Dimensions offers evidence-based peeer-reviewed continuing education courses written by world class educators and researchers CBD Oil for Oral Health: Can It Help with Gum Disease? When you fail to take routine care of your gums, teeth and mouth, there are chances that you will end developing gum disease. The first In recent years, CBD oil has been growing in popularity, but what can it offer dental patients? A holistic dentist explains in more detail.
Combating Periodontal Diseases With Cannabidiol
Emerging research provides preliminary evidence that the adjunctive use of cannabinoids supports the treatment of periodontal diseases.
Periodontal diseases are highly prevalent around the globe, affecting approximately 538 million individuals worldwide. In the United States, 64.7 million adults (46%) age 30 and older are impacted. 1–4
Periodontal diseases are chronic disorders of the periodontium, and many modalities exist to combat, reduce, and prevent these oral health problems. 5,6 In some instances, adjunctive local and systemic antibiotic therapies and even surgery may be necessary. A new and emerging modality, however, cannabidiol (CBD) may help reduce the inflammatory response associated with this chronic destructive disease.
Used for centuries, the Cannabis plant has both medicinal and recreational purposes. 7 Its two principal compounds—tetrahydrocannabinol (THC) and CBD—are referred to as cannabinoids. 7-9 More than 100 types of cannabinoids exist. They are classified as:
- Either endogenous (a substance created within the body) or endocannabinoids (produced in humans and animals and used as lipid messengers)
- Synthetic (produced in a laboratory)
- Phytocannabinoid (from stalks, seeds, leaves, and flowers of the cannabis plant)
In addition to THC and CBD, other cannabinoids include cannabinol (CBN), cannabigerol (CBG), and cannabichromene (CBC). 7–9
Cannabinoids are a group of secondary metabolites that act on the cellular cannabinoid receptors (CB1 and CB2) throughout the body’s endocannabinoid system. These receptors possess lipophilic ligands derived from arachidonic acid, an essential fatty acid that is necessary for chemical messaging. 10 The CB1 receptor is most abundant in the cerebellum, hippocampus, and basal ganglia of the brain, and is also located in peripheral sites, such as the heart, lungs, adrenal glands, and peripheral neurons. CB1 receptors are also found in retinal; fat; intestinal; and reproductive tissues (testes, sperm cells, uterus, and ovary). 10 The CB2 receptor is chiefly expressed in immune cells (spleen, tonsils, thymus) and has been shown to exert anti-inflammatory effects on leukocytes. 11 Recent evidence indicates that the CB2 receptor is also present in central nervous tissue, and both receptors are known to bind endocannabinoids and phytocannabinoids. 10,11 Unlike the cannabinoid CBD, THC acts mainly on the CB1 receptor of the central nervous system contributing to psychotropic effects such as alterations in mood, behavior, thoughts, and perception.
CBD has anti-inflammatory, antimicrobial, immunomodulatory, and antioxidant properties, which help in preventing inflammation, regulating the immune system, and protecting cells from tissue damage. 8,12 Various forms of CBD have been used to effectively reduce and prevent seizures in patients with severe pediatric epilepsy, help quell anxiety and improve insomnia, and alleviate chronic pain associated with cancer, nausea, neuropathic pain, and multiple sclerosis. 8,12–14 Studies have shown CBD provides protective effects in those who have experienced stroke and in patients with Alzheimer disease who have amyloid plaques; CBD may even help patients with Huntington disease and Parkinson disease. 12
Cannabidiol and other cannabinoids have demonstrated antimicrobial effects against deadly bacteria including methicillin-resistant Staphylococcus aureus, Streptococcus pneumoniae, and Clostridioides difficile. 15,16
The inflammatory response of periodontal diseases directly impacts systemic health. Inflammation, whether chronic or acute, results in a host response. Activation of either the inflammatory (innate) and/or immune (adaptive) system triggers the body to initiate a series of protective responses, including the secretion of sulcular fluid composed primarily of leukocytes, enzymes, and other cellular elements. The stimulation of the inflammatory response system is largely responsible for tissue destruction in periodontal diseases.
