More and more nervous patients are showing up stoned for dental appointments, often forcing dentists to postpone treatment until the patient sobers up, new survey data shows.
As more states are legalizing marijuana, more than half of dentists (52%) report seeing patients high on weed or other drugs, a new survey from the American Dental Association (ADA) found.
"In my practice, I'm seeing more patients who are openly disclosing marijuana use," said ADA spokeswoman Dr. Tricia Quartey.
Many use marijuana to relax before an appointment, but being high can limit the care dentists can give and result in procedures being postponed, Quartey added.
"When somebody is under the influence, oftentimes we need to give more anesthesia or we may have difficulty with anesthesia," Quartey said. "If you can't get somebody fully numb, it's not exactly creating the same experience and lessening the anxiety. You have to stop a visit and send somebody home."
The survey found 56% of dentists did just that, stating that they limit treatment while patients are high.
The data were gleaned from two online surveys, which included over 550 dentists across the United States and just over 1,000 patients. Among patients, the second survey found that 39% said they used marijuana. In addition, 25% of patients said they vaped, and of those respondents, 51% vaped marijuana.
Quartey said dentists should ask their patients if they use marijuana, and patients should discuss their marijuana use with their dentist. The ADA survey found that 67% of patients are comfortable talking to their dentist about marijuana.
"The advice to patients is to not use marijuana prior to an appointment," Quartey said. "You think it's going to reduce anxiety and it's not. But if you do, inform your dentist so they can be fully aware of what is going on at the appointment. You should also be aware that the dentist oftentimes cancels the appointment."
Dr. Anna Green, chief pediatric dental resident at Cohen Children's Medical Center in Queens, N.Y., said that it's difficult to treat patients who are high on marijuana or other psychoactive drugs.
"A patient who is under the influence of any type of drug will not be in the sober and healthy mindset to understand treatment and give consent. Usually, a patient will have to be rescheduled and be seen when sober," she said.
And marijuana can cause increased bleeding and complications after dental procedures, Green added.
Marijuana can also increase the risk of periodontal disease and dry mouth. “If you know of a patient who uses marijuana, it is important to inform them of all the oral health risk factors they may encounter if they continue to use,” she noted.
In addition, patients who use marijuana may have an increased risk for cavities. “Most users, in general, have poorer oral health and hygiene,” Green said.
People who use marijuana are also prone to higher heart rate, anxiety and hyperactivity. "This may lead to increased dental stress in the chair. This also makes the use of epinephrine in local anesthetics a potential life-threatening risk," Green warned.
"It is important to educate your patients of the adverse effects of marijuana use while stressing the importance of routine dental visits, oral hygiene and a healthy diet," she said.
For more on oral health and marijuana, head to the American Dental Association.
SOURCES: Tricia Quartey, DDS, spokeswoman, American Dental Association; Anna Green, DDS, chief pediatric dental resident, Cohen Children's Medical Center, Queens, N.Y.; American Dental Association, survey, Nov. 7, 2022