Relationship Between Frequent Recreational Cannabis (Marijuana and Hashish) Use and Periodontitis
posted 01/03/2017
publication Journal of Periodontology March 2017, Vol. 88, No. 3, Pages 273-280 , DOI 10.1902/jop.2016.160370 https://doi.org/10.1902/jop.2
Abstract
elationship Between Frequent Recreational Cannabis (Marijuana and Hashish) Use and Periodontitis in Adults in the United States: National Health and Nutrition Examination Survey 2011 to 2012
Jaffer A. Shariff,* Kavita P. Ahluwalia,† and Panos N. Papapanou*
*Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York, NY.
†Division of Behavioral Sciences, Section of Population Oral Health, Columbia University College of Dental Medicine.
Correspondence: Dr. Jaffer A. Shariff, Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, 630W 168 St., PH-7-E-110, New York, NY 10032. E-mail: jas2400@cumc.columbia.edu.
Background: Recreational use of cannabis, following its legalization in some countries, poses emergent oral and periodontal health concerns. The objective of this study is to examine the relationship between frequent recreational cannabis (FRC) (marijuana and hashish) use and periodontitis prevalence among adults in the United States.
Methods: Data from the National Health and Nutrition Examination Survey (NHANES) 2011 to 2012 were analyzed. Primary outcome (periodontitis) was defined using the Centers for Disease Control and Prevention/American Academy of Periodontology classification as well as continuous measurements of probing depth (PD) and clinical attachment loss (AL). Exposure of interest was self-reported cannabis use, defined as “FRC use” versus “non-FRC use.” Bivariate and multivariable regression models were performed using the entire analytical sample (model 1) as well as those who had never used tobacco (never-users) (model 2).
Results: Of 1,938 participants with available cannabis use data and essential covariates, 26.8% were FRC users. Mean number of sites per participant with PD ≥4, ≥6, and ≥8 mm and AL ≥3, ≥5, and ≥8 mm was significantly higher among FRC users than among non-FRC users (mean difference in number of PD sites: 6.9, 5.6, and 5.6; P <0.05; mean difference in number of AL sites: 12.7, 7.6, and 5.6; P <0.05). Average AL was higher among FRC users than among non-FRC users (1.8 versus 1.6 mm; P = 0.004). Bivariate analysis revealed positive (harmful) association between FRC use and severe periodontitis in the entire sample (odds ratio [OR]: 1.7, 95% confidence interval [CI]: 1.3 to 2.4; P = 0.002) as well as in never-smokers (OR: 2.0, 95% CI: 1.2 to 3.5; P = 0.01). This association was retained in multivariable models adjusted for demographics (age, sex, race/ethnicity, and income level), alcohol and tobacco use, diabetes mellitus, and past periodontal treatment (model 1: adjusted OR [aOR]: 1.4, 95% CI: 1.1 to 1.9; P = 0.07; model 2: aOR: 1.9, 95% CI: 1.1 to 3.2; P = 0.03).
Conclusion: FRC use is associated with deeper PDs, more clinical AL, and higher odds of having severe periodontitis.
KEYWORDS: Cannabis, nutrition surveys, periodontitis, tobacco use
Cited by
Donald Bourne, Wesley Plinke, Elizabeth R. Hooker and Carrie M. Nielson. (2017) Cannabis use and bone mineral density: NHANES 2007–2010. Archives of Osteoporosis 12:1.
Online publication date: 13-Mar-2017.
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Hooman Baghaie, Steve Kisely, Malcolm Forbes, Emily Sawyer and Dan J. Siskind. (2017) A systematic review and meta-analysis of the association between poor oral health and substance abuse. Addiction 112:5, 765-779.
Online publication date: 16-Mar-2017.
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