Federal Council of Dentistry recognizes the potential use of cannabinoids in dental pathologies

By Manuela Borges

For the first time, the Federal Council of Dentistry (CFO) openly positions itself on the use of cannabis-based medications by dentists. The news that the National Health Surveillance Agency (Anvisa) included the specialty in the product import platform - containing cannabinoids in their composition - was positively received by the CFO. Journalist Manuela Borges had an exclusive conversation with the CFO treasurer, dentist Luiz Evaristo Volpato. A postgraduate professor and researcher at the University of Cuiabá, Volpato stated that within their field of practice, dentists have no restrictions on prescribing medications - of any kind - as long as the purpose is dental. The CFO treasurer also advocated for promoting cannabis research for dental purposes and updating professionals who wish to prescribe this type of medication.  

Check out the full interview:

- Anvisa updated the cannabinoid import platform, because previously the dentistry specialization was not listed and now the patient can enter the CRO and the name of the prescribing dentist. Was this a step forward, right?

We saw this correction made by Anvisa in a very positive light. Since the dentist is qualified to make the prescription, they should be listed on the platform, so that the prescribing professional - in this case the dentist - can be identified, providing security to the patient seeking this medication.

 - Did the lack of specification of the specialty (dentistry) create insecurity for the patient?

Certainly, because if the patient goes to the dentist, and the dentist makes the prescription and that prescription needs to be entered in the platform, but there is no specific field for that information, it ends up creating insecurity for the patient. They start wondering: Is something wrong? Shouldn't the dentist be making this prescription? By correcting this, it is now possible to make this identification, providing more security to the patient.

- How does the Federal Council of Dentistry view the use of cannabinoids in the profession today?

We understand that the search for new therapies and medications should be a constant in the healthcare profession. This search should always be carried out with great responsibility and scientific basis. In our view - here I speak on behalf of the Federal Council of Dentistry and President Dr. Juliano do Vale - once the medication is indicated for dentistry and has a scientific basis, it is very interesting for the professional to be aware of and use that medication. Always taking into account these two fundamental points: the scientific basis and the indication within the field of practice.

- Does this mean that, of course, the dentist cannot prescribe to treat cases of anxiety, only if it is in the case of pre-surgery anxiety, for example?

The dentist should address alterations that are relevant to their field of practice. So, let's imagine that there is a patient who will undergo a surgical procedure, a lengthy procedure, and this patient is anxious, fearful. Usually, the dentist already manages pre-dental appointment anxiety. Therefore, they can prescribe a medication to help the patient enter the surgical environment more calmly. Whether this medication is derived from an opioid or from cannabidiol, it will be the dentist's free choice to determine which medication is most suitable at that time. However, this does not mean that the dentist will provide treatment outside their field of practice. But within their field of practice, there are no restrictions regarding the medication to be used.

- How does the Federal Council of Dentistry view these courses on prescribing cannabinoids in dentistry? We see an increasing demand and supply of these courses. Is it important for the professional to seek specialization before starting to prescribe cannabis?

The Federal Council of Dentistry always views the pursuit of knowledge in a positive light. If this pursuit of knowledge is happening, whether formal or informal, but always based on best practices, scientific evidence, it will always be seen positively. The guidance we give to professionals seeking this qualification is to research who is offering this qualification, what is the background of that person? Do not rely solely on what you are learning in the course, seek information on your own, search in databases, search in scientific papers. Science evolves very dynamically, so new knowledge is produced all the time. It is essential for the dentist, like any other professional, to always be updated on what is being produced in terms of scientific knowledge.

- Today, does the Federal Council of Dentistry recognize the treatment with cannabinoids in dentistry for bruxism, orofacial pain, there are some indications... Is it recognized?

We see that today cannabidiol has the potential to treat various dental conditions. In some cases, this potential is already well supported by scientific sources, not only in terms of efficacy but also safety in its use for treatment. So, specifically for the treatment of chronic pain and anxiety, we have scientific evidence in this regard. For the treatment of inflammation, gingivitis... we know there is potential, but more research, more scientific basis is needed for this to become part of the daily practice of dentist's recommendations. 

- You teach. Is it important to expand knowledge, conduct new research, and deepen the use of cannabis in dentistry?

We know that there is empirical knowledge and ancestral knowledge in various cultures regarding the use of various plant extracts. Academia and professionals need to focus on this knowledge, take it to the lab, get to know the active components more specifically and how these active components work. By better understanding each of these extracts, you will have the opportunity to use these medications more precisely. In the specific case of cannabis, it is a plant that has been used for various purposes for thousands of years. Today, there is a possibility to know in more detail each of its components and evaluate how they can be used. The more research is conducted on these components, this medication, and these substances, we will certainly have more indications for their use in the future. I appreciate the opportunity for the Council to take a stand on such an important topic for everyone.

In 2015, with the publication of RDC n° 17, on May 6, 2015, Anvisa began regulating the exceptional import of products based on Cannabidiol in association with other cannabinoids, by individuals, for personal use, upon prescription by a legally qualified professional, for health treatment.

This regulation was conceived in a context of the need for exceptional access to cannabis-derived products, given the lack of alternatives for accessing such products in the country.

In this sense, still in terms of access, although the professional prescriber's class is not explicitly stated in RDC No. 335/2020, it is understood that, as stated in Article 38 of Portaria SVS 344/98, prescriptions by dentists can only be made for dental use.

The system change was made to allow prescriptions by dental professionals.

Watch the interview video: