3CE SNJDHA: The Therapeutic Potential of Cannabis in Dentistry

Stigma

The studies suggested a positive relationship (correlation) between marijuana use (smoking) and oropharyngeal cancer risk.

No association was found between marijuana use and tongue cancer.

Also found in:

• Hops
• Coriander

High Pinene Strains

Jack Herer

Blue Dream

Dutch Treat

Romulan

High Humulene Strains

• Sour OG
• Sour Diesel
• Girl Scout Cookies
• Skywalker OG

Cannabinoids

Also found in:

• Lavender
• Mint, Cinnamon
• Rosewood
• Jasmine.

Anxiety & GERD are common co-morbidities.

The ability to control anxiety with CBD and appetite, panic, GI spasms with CBG & THC is safer for the teeth than lemon water!

Nicole Greco, BS, MA

• Anti-bacterial
• Anti-inflammatory
• Anti-tumor

Super Lemon Haze

OG Kush

Durban Poison

High Limonene Strains

Examining Strains:

GERD & DENTAL DISEASES

Dental professionals must recognize and manage GERD intra-oral effects.

Aroma: Pine

Anti-inflammatory

Bronchodilator

Helps counter short-term memory loss associated with THC

Promotes alertness

Effective for GERD & Anxiety!

The Future

Linalool

• Promote Sleep
• Anti-Anxiety
• Anti-Depressant
• Anti-Inflammatory
• Anti-Bacterial

Terpenes

• Elevated mood
• Stress relief
• Antifungal properties
• Antibacterial properties
• May help relieve heartburn and gastric reflux

cannabichromene

(CBC)

Jack Herer

• Hemp Activist
• Author of: Emperor Wears No Clothes, 1973
• Founded: Help End Marijuana Prohibition (HEMP)
• Famous Cannabis strain

Contact:

THC

High Linalool Strains:

• Amnesia Haze
• Lavender
• Pure Kush
• Pink Kush
• Grand Daddy Purple

Ihateplaque

Terpenes

Linalool showed remarkable antibacterial effects

against the periodontopathic and cariogenic bacteria.

• Terpenes are the essential oils of cannabis.
• Terpenes determine the strain aroma: fruity, spicy, woody, skunky etc.

@Ihateplaque

The Therapeutic Potential of Cannabis in Dentistry

Anti-Tumor

Anti-inflammatory

Promotes brain growth

Anti-acne

Ihateplaque@aol.com

Linalool

Found in Citrus Rinds:

• Lemon
• Grapefruit
• Oranges

Tetrahydrocannabinol

www.nicolegreco.com

Beta-Caryophyllene

• Analgesic
• Anti-Inflammatory
• Anti-Bacterial
• Anti-Spasmodic

Also found in:

• Black Pepper
• Cloves
• Oregano
• Hops

Analgesic

Anti-Tumor

Ease Nausea & Vomiting

Beta-Caryophyllene

Bronchodilator

Ground breaking dental pain research!

CBD + BCP was more effective when treating dental pain compared to other cannabinoids and terpenes tested.

Protects Brain Cells

Epidiolex

Anti-Inflammatory

The potential of terpenes cannot be ignored.

Imagine a non-psychoactive terpene rich healing membrane, impregnated sutures, topicals, rinses, pastes, floss..

Dr. Sara Ward & I

Test Results

Sleep Aid

EPIDIOLEX was associated with significant reductions in total seizure frequency versus placebo.

Anti-Convulsant

Muscle Relaxant

Estimated cost:

$32,500 per year

Anti-Oxidant

Myrcene

Promotes Brain Growth

• Anti-Inflammatory
• Sedative
• Muscle Relaxant
• Pain

Pain Relief

Mycrene is found in hops, mango, bay leaves, eucalyptus, lemongrass and many other plants.

Anti-Bacterial

Dental Application

Treats PTSD

Anti-Convulsant

Check out these high BCP strains:

Anxiety Relief

Enhances Senses

Clove oil is Antibacterial!

Increases Appetite

Medicine continues to evolve.

Dentistry must continue to evolve.

Skin Disorders

Antimicrobial !

Isolated BCP and other terpenes are available online, dispensaries and vape stores.

This is recommended to supplement cannabis based medicine for maximum therapeutic value.

Pain Relief

The use of topical cannabinoids are showing promise in treating peri-oral infections like herpes, shingles, angular cheilitis, and more!

Consider the possibilities!