Cytokines, prostaglandins, and matrix metalloproteinases are among several biochemical mediators that initiate tissue destruction and bone loss in chronic inflammatory disease. 17 The anti-inflammatory, antibacterial, and immunomodulatory properties of CBD have prompted researchers to investigate its ability to combat periodontal diseases.
Napimoga et al 18 induced periodontitis in rats and compared the treatment with CBD vs a saline control. In this in vivo study, the control group did not receive a suture but did receive the injection. In the two other groups, a suture was placed around the mandibular first molar and the rats were divided into groups:
- Control group: no suture placement but still injected with saline
- Suture injected with saline
- Suture injected with CBD (5 mg/kg)
After 30 days, the animals were euthanized and the right and left mandibular areas were reviewed to determine bone loss. The gingival tissues were also removed, and interleukin-1β levels, tumor necrosis factor levels, and neutrophil infiltration were evaluated. Results showed that the rats who received daily intraperitoneal injections with CBD for 30 days had less alveolar bone loss, and the gingival tissue had decreased neutrophil migration compared to the control group. Reduced neutrophil migration signifies a depression in pro-inflammatory markers, suggesting that the modulation of the host response by CBD may be an alternative method to traditional periodontal treatment approaches.
Vasudevan and Stahl 19–21 conducted three studies on human subjects using dental plaque from patients with varying levels of periodontal diseases. The studies investigated CBD’s antibacterial properties in toothpaste, mouthrinse, and tooth polishing powder. In the first study, the researchers compared cannabinoids and toothpaste products to identify the efficiency of cannabinoids in reducing dental bacteria. 19 This was the first known study testing samples of human dental plaque with CBD. The study compared the antibacterial activity of 12.5% cannabinoids (CBD, CBC, CBN, CBG, and cannabigerolic acid), against two well-known brands of toothpaste. Broth agar-prepared petri dishes were subdivided into four sections, and each section was smeared with an individual cannabinoid or toothpaste. Plaque samples were collected from human interdental spaces and spread on each section. The samples were incubated (37° C) for 24 hours. After incubation, total bacteria counts were taken for each section and compared. Cannabidiol and all other cannabinoid-treated samples demonstrated less colony growth than the toothpaste-treated samples, with CBN and CBC proving to be most effective in reducing total bacterial growth. This study suggests that cannabinoids, including CBD, may be an effective antimicrobial agent against dental plaque-associated bacteria.
In the second study, Vasudevan and Stahl 20 conducted a randomized controlled trial comparing the bactericidal activity of cannabinoid-infused mouthrinses against total-culturable bacterial content from human dental plaque samples. The infused mouthrinses contained less than 1% of either CBD or CBG and were compared against a mouthrinse containing 0.2% chlorhexidine (higher than traditionally prescribed) and two commercially available mouthrinses: one containing essential oils with alcohol and one containing fluoride/potassium nitrate without alcohol. Human dental plaque samples were collected from interdental spaces and processed for in vitro assay. Using both the agar well diffusion method (30μl undiluted mouthrinse) and disc diffusion method (15μl undiluted mouthrinse), plaque samples were spread on the petri dishes and incubated (37° C) for 36 hours. After incubation, the zone of inhibition was measured. The in vitro assay was performed three times for each mouthrinse. The CBD-infused mouthrinse exhibited superior bactericidal efficacy over chlorhexidine in the inhibition of bacterial content from the human dental plaque samples. Cannabigerol also demonstrated higher inhibition of bacterial content when compared to chlorhexidine; however, it was not statistically significant. The two commercially available types of mouthrinse did not show any significant antimicrobial activity. This study supports cannabinoids’ antibacterial activity against bacterial content in dental plaque.
