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Marijuana Use: Relevance to Clinical Practice

Dr. Jose Lança, MD. PhD, Assistant Professor, Pharmacology  in the Faculty of Dentistry and the Faculty of Medicine at the University of Toronto, spoke with Dr. Chiraz Guessaier about the use of marijuana in dentistry as well as its impact on dental practice.


The government of Canada will be legalizing the use of marijuana in the Spring of 2017. Currently, marijuana is the most frequently used illegal drug in Canada and the United States.

Interesting facts

  • Naturally occurring endocannabinoid receptors (CB1 and CB2) can modulate the immunological responses, motor responses, and cognition and memory as well as pain and inflammation.
  • Naturally occurring neurotransmitters in the brain can also stimulate CB1 and CB2 receptors.
  • Various psychoactive components of marijuana such as THC and CBD are selective for the CB1 and CB2 receptors.
  • There are also prescription medications that are CB1 and CB2 agonists.
    • THC and CBD (Sativexâ). CB1 and CB2 Agonist. Therapeutic Indication: symptomatic relief of neuropathic pain and spasticity in patients with multiple sclerosis (MS).
    • Nabilone. CB1 agonist. Therapeutic Indication: Antiemetic. Management of nausea and vomiting associated with cancer chemotherapy.
    • Dronabinol (Marinolâ). Synthetic THC, CB1 and CB2 agonist. Therapeutic Indication: Antiemetic, appetite stimulant. Discontinued in Canada in 2012.
  • These medications have adverse effects, such as xerostomia and orthostatic hypotension. The development of tolerance and the potential risk of abuse must be carefully evaluated in patients with a history of substance abuse.

Adverse oral effects of cannabis use

  • Gingival hyperplasia
  • Erythematous edema of the uvula
  • Nicotine stomatitis
  • Increased periodontal disease
  • Increase caries risk
  • Oral papilloma
  • Leukoplakia
  • Alveolar bone loss





  1. Hello to all. Nice presentation. Thank you for the chance to learn a bit more about this timely subject.

  2. All the adverse effects listed are due to delivery by smoking marijuana.
    Could you address the use, toxcicity, of ingestion of cannabis oil.

  3. The important issue here is that the article only lists the risks of marijuana if you SMOKE it. Most users do not smoke it. Most users vape or ingest it. This results in a HUGE difference in risk. Can you please address this?

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