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CBD in Dentistry – Can Cannabis Cure Cavities?

Publié le 28 Avr 2015

Currently, the majority of research in medical marijuana focuses exclusively on analyzing its effectiveness in treating various ailments of the human body. Dental marijuana research has not been extensively investigated, and hallmark features critical to heal dentition with this medicinal drug are vastly unknown. This systematic research review aims to 1) identify various molecular caries (cavities) mechanisms and 2) determine future prospects of cannaboid research in dentistry.

Dental caries (rottenness) has been a somewhat intangible quality to measure, and attempts at eliminating it from dentistry have generally failed due to its intrinsic complexity. Dentistry pervades many aspects of our history and culture. During the mid 16 th century of the Renaissance period, dental patients sought to use herbs such as rosemary charcoal to not only maintain proper oral hygiene, but to alleviate painful tooth decay that many can empathize with to this day. Sage shrubs were also used to become an effective “teeth-whitening strip”, often cooked tediously and compounded to activate the “whitening” ingredients. Dentistry has evolved our entire life for hundreds of centuries, yet modern studies of dentistry have neglected to enhance or advance the same natural remedies used centuries ago to date. To this end, with the emerging knowledge of medicinal marijuana benefits, more specifically cannabidiol active ingredients (CBD), there has been a profound transition to identify the benefits of this drug at a clinical level. Many paste products focusing on hemp and marijuana plant driven ingredients have marketed this plant in hopes of penetrating the 12 billion dollar market share of the toothpaste industry. Yet the influences of various commercially available toothpaste products are fairly similar, with fluoride as their primary active ingredient in varying quantities. Generally, these pastes contain limited ingredients; resulting in limited data collection to determine the best paste that would effectively combat tooth decay. Furthermore, utilizing a wide range of focus group patients to evaluate caries, or recruiting study participants who are willing to use placebo paste, or ineffective paste in an effort to prevent caries, is often a violation of IRB research protocol. These two factors can limit the breadth and scope of most dental studies, as it is often difficult to control the basic parameters of the oral cavity unique to each participant.

Caries at Molecular Level

There is much dental literature that shows molecularly identified causes of dental caries (cavities). Various pathways that regulate protein metabolism, glucose regulation, and transaminase reactions have been shown clinically to cause caries. These unique pathways allow for colonization of biofilms in the oral mucosa and produce a harmful acidic environment that causes demineralization of dentition, and ultimately infection and caries. Traditionally, dental decay can more or less be detected with radiographs and clinical examination of the dentition. Various descriptions such as E1 (Enamel), E2, D1 (Dentin), D2, D3 lesions are often diagnosed by the dentist and assessed for treatment.

Of note, bacteria such as Streptococcus mutans and Lactobacillus are two of the most common bacterial organisms that are subject to scrutiny due to their prevalence in causing caries. 1 Furthermore, pH and availability of glycoproteins have the most salient influence on the composition and biochemical activities of biofilms. In other words, the more basic or alkaline the oral cavity, the less probability that bacteria will colonize and cause decay. Research in prevention and treatment of dental caries at the molecular level has become seemingly more important to the medical arena in recent years. 1, 2

STAMP tool

A novel method that is currently at a pilot stage is the STAMP tool, which is an acronym for “specifically targeted antimicrobial peptides.”

“The toothy tool comes from scientists including Wenyuan Shi, PhD, of the School of Dentistry at the University of California, Los Angeles (UCLA). They call their tool “STAMP” (specifically targeted antimicrobial peptides). Basically, STAMP is a tiny protein that knocks out a cavity-causing bacterium without harming healthy bacteria,” Dr. Shi explains in a news release from the National Institute of Dental and Craniofacial Research, one of the study’s sponsors.

“The good bacteria are mixed in with the bad ones,” Shi says.

Current treatments “simply clear everything away,” Shi says. “That can be a problem because we have data to show that the pathogens [the bad bacteria] grow back first.” More on this can be found here

Signal Recognition Particle Pathway

Much like other organisms that use various protein pathways to survive, one of the most prevalent mechanisms is the use of a signal recognition particle pathway (SRP) to deliver a protective protein layer to cellular membrane receptors in harsh acidic environmental conditions. 1, 7 Research has shown that a lack of infusion of protein to the membrane will yield a weakened cellular membrane that is prone to attack by bacterial defense mechanism in saliva such as beta-defensin-.1 1 S. mutans uses this pathway for growth by protein recognition and delivery to membrane. Recent research however has shown thatS.mutans can use an alternative form of this pathway for growth and adherence to tissue. 3 Two other molecular genes called YidC1 and YidC2 has been suggested to act as an alternate route for protein delivery to the membrane in the absence of the SRP pathway. 3