HERPES

Stimulates Bone Formation

Published: 1979

Scleroderma

OpioidS & DENTISTRY

Prevent Dental Caries!

The ADA supports statutory limits on opioid dosage and duration of no more than seven days for the treatment of acute pain, consistent with the Centers for Disease Control and Prevention evidence-based guidelines..

Inhibits Strep Mutans!

• Effective against Streptococcus Mutans
• Effective in inhibiting biofilm production
• Beta-Caryophyllene may be a preventive agent for dental caries.

Conventional Therapy

Anti-Virals may not be appropriate for all patients.

Note: Cannabinoids would not suppress an outbreak, but rather treat an outbreak.

Cannabis as an Opioid Replacement

Managing Dental Pain

More effective than CHX!

Trigeminal Neuralgia

The results showed that Beta-caryophyllene has antimicrobial activity against the proliferation of dog’s dental plaque-forming bacteria representing a suitable alternative to the use of chlorhexidine in prophylaxis ..

Scleroderma

We STILL have an obligation to manage our patient's post-operative pain & dental anxiety.

Cannabis can do both.

Slows Tumor Growth

Soft Tissue Pain

Addiction &

Recovery

Neuropathic Pain

Pulpal Pain

Fear & Anxiety

Pain Management is Crucial.

Anxiety, Fear, PTSD Management is Critical.

Periodontal Pain

Top Pain Relieving Strains

Improve Sleep

1. White Widow

2. Blue Dream

3. Bubba Kush

4. AK-47

5. Jack Herer

Cancer Pain

Scleroderma

Case Study

Disorder of tight/taught skin, joint pain, exaggerated response to cold

(Raynaud's disease), and heartburn.

Scleroderma Strain Recommendations

1. Skywalker

2. White Rhino

3. AK47

4. Blue Dream

5. Harlequin

Dentin Sensitivity

Burning Mouth Syndrome

High doses of THC may increase anxiety, paranoia and fear ...so we must counsel patients on selecting high CBD strains.

You will not know who suffers from PTSD.

So.. Remember..

FEAR

Traditional Anxiety Management Therapies:

Current therapies include:

• Antibiotics
• Antivirals
• Immunosuppresives
• Opioids
• Benzodiazepines

Chairside Delivery:

• Inhaler
• Oils
• Capsules
• Edibles
• Topicals
• Suppository
• Tampons

Cannabis is the safest option we have.

Ehlers-Danlos Syndrome

Headache Disorders

RDH Nitrous Oxide Exposure

Dental Hygienists NOT administering, but just working in the office, tested above the NIOSH recommended exposure levels.

Dental Hygienists Reported:

• Lack of training
• No standard procedure
• Unsure of engineering controls

Medical Cannabis Inhaler

CBD

Cannabidiol

CBG

Cannabigerol

Mango Infused Edibles

Abfraction

Myrcene assists cannabinoids in crossing the blood brain barrier.

Skin Disorders

Tissue Disorders

The future of pain management depends on the future of cannabis accessibility.

The therapeutic potential of cannabis stretches far beyond pain and anxiety management.

Dermatology Studies

As Cannabis gains acceptance and accessibility, the future landscape of medicine and dentistry changes.

I invite each of you to imagine the chair-side potential of cannabis.

Anti-Fungal & Anti-Bacterial

Epidermolysis Bullosa

Improve Mental Clarity

Pemphigoid Disorders

Managing patient's anxiety is critical to the successful management of patients.

Nitrous oxide is a costly solution which poses danger to all exposed. What other options do we have?

Case Study

One patient was weaned completely off oral

opioid analgesics.

All 3 reported faster wound healing, less blistering, and pain reduction with cannabidiol use.

Most Important...

Fun Fact

Anti-Cancer

DENTAL APPLICATIONS

CBG is the parent molecule to THC & CBD.

Reduce Inflammation

Smoking Cessation

Anxiety

Clonopin

XANAX

Combine CBD Oil + Vape to Increase Success.

Reduces Eye Pressure

Dental Anxiety

Dental fear was found to disturb sleep and to have a

profound affect socially, interfering with work and personal

relationships.

Anti-Inflammatory

The Basics of Bud

Dental anxiety is a significant

determinant of whether people will make regular dental visits.

CBD is safe for children and most medically compromised patients.

Skin Clarification

Compelling Evidence...

