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Read to learn about why cannabis users experience this cotton mouth undesired effect and how it may be prevented. Are you a cannabis user trying to get rid of a dry mouth? Here is the scientific reasoning behind cotton mouth syndrome and some remedies to fix it. [email protected]

Cannabis & Cotton Mouth: What Causes It & How to Avoid It

Most who use cannabis have heard of or have experienced cotton mouth (dryness of the mouth) as a side effect, but many do not understand why it happens. Scientists have recently begun to shed light on the causes and cures for cotton mouth. Read on to learn about why cannabis users experience this undesired effect and how it may be prevented [1]!

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The Science Behind Cotton Mouth

Before the onset of cannabis legalization that led to the wide selection of products seen in dispensaries today, recreational smoking was the primary method of use. In those times, many believed cotton mouth was caused by the thick smoke that resulted from burning cannabis. However, as users began vaping as an alternative to smoking, cotton mouth remained to be a side effect. As capsules, oils, and gummies began to make an appearance, those products also carried with them the same results. The question behind why cotton mouth occurs could only be answered when scientists began to study the problem [10].

Dry mouth as a side effect of consuming cannabis is fairly common, and most refer to it as “cottonmouth,” though the scientific name for dry mouth is “xerostomia.” In 2006, Juan Pablo Prestifilippo and his colleagues at the Centro de Estudios Farmacologicos y Botanicos in Buenos Aires searched for potential causes of cotton mouth, specifically, a decrease in saliva secretion. The team theorized that there are cannabinoid receptors located in the salivary glands which are responsible for this effect. Experiments on male rats determined receptors CB 1 and CB 2 were present in specific locations of the submandibular gland – a salivary gland in rats. It was discovered that the cannabinoid anandamide attaches to these receptors, resulting in hyposalivation (decreased saliva output) [2].

Olga Kopach and Juliana Vats at The State Key Laboratory of Molecular Biology in Kiev found that normally, the cells of saliva glands use the endocannabinoid system to signal feedback that inhibits the over accumulation of saliva in the mouth. When a person consumes cannabinoids, receptors CB 1 and CB 2 bring about a significant drop in saliva production, causing the mouth to feel dry. Kopach also reported findings that these receptors behave differently at the cellular level. “CB 1 receptors predominantly modulate the flow of saliva, while CB 2 receptors seem to influence consistency and content of saliva (such as sodium levels) . . . Cells in the salivary glands can synthesize anandamide” [3]. Dry mouth from consuming cannabis does not cause dehydration throughout the rest of the body, which is why it does not cause the type of hangover some experience from alcohol consumption. Interestingly, what scientists have learned about how the salivary glands and cannabinoids interact could lead to new therapies for those who experience complications with salivation [3].

Is Cotton Mouth Dangerous to Health?

A collection of research out of the Department of Periodontology at the Academic Centre of Dentistry in Amsterdam suggests that with increased cannabis use 4 , oral health is a concern. The researchers stated that providers of oral health care need to be more aware of the potentially chronic side effects associated with dry mouth from cannabis consumption. Mainly, these are:

    • Leukoedema – “A white or whitish-gray edematous lesion of the buccal and labial oral mucosa” [5].
    • Candida Albicans – A type of yeast present in microbes on the skin (including inside the mouth) and gastrointestinal tract that is healthy at normal levels but harmful when multiplied. In that case, it becomes known as thrush, or Candida overgrowth [6].
    • Periodontal Disease – An infection of the gums that can cause bad breath, swollen or red gums, bleeding or tender gums, pain when chewing, loss of teeth, sensitive teeth, and receding gums [7].
    • Tooth Decay and Cavities8

    Saliva lubricates the mouth so that we can taste food, swallow, and speak. It also protects the mouth, throat, and teeth from bacteria, viruses, and other microorganisms. As such, saliva levels that are consistently low become a risk factor for tooth decay, cavities, periodontal disease, and even tooth loss [8]. Less serious side effects include: feeling thirsty, hoarseness, sore throat, tingling in the mouth, a raw or red tongue, cracked lips, mouth sores, and skin that is split in the mouth [10]. While marijuana is not the only medicine that may result in xerostomia, hyposalivation is typically solved when the user stops taking the problem medication, such as with radiation treatments for cancer patients. On the other hand, those who consume cannabis tend to do so frequently and consistently over longer periods of time. Understanding ways to prevent or cure cotton mouth is key to avoiding these harmful side effects [8].

    How to Prevent Cotton Mouth

    The American Dental Association encourages consumers of cannabis to maintain regular visits with a dentist, chew sugar-free gum, and maintain a regimen of teeth brushing at least two times per day using fluoride-enriched toothpaste. Some other health professionals have suggested a reduction in citrus-based foods and alcohol-based breath sprays, beverages, and mouth wash because they can dry the mouth. Some drug stores carry gums and sprays that help keep the mouth moist and are a good idea for those who consume cannabis on a regular basis or who tend to experience cotton mouth [8]. Gum chewing helps by preventing signals from the endocannabinoid system that limit saliva production.

    Another obvious cure for dry mouth is to drink water, especially while consuming cannabis. While it may be tempting to have a refreshing beer or wine, those beverages contain tannins that can further dry the mouth. Some fruit juices and teas may also contribute to the problem. The important part is to sip on water throughout the day or before, during, and after cannabis consumption. Even drinking water will not be as effective once dry mouth has set in. Some prefer to eat crushed ice as a means to break up the monotony of drinking water [9].