In Vasudevan and Stahl’s 21 most recent study, regular tooth polishing powder was supplemented with CBD to determine if supragingival- and subgingival bacteria-forming colonies would be suppressed. Synthetic CBD powder was added to sodium bicarbonate tooth polishing powder at an equal 1% weight/weight ratio. The teeth of the 12 participants were polished with either the CBD-infused polishing powder or the control noninfused polishing powder. Two separate tooth polishing machines were used to prevent cross-contamination with CBD. Oral plaque samples were collected from the identical interdental spaces both pre- and post-treatment. The samples were prepared for in vitro assay. Broth agar plates were prepared and smeared with samples. The samples were incubated (37° C) and colony-forming units of bacteria were analyzed after 36 hours. Results suggested that the noninfused powder was only effective in removing dental plaque from gingival spaces and had no effect on the inhibition of colony-forming units. Conversely, teeth polished with the CBD-infused powder showed a significant reduction in colony-forming bacteria.
Safety and Concerns
The market is flooded with commercially available CBD and THC products designed for therapeutic, medicinal, and recreational purposes. 7,8,12–16 These products are distributed in various forms, including but not limited to oils, candies, gummies, balms, lotions, capsules, incense/herbal blends, and sprays. Such products can be purchased online and at many retail stores and dispensaries. 7,22–24
Although THC and CBD are both cannabinoids, they should not be used interchangeably. Products containing doses greater than 0.3% dry weight of THC (the legal dose in the United States) elicit the “high” commonly associated with marijuana, whereas CBD products containing less than the legal dose of THC do not cause psychotropic reactions. 7,24
Additionally, CBD has a safer profile than THC, which can alter cardiovascular functions, body temperature, or psychomotor or psychological function. 12 CBD oil (sometimes referred to as hemp oil) and hemp seed oil can easily be confused; however, hemp seed oil does not actually contain any cannabinoids (CBD or THC). 24
The standard level of CBD, THC, and other cannabinoids allowed in products has not been established. The majority of CBD products are not regulated by the US Food and Drug Administration (FDA) and the only FDA-approved CBD product is a prescription medication used to treat severe seizures in children. 25 Products manufactured without undergoing FDA review are subject to the following: inconsistent quality controls, no guarantee on the accuracy or level of the active ingredients present, and inability to verify the safety and efficacy of the product. 25 Some products have been found to contain mold, pesticides, and heavy metals. 26 Inaccurate labeling and marketing of CBD and other cannabis-derived products place consumers’ health and safety at risk. 23–25
Emerging research—although controlled and limited with small sample sizes—is promising and it supports the adjunctive use of CBD, as well as other cannabinoids for the treatment of periodontal diseases. Continued trials are necessary to support CBD’s validity in combating periodontal diseases and should be further expanded to include other types of cannabinoids and modalities. The studies provided did not include THC or actual marijuana smoking; smoking cannabis/marijuana has deleterious effects on gingival tissue and increases the risk of head and neck cancer. 27
Practitioners should be mindful that each individual’s host response will be different and is contingent on the patient’s health. Because the majority of CBD products are not FDA regulated, it is imperative to understand the ingredients, risks, and benefits prior to speaking with patients. Considerations for pre-existing conditions and the interaction of prescribed pharmaceutical drugs are critical in determining the effect of CBD on periodontal diseases. Moreover, patients should be advised to consult with their physician before use to discuss potential adverse reactions. Oral health professionals can stay up to date on the most current FDA regulations and state laws related to cannabis and cannabis-derived products by visiting: https://bit.ly/3jPCnJz and https://bit.ly/3yJP0vV.
- Nazir M, Al-Ansari A, Al-Khalifa K, Alhareky M, Gaffar B, Almas K. Global prevalence of periodontal disease and lack of its surveillance. Scientific World Journal. 2020;2020:2146160.
- United States Centers for Disease Control and Prevention. Gum Disease. Available at: cdc.g/v/oralhealth/fast-facts/gum-disease/index.html. Accessed July 31, 2021.
- World Health Organization. Oral Health. Available at: who.int/news-room/fact-sheets/detail/oral-health Accessed July 31, 2021.