CBD & Cancer

Therapeutic Potential for Cancer

Mucositis

Analgesic

Anti-Tumor

Anti-Emetic

Appetite Stimulant

Neuroprotective

CBD could act both in the control of Oxidative Stress and the suppression of the inflammatory response, having a protective role against the development of Oral Mucositis.

Home Cultivation

Recreational Cannabis

Medical Cannabis

Home Cultivation

The ability to grow your own cannabis for personal use.

This allows patients to grow specific strains, saving them money and increasing therapeutic potential.

Consult your state laws.

Growing Cannabis

Medical Cannabis laws vary state to state.

These laws stipulate:

• Type of medicine available: plant, extracts, capsules, oils etc.
• Maximum possession rules
• Laws pertaining to growing cannabis
• Public Consumption
• Lab Testing
• Labeling of Products
• Zoning of Dispensaries
• Many Others: Consult your state laws.

Mental Relaxation

Cannabinol

(CBN)

Muscle Relaxation

New Jersey

• 16 qualifying Conditions
• Home Grow: illegal
• 6 Dispensaries (in entire state)
• Medical Market Expanded 5/30/19
• Legalization on the horizon

Improve Muscle Repair

Improves Focus

In the United States, Cannabis is federally illegal.

Marijuana is classified as a schedule I drug.

Schedule I drugs have no medical value, despite cannabis being used as medicine world wide.

Decreases Nausea

Now that we have established that marijuana, marihuana and cannabis are all medicine, let's examine the therapeutic potential of cannabis.

Indica Strain

Qualities

Annual Report

Strains

Opioid Reduction

Each Country, State, City can set laws regarding access.

Types of access include:

• Recreational: Any person meeting the minimum age requirement can access cannabis.
• Medical: Qualifying conditions are set by legislature; patients who are sick and dying can access the plant.
• Home Cultivation: The ability to grow your own cannabis.

Pain Relief

Increases Dopamine

Limitations to Access

Increases Appetite

The ability or inability to access cannabis is an infringement upon:

• Civil Rights
• Life: Health and Wellness
• Seizure Control
• Cancer Control
• Research
• Many More

• Anti-insomnia
• Promotes growth of bone cells
• Antibacterial
• Anti-inflammatory
• Anti-convulsive
• Appetite stimulant

Education

THC degrades to CBN over time.

CBN is a powerful sleep aid.

Termed the sleepy cannabinoid.

Couch-Lock

Indica Strains: Couch Lock

Couch lock is a common side effect of smoking or ingesting indica cannabis strains.

STRAINS

Best Strains for Couch Lock

Hybrid

1. Northern Lights

2. Shark Shock

3. Master Kush

4. Royal Domina

5. Gorilla Glue #1

Qualities of both strains.

Publications

Contributing Author

Anti-Anxiety

Anti-Depressant

Educational Career

Published 2008.

Pain Relief

Cannabis Plant Anatomy

Sativa Strain

Qualities

Increases Focus

Career

I've had a great educational, clinical and publishing career...

Improves Creativity

Increases Serotonin

Kief

Then this happened...

Trichomes which have been separated from the flower.

Kief is collected from the leaves and used for medicine in many forms.

The anti-bacterial properties of terpenes may prevent gingivitis and caries!

We will cover terpenes later.

This is a cannabis cigarette (a joint) coated with kief for added therapeutic benefits.

Police seized [valid] RX Drugs.

I was charged with possession of Narcotics.

Serious withdrawals ensued.

Education & Advocacy

Trichomes

Tiny hair like projections containing hundreds of cannabinoids, terpenes, and flavonoids.

The trichomes differentiate each strain of cannabis.

Terpenes & terpenoids are the essential oils of cannabis, also found in cloves, mango, pine, pepper and more.

Reducing periodontal disease risk reduces risks of systemic disease risk.

Dental hygienists are prevention specialists.

Cannabis is an exit strategy off pharmaceuticals.

Not a gateway drug.

Dental Hygiene

Job Security

Advocate

Cannabis Pollination

Portion of plant responsible for reproduction.

Lots of stigma surrounds this plant.

EducatE

Cola

The cola is the flower of the female plant.

This flower is then dried, as shown here:

Sativa Strains

Growth Time

1. Sour Diesel

2. Lemon Haze

3. Green Crack

4. Strawberry Cough

5. Jack Herer

Fan Leaves

The iconic leaf plays a vital part in the photosynthesis and growth, however the cola is where most medicine is extracted from.

