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Cannabis & Dry Mouth
Why do legal cannabis consumers sometimes suffer dry mouth (also called cotton mouth)? Below, students learn the science-based research regarding the biochemical mechanisms of cannabis consumption and decreased saliva production, which often leads to dry mouth.
Dry mouth, or xerostomia, is a condition suffered by some cannabis consumers. Although physical responses to consumption of tetrahydrocannabinol (THC) and other cannabinoids and terpenes produced by the marijuana plant vary (sometimes considerably), scientists have discovered some of the underlying biochemical mechanisms that explain why and how this phenomenon occurs.
Once believed to result from the smoking of cannabis, recent legalization and the resulting availability of a wide range of product formats involving several consumption avenues has revealed that dry mouth can be produced by smoking, vaping, or eating cannabis products.
"Unlike the body-wide dehydration that results from alcohol consumption, cannabis causes only decreased saliva production (hyposalivation)."
Unlike the body-wide dehydration that results from alcohol consumption, cannabis causes only decreased saliva production (hyposalivation) due to its interaction with certain salivary glands. Multiple peer-reviewed research studies have revealed this mechanism, as cited below.
Salivary Glands Have ECS Receptors
More specifically, research has revealed that salivary glands, particularly the submandibular variety under the jaw that produce up to 70 percent of saliva, contain CB1 and CB2 type receptors. These specialized microscopic cellular neurotransmitters are involved in management of the endocannabinoid system (ECS) and found with the greatest density in the brain and central nervous system (but in lower densities in nearly every organ and tissue of the body).
As part of the ECS, the CB1 receptors located in the submandibular glands are designed to bind with molecules such as delta-9 THC. When this occurs, impulse messages from the parasympathetic nervous system to the submandibular glands that instruct them to produce saliva are blocked—resulting in the experience of dry mouth.
Cannabis & Dry Mouth Studies
Cannabis & Dry Mouth. A variety of peer-reviewed research studies have revealed the mechanisms involved in the interaction of cannabis (and, more specifically, THC) with the salivary glands of the mouth. Multiple studies indicate that THC decreases the production of saliva via its effect on the microscopic CB1 receptors that densely populate the submandibular glands within the jaw (just as CB2 receptors have been found within the nasal cavity).
Cannabis & Dry Mouth: 2021 Study
A 2012 study entitled "Cannabinoid Receptors in Submandibular Cells: Functional Coupling between Saliva Fluid and Electrolytes Secretion" that was published in the Journal of Cell Science investigated the "functional CB1 and CB2 [ECS receptors] in acinar cells of rat submandibular glands and their essential role in saliva secretion."
"Our data demonstrate the expression of CB1and CB2 [endocannabinoid receptors] in acinar cells and their involvement in the regulation of salivary gland functioning."
Cannabis & Dry Mouth: 2019 Study
A 2019 study entitled "Impact of Cannabis on the Port of Entry-Oral Tissues: An Overview" that was published in the International Journal of Oral and Dental Health explored the overall side effects caused in the mouth when cannabis is consumed.
Reported the study, "the continuous use of cannabis was associated with effects on oral tissues such as increased xerostomia." The researchers concluded that "the increasing prevalence of cannabis users in the world demands the attention of oral health care providers of the diverse...effects of cannabis."
Cannabis & Dry Mouth: 2018 Study
A 2018 study entitled "Epidemiological Characteristics, Safety, and Efficacy of Medical Cannabis in the Elderly" that was published in the European Journal of Internal Medicine explored the efficacy of marijuana consumption by senior citizens. It surveyed 2,736 seniors, the mean age of which was 75 years, "who began cannabis treatment and answered an initial questionnaire." Among this cohort, the most common adverse events were "dizziness (10 percent) and dry mouth (seven percent)."
Cannabis & Dry Mouth: 2008 Study
A 2008 study entitled "Effect of Cannabis Usage on the Oral Environment: A Review" that was published in the International Journal of Dental Hygiene explored the "oral environmental changes in cannabis users."
The study's authors reported that "it seems justified to conclude that with increasing prevalence of cannabis use, oral health care providers should be aware of cannabis-associated oral side effects, such as xerostomia."
The researchers demonstrated that "both CB1 and CB2 [ECS receptors] are present in the submandibular glands."
Cannabis & Dry Mouth: 2006 Study
A 2006 study on rodents (all mammals feature an endocannabinoid system similar to that in humans) entitled "Inhibition of Salivary Secretion by Activation of Cannabinoid Receptors" that was published in the journal Experimental Biology & Medicine investigated if and how cannabis might decrease saliva production and result in dry mouth.
Wrote the study's authors, "We hypothesized that cannabinoid receptors are located in salivary glands to mediate that effect." The researchers demonstrated that "both CB1 and CB2 [ECS receptors] are present in the submandibular glands."
Cannabis & Dry Mouth: 1986 Study
A 1986 clinical study involving human subjects entitled "Open Label Evaluation of Cannabidiol in Dystonic Movement Disorders" that was published in the International Journal of Neuroscience involved oral doses of cannabidiol (CBD) ranging from 100 to 600 mg/day over a six week period. The study concluded that "dose-related improvement in dystonia was observed in all patients and ranged from 20 to 50 percent."
The study also found that side effects of CBD include "hypotension, dry mouth, and psychomotor slowing."
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