- Janakiram C, Dye BA. A public health approach for prevention of periodontal disease. Periodontol2000. 2020;84:202–214.
- Gasner NS, Schure RS. Periodontal disease. Available at: ncbi.nlm.nih.gov/books/NBK554590/. Accessed July 31, 2021.
- Könönen E, Gursoy M, Gursoy UK. Periodontitis: a multifaceted disease of tooth-supporting tissues. J Clin Med. 2019;8:1135.
- Karas JA, Wong LJM, Paulin OKA, et al. The antimicrobial activity of cannabinoids. Antibiotics (Basel). 2020;9:406.
- Larsen C, Shahinas J. Dosage, efficacy and safety of cannabidiol administration in adults: a systematic review of human trials. J Clin Med Res. 2020;12:129–141.
- Chilakapati J, Farris FF, Cannabinoids. In Wexler P, ed. Encyclopedia of Toxicology. 3rd ed. Cambridge, Massachusetts: Academic Press; 2014:649–654.
- Reggio PH. Endocannabinoid binding to the cannabinoid receptors: what is known and what remains unknown. Curr Med Chem. 2010;17:1468–1486.
- Turcotte C, Blanchet MR, Laviolette M, Flamand N. The CB2 receptor and its role as a regulator of inflammation. Cell Mol Life Sci. 2016;73:4449–4470.
- Campos AC, Fogaça MV, Sonego AB, Guimarães FS. Cannabidiol, neuroprotection and neuropsychiatric disorders. Pharmacol Res. 2016;112:119–127.
- Russo EB. Cannabinoids in the management of difficult to treat pain. Ther Clin Risk Manag. 2008;4:245–259.
- Khaleghi K. New arthritis foundation guidelines on CBD use could be first of many more to come. Alternative Therapies. 2020;26(S1)8–11.
- Appendino G, Gibbons S, Giana A, et al. Antibacterial cannabinoids from cannabis sativa: a structure-activity study. J Nat Prod. 2008;71:1427–1430.
- Blaskovich MAT, Kavanagh AM, Elliott AG, et al. The antimicrobial potential of cannabidiol. Commun Biol. 2021;4:7.
- Gehrig JS, Willmann DE. Foundations of Periodontics for the Dental Hygienist. 5th ed. New York: Lippincott, Williams & Wilkins; 2020.
- Napimoga MH, Benatti BB, Lima FO, et al. Cannabidiol decreases bone resorption by inhibiting RANK/RANKL expression and pro-inflammatory cytokines during experimental periodontitis in rats. Int Immunopharmacol. 2009;9:216–222.
- Stahl V, Vasudevan K. Comparison of efficacy of cannabinoids versus commercial oral care products in reducing bacterial content from dental plaque: a preliminary observation. A Cureus. 2020;12:e6809.
- Vasudevan K, Stahl V. Cannabinoids infused mouthwash products are as effective as chlorhexidine on inhibition of total-culturable bacterial content in dental plaque samples. J Cannabis Res. 2020;2:20.
- Vasudevan K, Stahl V. CBD-supplemented polishing powder enhances tooth polishing by inhibiting dental plaque bacteria. J Int Soc Prev Community Dent. 2020;10:766–770.
- Vandrey R, Dunn KE, Fry JA, Girling ER. A survey study to characterize use of spice products (synthetic cannabinoids). Drug Alcohol Depend. 2012;120:238–241.
- Fitzcharles MA, Clauw DJ, Hauser W. A cautious hope for cannabidiol (CBD) in rheumatology care. Arthritis Care Res (Hoboken). 2020;10:1002.
- VanDolah HJ, Bauer BA, Mauck KF. Clinicians’ guide to cannabidiol and hemp oils. Mayo Clin Proc. 2019;94:1840–1851.
- United States Food and Drug Administrations. FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD). Available at: fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd. Accessed July 31, 2021.
- Hurd YL. Leading the next CBD wave-safety and efficacy. JAMA Psychiatry. 2020;77:341–342.