Endocannabinoid System

Patient Education

Cannabis Sex Anatomy

Male plants pollinate female plants.

Medicine is extracted from female flowers.

Medicinal Cannabis

Oropharyngeal Cancer

Hemp

Let's examine the Therapeutic Potential of this miraculous plant.

Does smoking cause cancer?

Farm Bill

In simple terms, hemp is the sober cousin to Cannabis Indica.

Hemp contains less than 0.03% THC.

The "legal in 50 states CBD oil" is being manufactured from Hemp.

Hemp has also endless industrial possibilities!!

Forms of Administration

The authors could not make an association between marijuana smokers and increased head and neck cancer.

Note: Patients should be advised against smoking via combustion of cannabis. Smoking cannabis may cause cancer.. while ingesting, applying, inhaling may cure cancer.

Education is the first step!

It will take an Army!

Hemp Canvas

Smoking Effects

Combustion

Hemp Uses

Joint/J/Spliff

Rolled cannabis to be smoked using a flame.

This patient is using a filter when rolling. A filter improves air flow and reduces waste because all medicine can be smoked, eliminating "roaches."

A roach is the burned end of a joint.

As seen here:

Rolling Devices

Blunt

Cigar papers can be used to roll cannabis and smoke.

Glass Blunt

Periodontal Diseases

CBD

Cannabidiol

Extractions

Glassware

Infused Fats: Oils, Butter

Non-Toxic Diesel Fuel

Internal Applications

RoutEs of

Administration

Vaginal & Rectal

Infused Oils

Infused Butter

Home Infusion

• Olive Oil
• Coconut Oil
• MCT Oil
• Hemp Seed Oil
• Many More!

Tobacco smoking was strongly associated with periodontal disease experience, but there was no interaction between cannabis use and tobacco smoking in predicting the condition’s occurrence.

We have been extracting medicine from Cannabis for centuries.

The process has advanced significantly, and continues to advance.

Endless possibilities

Cannabis Extraction

Tincture

Hash

• Alcohol or Glycerine Infusions.
• Alcohol may irritate oral & GI tissues.
• Glycerine has a short shelf life.

• Pressurized Trichomes
• Potent!
• May be eaten, smoked, vaporized
• Bhang: Hash Drink

Cannabis Extractions

Dab Forms

Extraction methods, heat, chemicals and pressure are used to make:

• Dabs
• Wax
• Shatter
• Oils
• Tinctures
• More!

Consume at your own risk!

Do not drive after consuming high THC doses.

Medicate Responsibly.

Equipment Required.

Electric Dab Equipment.

Disclose for optimal patient education!

LUNGS

Pre-Procedural Anxiety

Inhaling a CBD dab before a dental appointment would be highly effective for anxiety..

Edibles

Dab

Also a popular dance.

Occular Delivery

Lungs: Inhalation

Effective Glaucoma Therapy

• Vaporization: Using a heating element to boil a liquid or soild to a gas.

• Combustion: Using a flame to smoke plant material.

Delivery options are endless!

Capsules

Lotions, Cosmetics, Oils

Vaporization

Combustion: Smoking

SMOKING CANNABIS

Vaporization

• Smoking cannabis forms combustion by-products, these increase risk for lung/mouth disease(s).

• Vaporization: Safer, more effective method of inhalation.
• Allows users to target the temperature of specific cannabinoids.

Xerostomia

Oral Delivery

Sublingual: Oils, Glycerine

Contact Irritation

Alcohol based medicine may irritate tissues.

Recommend apthous ulcer treatments.

Mix tinctures with food or milk.

Topical Delivery SystemS

Sublingual Absorption:

• Superior uptake over ingestion
• Many delivery options:
• Sprays
• Buccal Delivery
• Lozenges
• Gums, Mints, Candy
• Sublingual Strips

Medicated PAtches

Buccal Delivery

Cream, OIntment, Balm, LOtion

Oral Spray

Advanced Delivery

The Nanoliposphere delivery was superior to spray delivery.

Delivery options continue to advance.

Gum

Medicated Toothpicks

MinTS

Lozenge

Educate patients on:

• pH
• Alkaline Products
• Diet
• Strain Selection
• Administration Selection

Case Study

Prevention is key!

Management is crucial!

Recommend products to relieve symptoms.

Educate patients on the role of biofilm and pH.

Nicole Greco, R.D.H., B.S., M.A.

Cannabis Educator & Holistic Dental Hygienist