Cannabis use and periodontal disease

Cannabis was the most commonly reported drug. Many people use cannabis with minimal negative consequences

Periodontitis is one of the most common chronic diseases in the world and estimated to affect just over 11% of the global population.  A New Zealand cohort study (Dental Elf – 7th Jun 2016) suggested that cannabis smoking may have an impact on periodontal disease.

The aim of this review was to investigate if there is an association between cannabis use and periodontitis.


Searches were conducted in the PubMed, Scopus, ISI Web of Science, BVS— Virtual health library, and SCIELO databases. Cross-sectional and longitudinal studies investigating the possible association between cannabis use and periodontal disease were considered. Two reviewers independently extracted data and assessed study quality using the Joanna Briggs Institute checklist for observational studies. Periodontitis was the main outcome


  • 5 studies (1 Cohort, 4 cross sectional) involving a total of 13,491 patients were included.
  • Studies were conducted in Australia, Chile, New Zealand, Puerto Rico and the USA.
  • Periodontal disease was clinically assessed combining measurements of probing depth and attachment loss.
  • Cannabis use was assessed by self-report.
  • All studies were considered to be high quality with 4 contributing to the meta-analysis.
  • A positive association was observed between cannabis use and the presence of periodontal disease; Prevalence ratio= 1.12 (CI95%; 1.06-1.19).


The authors concluded: –

The results of systematic review and meta-analyses demonstrate that the use of cannabis is associated with a higher prevalence of periodontitis.


While this review suggests a positive relationship between cannabis use and periodontal disease the quality of the evidence to support this is low to very low.  Only one of the included studies in longitudinal, this is the New Zealand studies which we have considered previously (Dental Elf – 7th Jun 2016). The other studies are cross-sectional and as the review authors highlight, all of the studies have employed different definitions of periodontal disease in addition cannabis use was a self-reported measure with no standard approach taken.


Primary Paper

Chisini LA, Cademartori MG, Francia A, Mederos M, Grazioli G, Conde MCM, Correa MB. Is the use of Cannabis associated with periodontitis? A systematic review and meta-analysis. J Periodontal Res. 2019 Jan 24. doi: 10.1111/jre.12639. [Epub ahead of print] Review. PubMed PMID: 30677134.


Original review protocol on PROSPERO

Other references

Dental Elf – 7th Jun 2016 

Periodontal disease associated with persistent cannabis use #CannabisMatters









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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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