- American Dental Association. Cannabis: Oral Health Effects. Available at: ada.org/en/member-center/oral-health-topics/cannabis-oral-health-effects. Accessed July 31, 2021.
From Dimensions of Dental Hygiene. September 2021;19(9):14-17.
Donna Catapano-Martinez, DHSc, CDA, RDH, is a clinical assistant professor in the Department of Dental Hygiene and Dental Assisting at New York University College of Dentistry in New York. She is also an online adjunct professor in the School of Health Sciences at Georgia Highlands College in Rome. Catapano-Martinez has more than 20 years of experience in academia and has been treating patients in private practice since 1999.
Michelle Boyce, DHSc, RDH, is the dean of the School of Health Sciences and associate professor of dental hygiene at Georgia Highlands College. She has been working in academia for 11 years and has practiced as a dental hygienist in general and periodontal practices since 1999.
Naquilla Thomas, EdD, RDH, is an assistant professor in the Department of Dental Hygiene at Clayton State University in Morrow, Georgia. She has 10 years of experience as an academic educator and administrator. Thomas has worked as a dental hygienist in general and specialty practices since 2003.
CBD Oil for Oral Health: Can It Help with Gum Disease?
When you fail to take routine care of your gums, teeth and mouth, there are chances that you will end developing gum disease. The first stage of gum disease is medically known as gingivitis, where gums start bleeding and sometimes, even hurt, which is usually, the second stage, known as periodontitis.
The best way to keep your gums healthy and happy is to brush and floss your teeth on a regular basis. Even so, we aren’t used to taking proper care of our oral health. Perhaps this is the reason why more than 40% of the adult population pays a visit to the dentist once in a month or two. While there are several medical procedures and medicines available to help you take care of your gums, CBD is one natural and potent way to do the same. In fact, many people suffering from gum disease have reportedly felt relieved in their pain, bleeding and bad breath of the gums. How CBD oil can do that, we will find out in a jiffy!
What is CBD oil?
Cannabidiol, popularly known as CBD, is a naturally-occurring compound found in the cannabis family. It is one of the 104 compounds that are a part of the cannabis sativa plant. However, it is specially known for not containing any or almost nil quantity of THC—another cannabis compound responsible for getting you high or stoned. Thus, CBD is a non-psychoactive substance. The best thing about this product is that CBD has proven therapeutic abilities. For instance, it has helped people from across the globe in dealing with their anxiety, depression, inflammation, and chronic pains, amongst many other health conditions. While research is still in its infancy to prove its potential as a natural medical treatment, there are several anecdotes that are affirmative in nature. In the same way, CBD oil is being considered as a great alternative to help you keep your oral health in place.
CBD and Oral health
One should know that prescribing medicine should still be your number one pick, when it comes to seriously taking care of your gums. However, using CBD as a supplement in the beginning will make you realize why it is an option worth-going after. Even scientists have approved the CBD has many properties that can bring improvement in your oral health, such as-
- It is anti-bacterial in nature
- It also has analgesic or pain-relieving characteristics
- It is antiseptic in nature
- It is anti-inflammatory as well
Thus, there are several dental conditions where CBD oil comes in handy. Some of them are listed below-
- Tooth decay – The anti-inflammatory properties of CBD makes it a good aid for minor tooth decay. It can also reverse the damage in some cases.
- Tooth ache –It’s anti-inflammatory and pain-killing characteristics again help in relieving people from any kind of toothache. The best part is that it is a natural healer. Thus, no side effects.
- Swollen gums – Due to bad dental hygiene, many people develop bacteria in their gums which leads to their swelling. This can also result in bleeding and ache, if not treated within time. Swollen gums can also be a result of inflammation, and this is where CBD can help in making them healthy again.
- Tooth sensitivity – A swollen nerve often leads to sensitivity in tooth or gums. CBD has the ability to create a cover or a shield on the sensitive tooth or gum, in order to protect it from hurting or being exposed to the damage.
How to apply CBD oil in gums?
