Cannabis will become legal on July 1st, 2018; and we at CDA Oasis are exploring the many facets of this professional issue. In particular, we are exploring the various impacts of this substance, namely clinical and legal.
I welcomed once again Dr. Mark Donaldson, pharmacologist and senior executive director at Vizient Pharmacy Advisory Solutions. He is also clinical professor in the Skaggs School of Pharmacy at the University of Montana. Dr. Donaldson shared his expertise on the topic of cannabis in the dental office.
We recognize this is an important conversation that needs to take place in the dental practice as well as within the overall dental profession and we welcome your feedback, questions and suggestions. Please get in touch with us at firstname.lastname@example.org
Until next time!
Chiraz Guessaier, CDA Oasis Manager
Cannabis has been available and used from the time of early civilizations to treat various conditions. Evidence-based research suggests that there are certain indications for the medical use of cannabinoids. As an example, clinical evidence supports the use of medical grade cannabis in angle glaucoma to decrease the intraocular pressure in patients. However, from a dental perspective, there is no evidence-based information for the use of cannabis in the management of TMJ, neuropathic or post-operative orofacial pain.
As oral health care professionals, dentists must be aware of the oral manifestations of disease that may arise from the use of medical-grade marijuana. The inhaled form of cannabis poses a risk to the patient’s respiratory tissues and may lead to various conditions, including hyposalivation and xerostomia.
Dentists will also need to be mindful of the psychoactive reactions that patients using cannabis might experience. As well, there are potential drug interactions with benzodiazepines or antihistamines that may occur with the use of this substance. Because cannabinoids are organic matter and contain active ingredients, it is challenging to know the perfect ratio of cannabinoids as the potency may vary from dose to dose and batch to batch and as a result, make it difficult to ascertain the drug interactions which may occur.
On the legal implications for dentists, it is important to determine whether the patient is an active user. Active users should not have elective dental treatment. At times, this may be easy to spot; however, where the patient ingests this substance, it may be more difficult to predict. In these cases, dentists will benefit from having an open, non-judgmental conversation with patients to determine whether the patient is using cannabis or not to assess potential risks to the patient’s safety.
In terms of prescribing medical grade cannabis, it is likely that the prescription privileges will be restricted to a specific group of dentists and will require additional education and significant regulations around this substance.
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