Every time I read that the authorities in some country have either proposed or implemented the legal use of marijuana I shudder when I contemplate the social implications and more specifically, its general impact on the oral health status of that nation or state.

Since 1968 when the first comprehensive study of the oral changes induced by Cannabis Sativa (marijuana) was completed, this resin of plant origin and regarded as a drug, has undergone further research and documentation.
Numerous carcinogens (cancer producing agents) are to be found in cannabis smoke and its condensate (tar) has a 70 per cent higher concentration of naphthalenes than tobacco smoke. The carcinogen benzopryne is abundantly present. Other irritants, including ammonia, hydrocyanic acid, acrolein and benzene are also more abundant in cannabis smoke than in tobacco smoke.
One researcher, Dr. P.J. Donald in 1986 reported six cases of advanced head and neck cancer in young marijuana users whose average age was 27. Four of these cancers were located in the throat area, one on the lower lip and one on the tongue. Xerostoma (under production of saliva) is often a feature. In fact, when a patient sits in my dental chair for treatment and he or she appears in my discernment to be “stoned”, I ask them to lean over and spit in the spittoon. If they have obvious difficulty in doing so that convinces me that the patient is indeed high on marijuana.
The prevalence of dental caries ( tooth decay) and periodontal (gum) disease may therefore be increased with marijuana users. Usually, cannabis abusers generally have poor oral hygiene in addition to candidiosis (oraltrush). The latter condition some scientists believe may be due to a compromised immune system similar to AIDS.
It is also observed by dentists that frequent marijuana users often suffer from fiery red gums and the presence of hyperkeratosis (white patches on the gums). Chronic signs include inflammation of the oral epithelium (lining membrane) and leucoplakia (possible pre-cancerous condition).
The facial appearance typical of a marijuana abuser that we Guyanese call a “junkie” is “shrivelled” lips (due to xerostomia and sialostasis), dull looking skin, bilateral mydriasis (dilation of the pupils in the eyes) and a vacant stare (lack of facial expression).
Marijuana may produce orthostatic hypertension (high blood pressure only when standing) and in conjunction with increased levels of adrenal gland secretions, could result in fainting spells especially in response to dental treatment because dental anaesthetic injections also contain adrenaline.Since cannabis produces tachycardia (up to 550% acceleration of heartbeat), when the usual dental anaesthetic is administered, this may be seriously prolonged, which in extrapolation may contribute to subsequent heart disease.
Marijuana can elicit an abnormal stress response and oral surgical procedures on patients who have smoked it within a few hours, can cause acute anxiety, dysphoria and psychotic-like paranoiac (mad) thoughts, all intensified by the stress of a simple extraction. These are only a few of the negative effects of this dangerous drug.

**** PULL QUOTE:
The facial appearance typical of a marijuana abuser that we Guyanese call a “junkie” is “shrivelled” lips (due to xerostomia and sialostasis), dull looking skin, bilateral mydriasis (dilation of the pupils in the eyes) and a vacant stare (lack of facial expression).