Cannabis and its derivatives, particularly Cannabidiol (CBD), are emerging as promising tools in the field of dentistry. A comprehensive scoping review published in 2021 unveiled that CBD is being employed across three distinct applications in dentistry. These applications encompass periodontal therapy, aid in bone regeneration processes during oral surgeries, and general use in oral treatments. This demonstrates the growing interest in the potential of CBD as a therapeutic agent in the world of dental medicine.

Traditional Knowledge and Modern Science

The historical use of Cannabis sativa in traditional Asian medicine for managing tooth pain, preventing dental caries, and reducing gum inflammation is a testament to its healing properties. This time-honored knowledge has been substantiated by recent research, which elucidates that the distribution of cannabinoid receptors within the oral cavity provides a compelling rationale for investigating the endocannabinoid system’s role in treating oral and dental diseases. In this context, CBD is celebrated for its multifaceted nature. With established antioxidative, anti-inflammatory, and analgesic properties, it has the potential to address various oral health concerns, making it a versatile candidate for therapeutic use.

Fighting Periodontal Disease with Cannabis

Periodontal disease is a prevalent oral health challenge. A growing body of evidence underlines the potential of cannabinoids in combatting oral pathogens. Recent research findings shed light on the promising role of CBD in attenuating periodontal inflammation.

In 2019, a study revealed that physiologically relevant doses of major cannabis-derived phytocannabinoid subtypes, including CBD, can suppress the release of pro-inflammatory cytokines triggered by oral pathogens. 

A 2023 study reported that CBD’s effectiveness extends to its ability to attenuate periodontal inflammation by inhibiting the TLR4/NF-κB pathway, a significant contributor to the inflammatory cascade in periodontal diseases.

A critical assessment published in 2022 evaluated its effects on diseases caused by bacterial virulence factors. This assessment delved into the potential benefits and drawbacks of CBD use in dentistry, paying particular attention to CBD’s interaction with microbially colonized oral tissues, its impact on the inflammatory response in relation to the immune response, and its influence on the destruction and regeneration of hard and soft tissues of the periodontium. Notably, phytocannabinoids’ ability to regulate inflammation in gingival fibroblasts was highlighted. Another study had already indicated the antibacterial properties of another cannabinoid, cannabigerol (CBG), against Streptococcus mutans, bacteria commonly associated with dental infections.

A 2021 study explored the application of Δ9-tetrahydrocannabinol (THC) in chronic periodontal disease in patients with HIV/AIDS. The results indicated that THC exhibited anti-inflammatory and anti-dysbiotic effects within the oral cavity. This research offers a promising outlook for potential therapeutic interventions for this prevalent comorbidity.

Bone Health

A 2009 research examined the impact of CBD on bone resorption and the expression of pro-inflammatory cytokines during experimental periodontitis in rats. The results revealed that CBD contributed to reduced alveolar bone loss and mitigated inflammatory responses, highlighting its potential in managing periodontal diseases. A 2016 study investigating the effects of a synthetic cannabinoid, HU-308, in a rat periodontitis model reported significant reductions in alveolar bone loss and inflammatory activity, showcasing the potential for cannabinoid-based interventions to address oral bone health.

In 2022, a study explored the role of CB1 receptors in stimulating new bone growth under inflammatory conditions, raising the possibility of targeting these receptors for bone regeneration in oral diseases.

Holistic Benefits Beyond Treatment

Moreover, cannabis can also aid individuals suffering from bruxism and oral facial pain. Bruxism, the habitual grinding of teeth, and associated oral facial pain can be incredibly distressing conditions, reducing sleep quality and impacting the patient’s overall life. Studies suggest that cannabinoids’ analgesic and muscle-relaxant properties may help alleviate the discomfort associated with these conditions.

Beyond its direct applications in dental therapy, medicinal cannabis offers holistic benefits for patients. It can be particularly valuable for individuals who experience anxiety when facing dental appointments. Dental anxiety is a common issue, and cannabis, especially CBD, is recognized for its anxiolytic properties. By alleviating anxiety, it can make dental visits a less daunting experience, ultimately leading to better therapeutic outcomes.

Ongoing research explores the role of phytocannabinoids and the endocannabinoid system in various oral and periodontal diseases. While promising, it is essential to note that the solidity of the evidence should be expanded. The groundwork has been laid for future research to provide even more valuable therapeutic options for dental health management. The integration of cannabis into oral healthcare presents a promising avenue for improving patient comfort and the effectiveness of dental treatments.

References:

• Abidi AH, Abhyankar V, Alghamdi SS, Tipton DA, Dabbous M. Phytocannabinoids regulate inflammation in IL-1β-stimulated human gingival fibroblasts. J Periodontal Res. 2022 Dec;57(6):1127-1138. doi: 10.1111/jre.13050. Epub 2022 Sep 7. PMID: 36070347.
• Avraham M, Steinberg D, Barak T, Shalish M, Feldman M, Sionov RV. Improved Anti-Biofilm Effect against the Oral Cariogenic Streptococcus mutans by Combined Triclosan/CBD Treatment. Biomedicines. 2023; 11(2):521. https://doi.org/10.3390/biomedicines11020521
• Aqawi M, Sionov RV, Gallily R, Friedman M, Steinberg D. Anti-Bacterial Properties of Cannabigerol Toward Streptococcus mutans. Front Microbiol. 2021 Apr 22;12:656471. doi: 10.3389/fmicb.2021.656471. PMID: 33967995; PMCID: PMC8100047.
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