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Letters
May 21, 2008

Association of Cannabis Smoking and Periodontal Disease

JAMA. 2008;299(19):2273-2274. doi:10.1001/jama.299.19.2273-a

To the Editor: Dr Thomson and colleagues1 established evidence of an association between cannabis smoking and periodontal disease among young adults. We believe that the discussion could have been extended to other drug abuse.

The study did not provide data on the use of any other illicit drugs in this population, which may have occurred. Methylenedioxymethamphetamine (MDMA, ectasy) may also be associated with gingival and mucosal ulceration and periodontitis.2 Chronic gingival application of cocaine may be associated with gingival and mucosal ulceration, periodontitis, and local vasoconstrictive ischemia.3 In association with cocaine use, chronic alcohol consumption may increase periodontitis development.4

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