Oral Surgery and Cannabis 2025 Update: What's New About Wisdom Teeth Removal

If you're preparing for wisdom teeth removal or another oral surgery, you may be wondering how cannabis fits into the picture. With more patients using cannabis for relaxation, pain relief, or anxiety management, dentists and surgeons are seeing new challenges around anesthesia, healing, and recovery. From the risks of smoking too soon to safer non"smoking alternatives like tinctures or capsules, recent studies shed light on what cannabis users should know before and after surgery. This updated guide explores the latest research and expert recommendations to help you recover smoothly while staying informed.

How Cannabis Affects Anesthesia

One of the most important considerations is how cannabis influences anesthesia. Studies show that regular cannabis users often require higher doses of sedatives and anesthetics compared to non-users. A retrospective cohort study published in the Journal of Oral and Maxillofacial Surgery found that marijuana users needed significantly more propofol during sedation than non-users, raising the risk of respiratory complications and cardiovascular instability.

The American Association of Oral and Maxillofacial Surgeons also notes that cannabis can increase heart rate and blood pressure, complicating anesthesia management. For this reason, many surgeons recommend abstaining from cannabis for at least 72 hours before surgery, and longer if you are a daily user. This advice applies directly to common procedures like wisdom teeth removal, where sedation is frequently used.

Risks During Recovery

After surgery, smoking cannabis poses a direct risk to healing. The act of inhaling creates suction in the mouth, which can dislodge the protective blood clot that forms in the surgical site. This can lead to alveolar osteitis, better known as dry socket, a painful condition that is especially common after wisdom teeth extraction. Heat and chemical irritants in smoke also damage tissue and restrict blood flow, further slowing healing.

Non-smoking alternatives may be safer during recovery, but patients should still consult their surgeon. Cannabinoids can interact with prescription pain medications, altering metabolism and potentially increasing drowsiness or side effects.

Non-Smoking Cannabis Consumables During Recovery

If you want to avoid the risks of suction and heat from smoking or vaping, non-smoking consumables-such as edibles (soft, low-chew), sublingual tinctures, oral capsules/softgels, and transdermal patches-can be considered. This is particularly relevant for wisdom teeth removal, where chewing near the extraction site can disrupt healing. Sublingual tinctures and dissolving strips offer faster onset without chewing; capsules and softgels provide measured dosing with minimal oral contact; and transdermal patches deliver cannabinoids systemically without using the mouth.

Timing and dosing matter. Many experts recommend waiting at least 24-48 hours post-op before introducing non-smoking cannabis products, starting with low doses due to delayed onset (especially with edibles) and longer duration. Choose soft, melt-away formats, avoid chewing near the extraction site, and rinse gently with surgeon-approved solutions. Always confirm with your oral surgeon, especially if you're using prescribed pain medications, since cannabinoids can affect how some drugs are metabolized.

Why Disclosure Matters

Perhaps the most important step is being transparent with your surgical team. Letting your surgeon know about cannabis or CBD use helps them plan anesthesia safely, adjust medication dosages, and monitor your vital signs more closely. Medical professionals operate under confidentiality guidelines, so disclosure is about safety, not judgment.

Chronic cannabis users may also have lower tolerance for post-operative pain, requiring tailored pain management strategies. By sharing your usage history, you enable your surgeon to provide care that is customized to your needs.

Key Takeaways

Cannabis can complicate both anesthesia and healing in oral surgery. Patients are advised to stop cannabis use at least 72 hours before surgery, avoid smoking during recovery, and disclose their usage to their surgical team. Non-smoking consumables-like sublingual tinctures, capsules/softgels, soft edibles, and transdermal patches-may be safer than smoking, but they should be delayed for 24-48 hours, started at low doses, and used only under medical guidance. For wisdom teeth removal in particular, avoiding suction and chewing is critical to prevent dry socket and ensure smoother recovery.