Medical cannabis in dentistry: an analysis of the clinical evidence

Authors

DOI:

https://doi.org/10.30972/rfo.1829031

Keywords:

cannabis sativa, cannabidiol, oral health, topical administration

Abstract

The objective of this study was to synthesize available scientific evidence regarding the clinical applications of cannabis as a therapeutic agent in dentistry. A narrative review was conducted based on scientific literature available in PubMed, Scielo, and Google Scholar databases through an electronic search using the keywords cannabis, cannabidiol, dentistry, therapeutics, oral health, and tooth, including articles up to January 2025. The initial search yielded 438 records; after removing duplicates and reading full-text articles, 12 records were included for subsequent qualitative analysis. The oral cavity and orofacial conditions in which cannabinoids have been used as treatment are heterogeneous. The products employed are also varied; diverse extracts, both commercial and experimental, have been tested with different cannabinoids as active ingredients. Cannabinoids were administered systemically through oral ingestion in the form of oils/extracts and locally through topical application on facial skin and oral mucosa in the form of creams, gels, or toothpastes. Although clinical studies on the use of cannabinoids in different orofacial conditions have been reported, the available clinical evidence remains limited, and studies across different conditions are heterogeneous regarding treatment protocols employed as well as control methods.

References

Pratt M, Stevens A, Thuku M, Butler C, Skidmore B, Wieland LS, et al. Beneficios y daños del cannabis medicinal: una revisión exploratoria de las revisiones sistemáticas. Syst Rev. 2019;8(1):320. doi:10.1186/s13643-019-1243-x

Radwan MM, Chandra S, Gul S, ElSohly MA. Cannabinoids, phenolics, terpenes and alkaloids of cannabis. Molecules. 2021;26(9):2774. doi:10.3390/molecules26092774

Lowe H, Toyang N, Steele B, Bryant J, Ngwa W. The endocannabinoid system: a potential target for the treatment of various diseases. Int J Mol Sci. 2021;22(17):9472. doi:10.3390/ijms22179472

MacCallum CA, Russo EB. Practical considerations in medical cannabis administration and dosing. Eur J Intern Med. 2018;49:12-19. doi:10.1016/j.ejim.2018.01.004

Mederos M, Francia A, Chisini LA, Grazioli G, Andrade E. Influencia del consumo de cannabis en la enfermedad periodontal: una scoping review. Odontoestomatol. 2018;20(31):4-15. doi:10.22592/ode2018n31a2

Chisini LA, Cademartori MG, Francia A, Mederos M, Grazioli G, Conde MCM, et al. Is the use of cannabis associated with periodontitis? A systematic review and meta-analysis. J Periodontal Res. 2019;54(4):311-317. doi:10.1111/jre.12639

Cretu B, Zamfir A, Bucurica S, Scheau AE, Savulescu Fiedler I, Caruntu C, et al. Role of cannabinoids in oral cancer. Int J Mol Sci. 2024;25(2):969. doi:10.3390/ijms25020969

Helmi M, Aldawood A, AlOtaibi M, Alnasser E, AlSubaie A, Aldosari M. Oral health status among recreational cannabis users in the USA: a NHANES-based cross-sectional study. Saudi Dent J. 2024;36(4):596-602. doi:10.1016/j.sdentj.2024.01.015

Yoshida R, Ohkuri T, Jyotaki M, Yasuo T, Horio N, Yasumatsu K, et al. Endocannabinoids selectively enhance sweet taste. Proc Natl Acad Sci U S A. 2010;107(2):935-939. doi:10.1073/pnas.0912048107

Beneng K, Renton T, Yilmaz Z, Yiangou Y, Anand P. Cannabinoid receptor CB1-immunoreactive nerve fibres in painful and non-painful human tooth pulp. J Clin Neurosci. 2010;17(11):1476-1479. doi:10.1016/j.jocn.2010.04.005

Borsani E, Majorana A, Cocchi MA, Conti G, Bonadeo S, Padovani A, et al. Epithelial expression of vanilloid and cannabinoid receptors: a potential role in burning mouth syndrome pathogenesis. Histol Histopathol. 2014;29(4):523-533. doi:10.14670/HH-29.10.523

Mederos M, Francia A. Medicina cannabinoide en el territorio orofacial: estado actual y perspectivas a futuro. Odontol Sanmarquina. 2023;26(4):e26154. doi:10.15381/os.v26i4.26154

David C, Elizalde-Hernández A, Barboza AS, Cardoso GC, Santos MBF, Moraes RR. Cannabidiol in dentistry: a scoping review. Dent J (Basel). 2022;10(10):193. doi:10.3390/dj10100193

Mederos M, Grazioli G. Biomateriales con el agregado de cannabinoides para uso odontológico. Rev Med Urug. 2024;40(3):e901. doi:10.29193/rmu.40.3.10

Jirasek P, Jusku A, Frankova J, Urbankova M, Diabelko D, Ruzicka F, et al. Phytocannabinoids and gingival inflammation: preclinical findings and a placebo-controlled double-blind randomized clinical trial with cannabidiol. J Periodontal Res. 2024;59(3):468-479. doi:10.1111/jre.13234

