title: Periodontal and oral manifestations of marijuana use.
abstract: Marijuana, prepared from the plant Cannabis sativa, is the most widely used illicit drug in the United States. Marijuana use has been associated with adverse psychosocial and health effects, including effects on oral tissues. Periodontal literature has limited references to the periodontal effects of cannabis use. In this report, we present two cases of marijuana-associated gingival enlargement and review the literature on oral complications of marijuana use.
  
  
  METHODS
  Two asymptomatic males, aged 23 and 42 years, presented independently for oral prophylaxis. Both had an unremarkable medical history and related a history of significant marijuana use of 2-16 years duration. Common findings following oral and periodontal examination were nicotinic stomatitis-like lesions, uvulitis and gingival enlargement. Marginal and papillary gingiva of the anterior dentition were the areas primarily affected by gingival enlargement, while some of these areas exhibited a nodular or "pebbly" appearance.
  
  
  RESULTS
  Marijuana-associated gingival enlargement was diagnosed in the reported cases. A review of the literature revealed two other reports of marijuana-associated gingival enlargement, all in young adult males with chronic (2 or more years) cannabis use. These authors reported a resemblance to phenytoin-induced enlargement. Biochemical similarities between phenytoin and cannabis active compounds suggest possible common pathogenetic mechanisms. Uvulitis and nicotinic stomatitis appear to be the two most common of the several oral manifestations of marijuana use.
  
  
  CONCLUSIONS
  Chronic marijuana use may result in gingival enlargement with clinical characteristics similar to phenytoin-induced enlargement.
authors: Department of Periodontology, University of Tennessee Health Science Center, College of Dentistry, Memphis, TN, USA.
authors: Swati Y
authors: SY
authors: Rawal
authors: Dimitris N
authors: DN
authors: Tatakis
authors: David A
authors: DA
authors: Tipton
mesh_terms: D000328:Adult; D002186:Cannabinoids / Q000009:adverse effects; D002188:Cannabis / Q000009:adverse effects* / Q000737:chemistry; D002908:Chronic Disease; D019214:Gingival Overgrowth / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects*; D009059:Mouth Diseases / Q000139:chemically induced; D012140:Respiratory Tract Diseases / Q000209:etiology; D013280:Stomatitis / Q000139:chemically induced; D014609:Uvula / Q000187:drug effects; D055815:Young Adult
chemical_list: D002186:Cannabinoids