The application of CBD oil depends on the oral area that you have a problem in. Even so, here are some suggestions on how to apply CBD oil in your gums.
- If you want you can directly buy a CBD toothpaste, or simply add a few drops of CBD oil in your toothpaste before brushing your teeth.
- If you suffer from toothache, then directly apply the oil on the region where it hurts the most. That would bring you instant relief as well. The same can be done in case of swollen gums.
- Another way of consuming the oil is by adding a few drops in your tea or coffee and gargling the same in your mouth, especially close to the area where your problem is.
- If you had a dental surgery, then you can simply add a few drops of the oil on a gauze pad and put the same in the space left after the surgery. The pad will help in reducing the pain since CBD is an analgesic.
Conclusion: Can CBD Help Oral Health?
CBD oil is the quickest way to relieve your gums from pain, bleeding and swelling. Also, it is a natural product that is easily available in the market. You must also know that there are no side-effects of consuming CBD. However, you might have to decide on the dosage of the oil yourself. You can start with the minimum dosage and stop when you feel you have reached your ideal dosage. In any case, CBD is absolutely safe to consume and there hasn’t been a single case of CBD overdose. All you have to do is make sure that you are buying your CBD oil from a reputable company and you will be good to try this magical compound!
Holistic Dentist Discusses the Benefits CBD Oil Can Provide
Holistic dentists understand that there are many safe and natural ways to take care of your oral health. A very popular compound right now known as cannabidiol (CBD) oil, is making waves online and throughout the country because of its numerous health benefits. In many cases, cannabidiol is known for its positive effects for seizure patients. However, did you know it also contains antibacterial and antifungal properties?
To learn how CBD can help those with gum disease, tooth decay and temporomandibular joint dysfunction (TMJ), keep reading!
Gum disease most commonly appears due to poor oral hygiene, however, some people are more susceptible to it based on their genetics as well. The most common culprit is dental plaque that is left on the teeth and gums, which causes inflammation and irritation. This leads to the early stage of gum disease known as gingivitis. After enough time, it can develop into a more serious form known as periodontitis which damages the tooth and bone holding it in place, eventually resulting in tooth loss.
Cannabidiol can reduce inflammation and sensitivity to pain as well as minimize damage caused by gum disease. This is because CBD interacts with the CB2 receptors in the brain, which mediate the immune functions of the body. While this results in a more effective immune response to gum disease, its still important to brush and floss daily and visit your dentist for routine cleanings.
A common cause of decay is oral bacteria, which releases plaque acids after consuming starches or sugars in the mouth. This common bacteria, known as Streptococcus mutans, erodes enamel and creates cavities in your teeth. As this cavity increases in size, so does the passage for bacteria to reach deeper into the tooth. If bacteria reaches the pulp, it can easily cause an infection, which leads to pain, sensitivity and the need for expensive root canal therapy later.
By including CBD oil in your oral care routine, you can defend yourself against oral bacteria, particularly Streptococcus mutans. While more testing is needed, it is shown to have positive effects against inflammation and decay associated with cavities.
TMJ is a disorder revolving around the joint that connects the lower jaw to the skull. It is characterized by pain and discomfort caused by erosion, inflammation and displacement. This condition typically results in chronic jaw pain, popping or clicking of the jaw, difficulty chewing and jaw locking.
Based on a study centered around participants with TMJ, those who used cannabidiol noticed a reduction in their symptoms. This is because cannabidiol can help with inflammation and decrease sensitivity to pain. CBD also works to relieve stress and anxiety, which is often the cause of habits related to TMJ, including teeth grinding and clenching.
Got a question regarding CBD oil and its place in the dental world? Schedule an appointment with a dentist today and stay informed!
About the Author
Dr. Benjamin Hornstein is experienced in a wide variety of areas in dentistry, including neuromuscular occlusion and therapies, periodontal treatment and holistic approaches in dental medicine. This allows him to create a dental care plan that truly meets the unique needs of every patient. To learn more about his practice or about holistic dentistry, you can contact him through his website.