Vaping is Associated with Less Tooth Loss Among Medical Marijuana Users in the 2020 Behavioral Risk Factor Surveillance System (BRFSS)

Abstract

Abstract Background In the United States (US), the prevalence of periodontitis is adults has been estimated to be as high as 46%, and chronic periodontitis leads to tooth loss. Tobacco use is an established risk factor for periodontitis and tooth loss, but evidence behind the relationship between marijuana use and periodontitis remains unclear. Recent innovations have led health-conscious individuals to switch from smoking to inhaling vaporized tobacco and MM (“vaping”). This paper aims 1) to characterize United States (US) MM users in the 2020 Behavioral Risk Factor Surveillance System (BRFSS); 2) to determine if vaping (compared to other MM use methods) is independently associated with oral healthcare utilization and outcomes and 3) to explore potential effect modification between tobacco and MM use and oral health outcomes. Methods Those reporting MM use with valid tobacco use variables were included in the analysis. After descriptive analysis, logistic regression was used to estimate whether method of MM use was independently associated with oral health outcomes in tobacco users and non-users. Results Of the 7,077 respondents reporting MM use, 69% smoked, 8% vaped, and 50% were also current tobacco users. In regression analysis, among tobacco users, vaping MM and vaping tobacco were associated with lower odds of having lost six or more teeth (compared to smoking both, and eating/drinking MM). Among tobacco non-users, vaping MM was associated with much lower odds of tooth loss than eating/drinking MM (compared to smoking, odds ratio [OR] vaping 0.40, 95% confidence interval [CI] 0.22–0.72, OR eating/drinking 0.73, 95% CI 0.57–0.95). Conclusions Our findings point to a potentially anti-inflammatory effect of vaping MM that deserves further examination. Additional studies should seek to accurately measure both tobacco and MM use, and determine whether there is indeed effect modification in terms of their relationship to oral health outcomes.