Well my fellow Texans, let’s face it, the word is out — Texas has no income tax and a relatively low cost of living. What does this mean for us locals? On one hand, an inflow of residents means increasing traffic and housing costs; on the positive side, it also means an increase in business. As practitioners of the oral cavity, these new patients from other states may bring with them new oral and systemic health concerns to look out for — so let’s talk marijuana.
As many of you know, medicinal use of marijuana is legal in Texas but recreational use is illegal. However, for our new transplants from California, Colorado, Virginia, DC and even our neighboring state of New Mexico, recreational use of marijuana is legal, and we are now seeing these patients in our chairs. Have you added “do you use marijuana" to your health history form? How comfortable are patients in disclosing that usage? If they do check “yes”, what do we do with that information? Whether marijuana is smoked, vaped, ingested in various foods or even brewed as a tea, it is passing through the oral cavity and it is our responsibility to understand its effects on our patients’ oral health.
With regular and chronic use of marijuana, oral findings include gingival inflammation, xerostomia, increased caries risk, candidiasis, leukoplakia and periodontitis. Some of these findings are complicated by compounding factors such as tobacco use, alcohol use and poor oral hygiene. If a patient is “high” while in our chair, impaired decision making, tachycardia, paranoia and increased anxiety have implications on the validity of our informed consents, the use of epinephrine in our anesthetics, and ultimately the ability to treat that day.
My hope is not to start a political or moral discussion on marijuana and its use, but to spark a dialogue about something that is becoming more prevalent in our society and therefore in our chairs. Will you add the question of marijuana usage to your health history form? Do you feel comfortable discussing its effects on the oral cavity with your patient? Let’s make this topic less taboo, educate ourselves, discuss it openly with our coworkers and staff, and most importantly, be open and willing to talk about it with our patients.