Torabi J, Luis HPS, Mkrtchyan G, Alavijeh SD, Dezfoli S, Hurlbutt M. Antimicrobial effects of cannabidiol (CBD)-infused lozenges against Streptococcus mutans in oral health. Braz Dent J. 2024;35:e24-5988. doi:10.1590/0103-644020245988

Chrepa V, Villasenor S, Mauney A, Kotsakis G, Macpherson L. Cannabidiol as an alternative analgesic for acute dental pain. J Dent Res. 2024;103(3):235-242. doi:10.1177/00220345231200814

de Andrade Silva S, Velozo C, de Almeida Souto Montenegro L, de Sousa WV, da Cunha Isaltino M, et al. Effect of preoperative oral cannabidiol-rich cannabis extract on anxiety and postoperative pain after endodontic treatment: a double-blind randomized clinical trial. J Endod. 2024;50(12):1698-1704. doi:10.1016/j.joen.2024.10.010

Puišys A, Auzbikaviciute V, Kubilius R, Linkevičius R, Razukevičius D, Linkevicius T. Postoperative healing assessment using cannabinoids in oral surgery. Stomatologija. 2019;18(4):1-7

Ostenfeld T, Price J, Albanese M, Bullman J, Guillard F, Meyer I, et al. A randomized, controlled study to investigate the analgesic efficacy of single doses of the cannabinoid receptor-2 agonist GW842166, ibuprofen or placebo in patients with acute pain following third molar tooth extraction. Clin J Pain. 2011;27(8):668-676. doi:10.1097/AJP.0b013e318219799a

Kalliomäki J, Segerdahl M, Webster L, Reimfelt A, Huizar K, Annas P, et al. Evaluation of the analgesic efficacy of AZD1940, a novel cannabinoid agonist, on postoperative pain after lower third molar surgical removal. Scand J Pain. 2013;4(1):17-22. doi:10.1016/j.sjpain.2012.08.004

Umpreecha C, Bhalang K, Charnvanich D, Luckanagul J. Efficacy and safety of topical 0.1% cannabidiol for managing recurrent aphthous ulcers: a randomized controlled trial. BMC Complement Med Ther. 2023;23(1):57. doi:10.1186/s12906-023-03886-0

Nitecka-Buchta A, Nowak-Wachol A, Wachol K, Walczyńska-Dragon K, Olczyk P, Batoryna O, et al. Myorelaxant effect of transdermal cannabidiol application in patients with TMD: a randomized, double-blind trial. J Clin Med. 2019;8(11):1886. doi:10.3390/jcm8111886

Walczyńska-Dragon K, Kurek-Górecka A, Niemczyk W, Nowak Z, Baron S, Olczyk P, et al. Cannabidiol intervention for muscular tension, pain, and sleep bruxism intensity: a randomized, double-blind clinical trial. J Clin Med. 2024;13(5):1417. doi:10.3390/jcm13051417

Gambino A, Cabras M, Panagiotakos E, Calvo F, Macciotta A, Cafaro A, et al. Evaluating the suitability and potential efficiency of Cannabis sativa oil for patients with primary burning mouth syndrome: a prospective, open-label, single-arm pilot study. Pain Med. 2021;22(1):142-151. doi:10.1093/pm/pnaa318

Gajofatto A. Refractory trigeminal neuralgia responsive to nabiximols in a patient with multiple sclerosis. Mult Scler Relat Disord. 2016;8:64-65. doi:10.1016/j.msard.2016.05.004

Farokhnia M, McDiarmid GR, Newmeyer MN, Munjal V, Abulseoud OA, Huestis MA, et al. Effects of oral, smoked, and vaporized cannabis on endocrine pathways related to appetite and metabolism: a randomized, double-blind, placebo-controlled, human laboratory study. Transl Psychiatry. 2020;10(1):71. doi:10.1038/s41398-020-0756-3

Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR, et al. Oral diseases: a global public health challenge. Lancet. 2019;394(10194):249-260. doi:10.1016/S0140-6736(19)31146-8

Bergamaschi MM, Queiroz RH, Chagas MH, de Oliveira DC, De Martinis BS, Kapczinski F, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226. doi:10.1038/npp.2011.6

Martin EL, Strickland JC, Schlienz NJ, Munson J, Jackson H, Bonn-Miller MO, et al. Antidepressant and anxiolytic effects of medicinal cannabis use in an observational trial. Front Psychiatry. 2021;12:729800. doi:10.3389/fpsyt.2021.729800

Lin CS, Wu SY, Yi CA. Association between anxiety and pain in dental treatment: a systematic review and meta-analysis. J Dent Res. 2017;96(2):153-162. doi:10.1177/0022034516678168

Sermet S, Li J, Bach A, Crawford RB, Kaminski NE. Cannabidiol selectively modulates interleukin (IL)-1β and IL-6 production in toll-like receptor activated human peripheral blood monocytes. Toxicology. 2021;464:153016. doi:10.1016/j.tox.2021.153016

