Oral health is rarely the first concern raised in cannabis policy discussions, yet mounting evidence suggests the mouth may be one of the most consistent biological targets of cannabis exposure. As legalization expands across North America and globally, dental and oral medicine researchers are beginning to map who bears the greatest burden — and the picture is more nuanced than population-wide averages suggest.
A symposium convened at the 2025 AADOCR/CADR Annual Meeting examined cannabis-related oral health outcomes across three groups identified as particularly vulnerable: Indigenous Canadians, adolescents and young adults, and 2SLGBTQI+ youth. Across these populations, the evidence most consistently supports associations between cannabis use and periodontal disease (gum disease affecting tooth-supporting structures) and xerostomia (chronic dry mouth). Links to dental caries and oral cancer exist in the literature but remain less conclusive — likely because they involve longer latency periods, confounding lifestyle factors, and smaller dedicated study samples.
The xerostomia–caries pathway is mechanistically plausible and worth watching: salivary flow is a primary defense against cavity-forming bacteria, so persistent dry mouth from cannabis use could theoretically accelerate decay over years of habitual exposure. Periodontal disease, for its part, has been independently associated with systemic inflammatory conditions including cardiovascular disease and diabetes — meaning cannabis-linked gum disease, if causal, could carry implications well beyond dental health. This communication reflects a growing recognition that cannabis research has historically under-sampled marginalized communities, even though those groups often report higher use rates and face compounding barriers to dental care. The designation of these three populations as 'priority' groups is itself a methodological signal: future trials and cohort studies should stratify by group identity rather than treating cannabis users as monolithic. This is an early-stage, expert-consensus framing rather than a meta-analysis, so causal claims remain premature — but the directional evidence is consistent enough to warrant clinical attention.