A crash course in CBD as it starts showing up in dental products

August 30, 2019

Get to know CBD, hemp, cannabis and their related compounds to understand this growing segment of the wellness market.

Mary, age 20, plopped herself down in my operatory chair and I couldn’t help but notice her new sleeve tattoos that covered both arms. She explained to me that her tattoo was a rite of passage and part of a new female gang in her biker club. As I was oohing and aahing over her new body artwork, Mary interrupted.

“Lynne, I was excited about seeing you today because I’ve just ordered some Hemp/CBD oil to create a new toothpaste and I’m super excited about it.”

I was expecting her to say it was a toothpaste containing charcoal (or some oil pulling, coconut mixture) but instead it was a concoction I’d never heard of-Hemp Oil Derived CBD (Cannabidiol) Toothpaste.

Mary gave me the web address for the company that sells the Hemp/CBD oil that is one ingredient of several in the homemade toothpaste. Other ingredients include baking soda, coconut and peppermint oil, glycerin and stevia or xylitol. The online company that provides the do-it-yourself hemp oil toothpaste claims the toothpaste fights gum disease, tooth decay and bad breath.1

Get to know CBD

Familiarity with CBD is important for oral healthcare providers because it’s a booming market across the globe that’s about to explode and triple by 2022. CBD is now being integrated into the oral care market for humans and even pets.

Related: Study finds cannabis increases risk of gum disease

Here’s a crash course on the flowering plants that can produce hemp, cannabis (AKA marijuana) and some of their components, including CBD:

Cannabis: An annual herbaceous plant with two primary classifications: Indica and Sativa. Both marijuana and hemp are members of this plant group (genus). Hemp belongs to the Sativa species, whereas marijuana can be a member of either the Indica or Sativa species. Even though marijuana and hemp come from the same Sativa species, there are major distinctions between the two plants so we’ll refer to them as cousins.  

Hemp: A cannabis plant that is harvested for its seeds, stalks and flowers. Seeds are sometimes used in food and cosmetics, and stalks are used as a source of fiber in building materials and clothing. Hemp has been cultivated on planet earth for more than 10,000 years. It has been an important source of food and fiber with references dating back to ancient China and Mesopotamia.

Applications of hemp plants evolved from simple rope and coarse woven fabric to paper and sail cloth. Hemp seed and flower tops were known to provide medical comfort from a variety of ailments during the period of 2,700 BC through to Roman times.

Hemp flowers are used for its cannabinoid content. Hemp has high concentrations of cannabidiol (CBD) which is the non-psychoactive cannabinoid and it carries almost no THC (below 0.3%) It’s the THC that gives cannabis its psychoactive effects. Unlike marijuana, hemp has been excluded from the Controlled Substances Act in the 2018 Farm Bill. As a result, hemp can be commercially grown and manufactured into CBD products for sale to the public.2

CBD: Cannabidiol or CBD is a naturally occurring chemical compound extracted from the flower of the hemp plant. CBD is closely related to THC, the compound that causes the “high” that cannabis is known for. Hemp-derived CBD oil usually contains high concentrations of CBD, but its THC content doesn’t exceed the legal 0.3% limit. CBD does not make a person feel “stoned” or intoxicated. CBD can be delivered in inhalable forms (smoking or vaping) or in non-inhalable forms made with cannabis oil concentrates taken sublingually, or via capsules, edibles, lozenges, beverages or tinctures.3

Cannabinoids: Cannabinoids are substances derived from the cannabis plant and include both the psychoactive and non-psychoactive compounds known as THC and CBD, among others.

THC: THC, or tetrahydrocannabinol, is the chemical responsible for most of marijuana's psychological effects. You can read more about THC here: https://www.livescience.com/24553-what-is-thc.html

CBD nutraceuticals and potential health benefits

While driving a rental car from the Portland, Oregon airport to Mt. Hood in August, 2019, CBD was on my mind. My son and I were on our way to Mt. Hood Resort for a family wedding. Billboards promoting cannabis and CBD were everywhere and it was a reminder of the 2015 bill declaring marijuana sales legal to recreational users from Oregon dispensaries. CBD and other cannabinoid products are even in Oregon food stores with lots of therapeutic claims.

While there, I visited a cannabis dispensary and explored the various products, including marijuana displays which included edibles, concentrates and flowers in different price ranges.

I was so blown away by all the delivery mechanisms for cannabis in Oregon that I started chatting about it at one of the pre-wedding parties. Low and behold, I found myself face-to-face with someone who works for a large cannabis distributor and he gave me a useful web address for a cannabidiol (CBD) California-based nonprofit project CBD https://www.projectcbd.org dedicated to promoting and publicizing research on the medical use of CBD and other components of the cannabis plant.

Using pharmaceutical industry terminology, nutraceuticals refers to alternatives to pharmaceuticals such as foods containing health-giving additives and having medicinal benefit. The global nutraceutical market is growing at a feverish pace and is expected to reach $578 billion by 2025.

Growing awareness of the need for healthier foods is feeding the demand for nutraceuticals. High performance, natural ingredients are the driving factor in this nutraceutical trend. Examples of nutraceuticals are natural foods, including antioxidants, dietary supplements, fortified dairy products, and citrus fruits, vitamins, minerals, herbals, milk, cereals, and even chewing gum. Mouth rinses and toothpastes are now being touted as having health benefits beyond oral health. These new CBD products hitting the store shelves often fall into the nutraceutical category.

More research is needed

Many of the nutraceutical CBD products I looked at made a lot of claims for better mood such as being happy, calm, collected, less stress, inflammation and anxiety, promotion of

cardiovascular health and one product I picked up offered comfort effects from neurological function. I wouldn’t be at all surprised if people starting adding CBD to their morning coffee!

The U.S. Food and Drug Administraton (FDA) has expressed written concern about many unanswered questions concerning the science, safety and quality of products containing CBD and they recognize the significant public interest.4 To date, other than one prescription drug product to treat rare, severe forms of epilepsy, the FDA has not approved any other CBD products and they emphasize that there is limited available information about CBD, including its effects on the body. 4

CBD is frequently used to treat anxiety and insomnia but data are still very limited and further research is required to determine strength of the evidence supporting CBD supplements. Some of the insomnia studies suggest that CBD helps with falling and staying asleep.5

Patients with various types of chronic pain are being treated with CBD including osteoarthritis, but many of the studies so far are animal model experiments or short-term studies with small samples.5,6

CBD side effects can include xerostomia, diarrhea, reduced appetite, drowsiness, fatigue and nausea.5,7 CBD can also interact with other medications such as the blood thinner Coumadin. The purity and dosage of CBD is considered unreliable in some products with some products containing less CBD than labeled.7

To date, the FDA does not regulate the safety and purity of dietary supplements so you never know if the product you purchase contains the active ingredients at the dose listed on the label. In addition, the product may contain other unknown elements and we also don’t know the most effective therapeutic dose of CBD for any particular medical or dental condition.5

References:

1. https://greenflowerbotanicals.com/hemp-oil-derived-cbd-toothpaste-fight-gum-disease-tooth-decay-bad-breath-simple-diy-toothpaste/

2. https://royalcbd.com/cbd-oil-hemp-vs-marijuana/

3. https://projectcbd.org

4. https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis

5. https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476

6. https://www.arthritis.org/living-with-arthritis/treatments/natural/supplements-herbs/cannabidiol-oil.php

7. https://www.mayoclinic.org/is-cbd-safe-and-effective/expert-answers/faq-20446700