Shebaby W, Saliba J, Faour WH, Ismail J, El Hage M, Daher CF, et al. In vivo and in vitro anti-inflammatory activity evaluation of Lebanese Cannabis sativa L. ssp. indica (Lam.). J Ethnopharmacol. 2021;270:113743. doi:10.1016/j.jep.2020.113743

Rodríguez Figueroa LA, Stefanelli L, Riva Bernasconi R. Efecto comparativo de la actividad física aeróbica y los dispositivos ortopédicos estabilizadores en el dolor orofacial de origen musculoesqueletal en individuos con trastornos temporomandibulares. Odontoestomatol. 2020;22(36):15-23. doi:10.22592/ode2020n36a3

Klieger SB, Gutman A, Allen L, Pacula RL, Ibrahim JK, Burris S. Mapping medical marijuana: state laws regulating patients, product safety, supply chains and dispensaries, 2017. Addiction. 2017;112(12):2206-2216. doi:10.1111/add.13910

Altenburg A, El-Haj N, Micheli C, Puttkammer M, Abdel-Naser MB, Zouboulis CC. The treatment of chronic recurrent oral aphthous ulcers. Dtsch Arztebl Int. 2014;111(40):665-673. doi:10.3238/arztebl.2014.0665

Bulanda S, Ilczuk-Rypuła D, Nitecka-Buchta A, Nowak Z, Baron S, Postek-Stefańska L. Sleep bruxism in children: etiology, diagnosis, and treatment—a literature review. Int J Environ Res Public Health. 2021;18(18):9544. doi:10.3390/ijerph18189544

Xiong X, Wang P, Su K, Cho WC, Xing Y. Chinese herbal medicine for coronavirus disease 2019: a systematic review and meta-analysis. Pharmacol Res. 2020;160:105056. doi:10.1016/j.phrs.2020.105056

Rosenberg CR, Fang X, Allison KR. Potentiating aminoglycoside antibiotics to reduce their toxic side effects. PLoS One. 2020;15(9):e0237948. doi:10.1371/journal.pone.0237948

Corroon J, Sexton M, Bradley R. Indications and administration practices amongst medical cannabis healthcare providers: a cross-sectional survey. BMC Fam Pract. 2019;20(1):174. doi:10.1186/s12875-019-1059-8

Rosenthal MS, Pipitone RN. Demographics, perceptions, and use of medical marijuana among patients in Florida. Med Cannabis Cannabinoids. 2020;4(1):13-20. doi:10.1159/000512342

Ministerio de Salud/Agencia Nacional de Vigilancia Sanitaria. Resolución RDC N°660, del 30 de marzo de 2022.

Notejane M, Zunino C, Rodríguez A, Speranza N, Giachetto G, Bernadá M, et al. Derivados cannábicos para uso medicinal en niños y adolescentes: aportes para un uso responsable y seguro. Arch Pediatr Urug. 2018;89(3):187-193. doi:10.31134/ap.89.3.6

Galzerano Guida J, Orellana Navone CC, Ríos Pérez D, Coitiño González AL, Mariano P, Ramos V. Cannabis medicinal como recurso terapéutico. Rev Med Urug. 2019;35(4):289-297. doi:10.29193/rmu.35.4.5

Areosa M, Argañaraz M, Garrone N, Jeldres C, Legelen A, Pose B, et al. Farmacovigilancia activa y caracterización de una población de uruguayos usuarios de derivados de cannabis medicinal. Bol Farmacol. 2018;9(4). Disponible en: https://www.boletinfarmacologia.hc.edu.uy/images/2018/2018-4/6_farmacovigilancia_activa_y_caracterizacin_de_una_poblaci_n_de_uruguayos_usuarios_de_derivados_de_cannabis_medicinal.pdf

De Santis A, Wood I, Galarraga F, Jara J, Mansilla S, Tamosiunas G, et al. ¿Quiénes prescriben cannabis medicinal en Uruguay?: estudio preliminar sobre actitudes y conocimientos de los prescriptores. Anfamed. 2025;12(1):e205. doi:10.25184/anfamed2025v12n1a8

Galzerano J, Ríos MD, Velázquez PM. Beneficio clínico del tratamiento con cannabinoides para el dolor crónico no oncológico. Rev Med Urug. 2023;39(3):e201. doi:10.29193/rmu.39.3.1

Zeng L, Lytvyn L, Wang X, Kithulegoda N, Agterberg S, Shergill Y, et al. Values and preferences towards medical cannabis among people living with chronic pain: a mixed-methods systematic review. BMJ Open. 2021;11(9):e050831. doi:10.1136/bmjopen-2021-050831

Evanoff AB, Quan T, Dufault C, Awad M, Bierut LJ. Physicians-in-training are not prepared to prescribe medical marijuana. Drug Alcohol Depend. 2017;180:151-155. doi:10.1016/j.drugalcdep.2017.08.010

Piovesan Suárez S. Un acercamiento a la situación de la salud bucal en Uruguay. Odontol Sanmarquina. 2020;23(3):333-340. doi:10.15381/os.v23i3.18134

Published

2025-12-29

Issue

Section

Divulgación