    In an article published by American Marijuana titled, “Cannabis & Cotton Mouth – Get Rid of Marijuana Dry Mouth,” Dwight Blake provides the following additional remedies for cotton mouth:

    Cannabis & Dry Mouth: Why It Happens and How to Solve It

    Using cannabis and having a dry mouth seem to go hand in hand. Whether you call it dry mouth, cotton mouth or pasty mouth, it can be quite annoying! But do cannabis users just have to put up with it? Or is there a way to get rid of it? Here’s a look into studies that show probable causes, and what cannabis users can do to avoid a constant dry mouth.

    Cannabis users all over the world are sure to be familiar with that sticky, dry, pasty sensation that affects the mouth after smoking cannabis. In fact, it is so inevitable that people rarely question the mechanism at work behind this strange little phenomenon—except for a handful of researchers who believe they know why it happens.

    How is saliva formed?

    First, we should take a brief look at the process of saliva production. It appears that saliva formation involves a two-stage process. Initially, specialised cells known as acinar cells secrete a fluid that is similar in composition to plasma. This fluid then passes through the salivary ducts on its way to the oral cavity, and as it does so, sodium and chloride are removed from it and potassium and bicarbonate are added to it. This process is what produces the final ‘hypotonic solution’ that is secreted into the mouth.

    Secretion of saliva is controlled by the parasympathetic nervous system (PSNS). The PSNS is responsible for various metabolic processes related to food intake, appetite, and anticipation of eating.

    Receptors in the salivary glands are activated via impulses from the chorda tympani nerve. This important nerve originates in the taste buds before travelling through the submandibular ganglion (the cluster of nerve cells in the submandibular gland) and on to the brain. The chorda tympani nerve releases a compound known as acetylcholine, which is one of the body’s main saliva-stimulating substances and works directly on the receptors of the submandibular gland.

    Another important compound involved in salivary secretions is known as norepinephrine. This compound is released by the preganglionic nerves that lie upstream from the submandibular ganglion. It works directly on the myoepithelial cells that surround the acinar cells by causing them to contract, which then leads to the secretion of saliva.

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    CB-receptors in the salivary glands

    Several studies show that cannabis use can cause oral dryness. In 1986, a study into the effects of cannabidiol (CBD) noted that the side-effects of administration of oral CBD included dry mouth. Since then, several other studies have also observed cannabinoid-induced oral dryness. The scientific name for oral dryness is xerostomia.

    Perhaps the most in-depth study on cannabis-induced xerostomia to date was performed by researchers at the University of Buenos Aires, Argentina in 2006. The researchers found that cannabinoid receptors type 1 and 2 are present in the submandibular glands, which lie beneath the floor of the mouth and are responsible for producing 60-67% of the saliva.

    The researchers found that the endocannabinoid agonist anandamide (AEA) binds with high affinity to the glandular cannabinoid receptors and blocks the action of the saliva-inducing compounds norepinephrine and methacholine, leading to a decrease in the secretion of saliva.

    As mentioned above, these saliva-inducing compounds are part of the normal working of the parasympathetic nervous system. THC is also an agonist of the CB receptors, and is likely to affect the receptors of the submandibular glands in a similar manner.

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    The fundamental role of the endocannabinoid system

    Interestingly, the Buenos Aires study also concluded that the role of the endocannabinoid system is not limited to blocking signals at the submandibular glands themselves. The nervous impulses that are expressed via the chorda tympani also originate in the brain.

    The researchers hypothesized that intravenous administration of cannabinoids via the femoral vein not only exerted their primary effect via the submandibular glands, but may also have acted on the cannabinoid receptors in the brain itself. They argued that a central nervous system mechanism helps to control production of saliva at glandular level.

    The fact that the endocannabinoid system is so fundamentally involved with the inhibition of salivary secretions implies that it also has a role to play in causing the production of saliva. If an agonist or antagonist of the cannabinoid receptors inhibits salivation, it is likely that an inverse agonist such as the synthetic cannabinoid AM-251 may cause a reversal of this effect and an increase in salivation.

    Indeed, the Buenos Aires study also demonstrated that the presence of AM-251 partly reversed the effect of AEA (although there appears to be a lack of consensus as to whether AM-251 is an antagonist or an inverse agonist).

    How to get rid of dry mouth after cannabis use

    Experiencing a dry mouth and throat after cannabis use is extremely common, and often it does not take much cannabis to induce this effect. However, during a heavy session, the dry-mouth effect can often increase until it becomes extremely unpleasant.

    If experiencing unpleasant cotton mouth, there are a number of things you can do to help alleviate it. A few of these include:

    • Stay hydrated! This will mitigate the issue to some extent
    • Chew gum – This can also help, as the action of chewing stimulates the salivary glands to produce more saliva
    • Use ice cubes or lollies to suck on, which can also help keep saliva flowing
    • Similarly, foods that require decisive chewing such as dried fruit or beef jerky can also help stimulate the production of saliva

    For more complete relief, using a demulcent (a substance that coats a mucous membrane with a moist ‘film’) designed for oral use should suffice. Many different prescription medications can cause users to experience dry mouth, so there are numerous oral demulcents commercially available to combat the problem.

    In the future, research into the specific nature of the endocannabinoid system and how it controls the process of salivation may yield targeted products that can reverse the effect of xerostomia. This would benefit not just those who have smoked a little too much cannabis, but also individuals suffering from a range of conditions (or taking certain medications) that cause a permanent state of cotton mouth.

    This article is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with your doctor or other licensed medical professional. Do not delay seeking medical advice or disregard medical advice due to something you have read on this website.

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