在护理过程中出现潜在的患者安全问题。本文还提出了在牙科实践中应对大麻使用的一般建议。
