Research is just research. It is information that may make a difference in humans once it has been tried and tested in humans. I see the potential in new research published in the Journal of Neuroinflammation (June 3, 2016) that could enhance the treatment of periodontitis. We as a profession have not adopted this new research yet.
The new research revolves around biochemicals that are manufactured by various cells in the body. The specific biochemicals described in the research are called cannabinoids, biochemicals with a recognized anti-inflammatory effect. When cannabinoids are damaged or prevented from doing their work in the body, the body suffers. These biochemicals are also available from external sources and could support those made by the body.
Specifically, cannabidiol (CBD), one of the cannabinoids, is available from the hemp plant. It is not tetrahydrocannabinol (THC), which is another cannabinoid compound that is the active ingredient in marijuana. Cannabidiol has no or minimal psychoactive effects or toxic effects, and it is available as an over-the-counter supplement.
Science and periodontitis
Destruction of the jawbone in periodontitis is related to specific mediators causing inflammation and resorption of bone. Previous animal research has shown that CBD will decrease this inflammation and prevent destruction of the jawbone that is part of the progression of periodontitis (International Immunopharmacology, February 2009, Vol. 9:2, pp. 216-222). A 2006 study posited that it might be possible that supplemental CBD could improve healing following periodontal treatment by reducing these damaging effects caused by advanced gum disease (FEBS Letters, January 23, 2006, Vol. 580:2, pp. 613-619).
In contrast, a 2012 paper suggested that using CBD as a supplement could possibly cause an overgrowth of periodontal tissue, especially if there was existing gum infection (Journal of Periodontal Research, June 2012, Vol. 47:3, pp. 320-329).
Future potential
In the future, clinical trials need to be done to show that CBD would be beneficial in treating periodontal disease. Only then could we consider embracing its potential.
Other questions that need to be answered include the following:
- How much CBD would a patient need to consume to improve healing?
- Since many structural forms of CBD are available, which one would be most biologically available to the body?
- Are there any side effects from supplemental CBD on the rest of the body?
These questions must be answered before I could recommend CBD as a supplement in periodontal treatment to my patients. However, I do emphasize to them that the best prevention for periodontal disease is a nutrient-dense, anti-inflammatory diet and proper oral hygiene as I described in my series of blog posts.
Unfortunately, science at times has created medicines or supplements processed from natural sources only to learn the intended benefits are not what they should be or the side effects prove to be harmful. That said, I am eager to learn what CBD might be able to do for my periodontal patients.
Alvin Danenberg, DDS, practices at the Bluffton Center for Dentistry in Bluffton, SC. He is also on the faculty of the College of Integrative Medicine and created its integrative periodontal teaching module. He also spent two years as chief of periodontics at Charleston Air Force Base earlier in his career. His website is drdanenberg.com.
A version of this column first ran on Dr. Danenberg's blog. DrBicuspid.com appreciates the opportunity to reprint it.
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