Cannabis use not linked with increased risk for periodontitis

Periodontitis is a microbially associated inflammatory disease of the tooth-supporting tissue that affects approximately 50% of the adult population, with 10% suffering from severe periodontitis. It is a major cause of tooth loss. Subgingival bacterial dysbiosis, diabetes mellitus, and tobacco smoking are well-recognized risk factors for periodontitis. Cannabis is the most widely smoked substance after tobacco, and its prevalence is increasing as more legal markets emerge. There is strong evidence from prospective observational studies, Mendelian randomization (MR) studies, and laboratory-based studies that tobacco smoking increases the risk of periodontitis. Cannabis smoke shares many of the chemical constituents of tobacco, except for cannabinoids and nicotine. The well-established effect of tobacco smoke on the periodontium and the oral mucosa and the similarities in the toxicological profiles of tobacco and cannabis smoke suggest that cannabis may also be a candidate in the aetiology of periodontal disease.

This study aimed to leverage human genetic data to investigate whether cannabis use causally affects periodontitis.

Data were obtained from summary statistics of genome-wide association studies of lifetime cannabis use (N = 184,765), cannabis use disorder (17,068 cases; 357,219 controls), and periodontitis (17,353 cases; 28,210 controls). We performed two-sample Mendelian randomization (MR) analysis using 6 genetic variants as instrumental variables for lifetime cannabis use and 11 variants as instruments for cannabis use disorder to estimate associations with periodontitis.

Results

• There was no evidence for an association between genetic liability for lifetime cannabis use or cannabis use disorder with periodontitis.
• The estimates from the primary analyses were supported in multivariable MR analysis, which considered potential pleiotropic pathways and in weak instrument analyses.

This study provides little evidence to support the detrimental effect of genetic liability for cannabis use on periodontal health.

Reference:

Baumeister, S.-E., Alayash, Z., Baurecht, H., Reckelkamm, S. L., Kocher, T., Holtfreter, B., Ehmke, B., & Nolde, M. (2022). Cannabis use and the risk of periodontitis: A two-sample Mendelian randomization study. Journal of Clinical Periodontology, 49( 7), 654– 661. https://doi.org/10.1111/jcpe.13632