Abstract Title

COMMENTARY: Phytocannabinoids as therapeutic agents to combat chronic gingival disease.

Lead Author Affiliation

DDS

Lead Author Program & Year

DDS Year 3

Presentation Category

Literature Review

Introduction/Context/Diagnosis

The therapeutic potential of cannabis has been harnessed for thousands of years yet the United States Food and Drug Administration (FDA) has still not approved cannabis as a safe or effective drug. The FDA has, however, approved the manufacturing of pharmaceutical drugs, which contain a “synthetic version of a substance that is present in the marijuana” and other compounds that mimic its action. A search of the US National Library of Medicine and National Institute of Health for keywords “CBD” and “Periodontitis” together yields only 2 publications. Although the current State and Federal regulations on the use of cannabis for research and medicinal purposes seem to contradict one another, there is much room for optimism as the number of States allowing its use increases. This manuscript highlights the recent advances made in cannabinoid research as it pertains to oral health and gingival inflammatory disease. With a brief overview of the endocannabinoid system and its network of receptors and ligands, such as CBD, this manuscript provides the reader with the foundational knowledge necessary to answer common patient questions in a clinical setting.

Methods/Treatment Plan

The literature was gathered from relevant publications found by doing keyword searches as they pertain to immune response, oral health and cannabinoids on the National Institute of Health directory (PubMed). Literature was assessed for validity and conflict of interest. However since inclusion/exclusion criteria were not outlined at the start of the project, a reflective narrative is taken utilizing the authors existing knowledge and experience in the field of immune biology.

Results/Outcome

This preliminary review of the literature demonstrates the vast complexity of the endocannabinoid system and underline indications for the use of full or broad spectrum phytocannabinoid extracts for therapeutic uses. Due to Federal and State regulations, cannabinoid pharmaceuticals have been slow to enter the market, however, for families with children battling debilitating seizures, or the families of the 130 Americans that die from opioid abuse, hope remains that researchers will find new ways to reign in the touted benefits of the cannabis plant. Long term clinical studies on the effects of CBD mediated immune-suppression on gingival inflammation is strongly encouraged.

Significance/Conclusions

A search of the US National Library of Medicine and National Institute of Health (PubMed) for keywords “CBD” and “Periodontitis” together yields only 2 publications. Our understanding of the innate and adaptive immune systems and their role in the realm of inflammatory disease processes of the mouth has made many advancements thanks to the practice of evidence based dentistry. For years, the idea that periodontitis was a ubiquitous condition with its main etiologic factor being bacterial plaque formation has been replaced with the understanding of the influence of host susceptibility and epigenetic control contributing to individual risk. Major determinants of disease susceptibility are the immune‐inflammatory response to antigens found in gingival crevicular fluid. Interestingly, it is these very defense measures that result in the majority of the tissue damage leading to the clinical manifestations of disease. The unique anatomy of the periodontium adds complexity to the pro- and anti- inflammatory signaling that dominates during a pathologic challenge such as periodontal disease. The lack of the endocannabinoid system in a mouse model didn’t create a notable phenotype, indicating that the ECS may potentiate homeostasis and immune response primarily during a pathologic challenge. This manuscript provides a basic outline to investigate CBD-mediated immunosuppression in response to a pathologic challenge like periodontitis in a humanized BLT-mouse model.

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COMMENTARY: Phytocannabinoids as therapeutic agents to combat chronic gingival disease.

The therapeutic potential of cannabis has been harnessed for thousands of years yet the United States Food and Drug Administration (FDA) has still not approved cannabis as a safe or effective drug. The FDA has, however, approved the manufacturing of pharmaceutical drugs, which contain a “synthetic version of a substance that is present in the marijuana” and other compounds that mimic its action. A search of the US National Library of Medicine and National Institute of Health for keywords “CBD” and “Periodontitis” together yields only 2 publications. Although the current State and Federal regulations on the use of cannabis for research and medicinal purposes seem to contradict one another, there is much room for optimism as the number of States allowing its use increases. This manuscript highlights the recent advances made in cannabinoid research as it pertains to oral health and gingival inflammatory disease. With a brief overview of the endocannabinoid system and its network of receptors and ligands, such as CBD, this manuscript provides the reader with the foundational knowledge necessary to answer common patient questions in a clinical setting.