Cannabinology, the study of compounds derived from Cannabis sativa and their interactions with the endocannabinoid system (ECS), has gained increasing relevance in dentistry. Cannabinoids such as cannabidiol (CBD) and tetrahydrocannabinol (THC) demonstrate therapeutic potential in the management of orofacial pain, dental anxiety, periodontal inflammation, and tissue regeneration [1,2]. This narrative review explores the biological basis of cannabinoid action in oral tissues, clinical applications, regulatory challenges, and future perspectives for cannabinoid-based therapies in dental practice [3]. Despite promising preliminary evidence, more robust clinical trials are needed to establish safety, efficacy, and standardized therapeutic protocols [4]. The integration of cannabinology into dental education and research can expand the therapeutic arsenal available to oral health professionals.
Cannabinology, Dentistry, Cannabidiol, Orofacial pain, Periodontal inflammation, Tissue regeneration
Cannabinology, the field that studies compounds derived from Cannabis sativa and their effects on the organism, has gained prominence in dentistry [5]. Cannabinoids such as CBD and THC interact with the endocannabinoid system (ECS), which regulates essential functions such as pain, inflammation, and immune response [1,6]. Dental interest grows due to therapeutic potential in conditions such as orofacial pain, anxiety, periodontal inflammation, and tissue regeneration [7]. With advancing research and progressive legislative flexibility in various countries, cannabinoids are being considered promising therapeutic options, especially for chronic conditions refractory to conventional treatments [3].
The ECS is composed of cannabinoid receptors (CB1 and CB2), endocannabinoids (endogenous agonists such as anandamide and 2-AG), and synthesis and degradation enzymes [1,8]. The CB1 receptor is abundantly expressed in the central nervous system, while CB2 is found predominantly in immune system cells. Both receptors are expressed in multiple oral cavity tissues, including tongue, salivary glands, dental pulp, periodontal tissues, and oral mucosa [6,9]. Activation of these receptors modulates crucial physiological processes such as inflammatory response, nociception, and tissue healing, which provides the foundation for their vast therapeutic potential in dentistry [10,11].
TMD represents one of the main causes of orofacial pain of non-dental origin [12]. CBD, due to its capacity to modulate CB1 and CB2 receptors and suppress the release of inflammatory cytokines, demonstrates significant potential in relieving joint and muscle pain associated with TMD [3,13]. Preclinical studies indicate that phytocannabinoids and terpenes exert robust antinociceptive effects in neuropathic and inflammatory pain models [14].
CBD exhibits notable anxiolytic effects, primarily through modulation of the hypothalamic-pituitary-adrenal (HPA) axis and interaction with the serotonergic system [15]. Preclinical studies demonstrate that CBD is capable of reducing conditioned fear and anxiety-associated behaviors, suggesting a potential benefit for managing patients with dental anxiety and phobia [16,17].
Although recreational cannabis use in smoked form is associated with increased periodontal risk, isolated cannabinoids, such as CBD, exhibit potent anti-inflammatory and antimicrobial properties [18,19]. CB1 and CB2 receptors play a role in regulating cellular differentiation and periodontal ligament healing [20]. The expression of these receptors is altered in inflammatory conditions, positioning them as promising therapeutic targets [21].
Emerging evidence suggests that CBD may favor osteogenic and odontoblastic differentiation, promoting reparative dentin formation and dentino-pulpar complex regeneration [22]. Human dental pulp stem cells (hDPSCs) treated with CBD demonstrate greater mineralization capacity and exhibit immunomodulatory properties in inflammatory environments, highlighting their potential for dental tissue engineering [23].
• Xerostomia: CB receptors are involved in modulating salivary secretion, opening pathways for dry mouth treatment [11].
• Nausea and Vomiting: Cannabinoids are clinically used for controlling chemotherapy-induced nausea and vomiting in oncology patients [24].
• Oral Mucositis: CBD has demonstrated efficacy in reducing severe oral inflammation induced by chemotherapy in preclinical models [25].
Most evidence regarding cannabinoid use in dentistry is still based on preclinical studies (in vitro and animal) [4]. The scarcity of randomized controlled clinical trials in humans represents a significant barrier for defining therapeutic protocols, dosage regimens, and ideal administration routes [3,26]. The heterogeneity of cannabis chemovars and available extracts also complicates standardization and result reproducibility.
Cannabinoid use is not without risks. Adverse effects may include xerostomia, dizziness, and somnolence. Regarding oral health, cannabis smoking is associated with increased risk of periodontal diseases [18]. Systemic impacts such as tachycardia, cognitive alterations, and immunosuppression should also be considered, as well as risks associated with use during pregnancy, such as low birth weight [27,28].
The legal status of cannabinoids for medicinal purposes varies substantially between countries. Nations such as Canada, Germany, Australia, and several U.S. states have established regulatory frameworks that allow prescription by healthcare professionals. Pharmacovigilance initiatives, such as the Quebec Cannabis Registry in Canada, are fundamental for monitoring clinical use and adverse effects on a large scale, generating real-world data that are essential to complement clinical trial evidence [29,30,31].
There is a notorious gap in cannabinology training in dental undergraduate curricula worldwide [4,5]. It is imperative that dentists be trained to discuss risks and benefits, obtain informed consent, and responsibly integrate cannabinoid use into the patient's medical history.
The future of cannabinology in dentistry lies in developing topical and local application formulations, such as gels, orodispersible films, oral rinses, and biomaterials (cements, scaffolds), aimed at maximizing local therapeutic effect with minimal systemic absorption and effects [8,12].
The formal inclusion of endocannabinoid system pharmacology in undergraduate and graduate dental curricula is fundamental for preparing the next generation of professionals to prescribe these therapies safely, effectively, and evidence-based [4,5].
The research agenda should prioritize: robust clinical trials on orofacial pain, TMD, and periodontal diseases; studies to elucidate molecular mechanisms of action in oral tissues; long-term safety and efficacy evaluation; and the development of controlled-release systems specific to the oral cavity [3,4,32].
Cannabinology presents a promising frontier in dentistry, offering innovative approaches for managing chronic pain, anxiety, inflammation, and tissue regeneration. Despite enormous potential, translation to routine clinical practice requires overcoming regulatory, ethical, and scientific challenges. Adequate professional training, promotion of high-quality clinical research, and interdisciplinary collaboration will be decisive for consolidating the therapeutic and safe use of cannabinoids as a valuable tool in the oral health arsenal.
• Comprehensive review of cannabinoid applications in dentistry
• Analysis of the endocannabinoid system's role in oral health
• Discussion of regulatory and ethical considerations
• Identificationof future researchpriorities
None declared.
No funding received.