Alcohol, Tobacco, and Cannabis

Alcohol, tobacco, and cannabis use cause oral problems through direct contact, altered immune response, poor blood flow, carcinogenesis, teratogenesis, and accidental trauma. In the case of oral cancers, the effects may be additive when more than one substance is used.


Effects of Tobacco Use

  • Tooth stains
  • Altered taste and smell
  • Periodontitis
  • Xerostomia
  • Caries
  • Oral, head, and neck cancers
  • Congenital anomalies in offspring, such as cleft lip and palate

Effects of Alcohol Use

  • Periodontitis
  • Xerostomia
  • Caries
  • Oral and throat cancers
  • Fetal alcohol syndrome and effects in offspring.
  • Congenital anomalies in offspring, such as cleft lip and palate

Effects of Cannabis Use

  • Dental caries
  • Increased oral infections
  • Xerostomia
  • Periodontal disease
  • Dysplastic changes and premalignant oral lesions (literature is unclear if cannabis has a direct carcinogenic effect)
  • Increase in oral infections (possibly from mild immune suppression effect of marijuana)


Naido S, et al, Fetal Alcohol Syndrome: Anthropometric and Oral Health Status, Journal of Contemporary Dental Practice, 2005, Nov (6) 4:101-115.

Petersen PE, Tobacco and Oral Health-the Role of the World Health Organization, Oral Health and Preventive Dentistry, 2003;1:309-315.

A Report of the Surgeon General: The Health Consequences of Smoking-50 Years of Progress. U.S. Department of Health and Human Services. Office of the Surgeon General. Rockville, MD. 2014.

Cho, CM, Hirsch, R, Johnstone, S. General and oral health implications of cannabis use. Aust Dent J 2005 Jun;50(2):70-4.

Huang YH, Zhang ZF, Tashkin DP, Feng B, Straif K, Hashibe M. An epidemiologic review of marijuana and cancer: an update. Cancer Epidemiol Biomarkers Prev. 2015 Jan; 24(1): 15-31.