Aspartate Amino Transferase

Delivery of protein by the SRP pathway (or other alternative pathways) has lead researchers to investigatehow the organism can metabolize protein within the cell. Investigators have identified much bacterial protein activity on the pellicle layer of teeth, which has been a causative agent in caries. Two of the most ubiquitous protein processes that many bacterial organisms utilize is the alanine amino transferase (ALT), and the aspartate amino transferase (AST) pathways. 7 Both amino transferases catalyzes the transfer of an amino group from alanine or aspartate to α-ketoglutarate, which in turn produce either pyruvate and glutamate or oxalacetate and glutamate respectfully. 3 This process allows bacterial organisms to use various glycoprotiens (such as proline) within the enamel surface for bacterial adhesion and growth. 3 Studies have shown that the AST and ALT pathways significantly increase with patients suffering from periodontal disease and high-risk caries. This implies a strong correlation with ALT and AST pathways in dental caries, though much analysis is required for recognition. 3

Glucose Transport

Glucose transport to various parts of cellular tissue is a common pathway for many organisms to function properly. 6, 7 Many bacteria use a specific glucose transport system to regulate their metabolism and allow for the survival of cohort species. Research has investigated that oral bacteria (S. mutan, S sanguis) generally use a Phosphoenolpyruvate (PEP-dependent) mechanism for glucose transport. 4, 5 Through various target receptors and secondary messengers, the main mechanism of action allows for phosphorylation of a glucose molecule at carbon 6, which has been shown to cause resistance to fluoride. 5, 6 Research has also shown that this pathway has inhibitory effects on glycolysis by blocking enolase activity, thus allowing the bacteria to prevent excessive uptake of glucose while in the anabolic process of growth. 4, 5

These pathways are just a select few that have given dental clinicians artillery of information to combat dental decay. The focus on the mechanism of action (protein metabolism, glucose regulation, and transaminase reactions) of oral bacteria can be one of the most promising areas of knowledge to prevent dental caries. There may be a growing need for many clinicians is to look further into medical marijuana effects in dental caries, more specifically enabling biofilm degradation as well as preventive treatment of caries with antibacterial properties of CBD. The technology and science behind this type of dental research has been documented for decades, but lacks the necessary focus required to determine CBD effects in dentistry. I believe as the general public becomes more aware of the beneficial ingredients of medical marijuana in quality treatment and care, it will soon find its way to become a multi-billion dollar industry in dentistry.

Cannabidiol (CBD) and Dentistry
With the emerging indications of the effectiveness of CBD in medical therapy, dentists should begin to seriously consider the vast implications of medical marijuana as part of their dental therapy regiment. And while ignoring the stigma and taboo that marijuana often faces in society, progressive clinicians and dentists should recognize CBD as a powerful treatment modality. A simple google search on CBD and its benefits is readily available and such benefits are generally recognized by clinicians. Below is a chart adopted from marijuana.com that gives insight to the powerful affects of CBG, CBGA and CBCA. Note that antibacterial and anti-inflammatory ingredients are one of the most salient qualities needed in dentistry.

Cannabis Products

Cannabis products created by companies such as Axim Biotech are paving the way to fight dental decay with CBD. Cannabigerol, the active ingredient in Axim’s dental products, has shown to have anti-inflammatory properties, which are ideal in periodontal disease and gum sensitivity. This is a tantamount milestone in the world of dentistry. Much of the anti-inflammatory agents used currently are chlorohexidene irrigation rinses, which often tastes bitter and can leave a slight tooth discoloration with continual use. Axim is also engaged in creating a type of Canagum, which can basically allow for cannabinoids to be secreted into saliva, thus preventing biofilm attachment.

Another company, Cannaderm has a hemp infused toothpaste that is readily able to re-mineralize enamel and decrease tooth sensitivity.

The future of dentistry

Pilot clinical trials with CBD at a molecular level should be evaluated with the most common types of bacteria that cause tooth decay. (S. mutans, and Lactobacillis) Even a simple research experiment, where injections of CBD strains are assessed to determine colony forming units on a blood agar dish with S. mutans and Lactobacillis would be a promising attempt to develop an advance in this area. Dental research with CBD is far from over, but a handful of companies have demonstrated its potential value. In future work, clincians should seek to perform large-scale comparisons between CBD toothpaste vs regular toothpaste, and corresponding dental composite fillings treated with CBD infused composite glass ionomer products. The possibilities are truly endless.

This collective approach will allow us to combat tooth decay both comprehensively and vigorously. Future studies will emulate ideas conveyed in this paper and may realistically require more than 100 clinical trials in order to achieve profound evidence based clinical power, nevertheless, it is something that should be sought and meticulously scrutinized by dental clinical research.

CBD in Dentistry – Can Cannabis Cure Cavities?

CBD Oil Benefits for Better Dental & Overall Health

Are you afraid to go to the dentist? You’re not alone. One out of every four people has dental anxiety. Dental phobia is more common than a phobia of heights! ( 1 ) CBD for dental anxiety is an excellent solution. Science and user reports agree: taking CBD oil reduces anxiety. (Plus, it’s great for your dental health in other ways!)

My patients benefit from a dose of CBD right before dental procedures . But there’s a lot of misinformation out there around hemp and CBD oil benefits.

I have good news for you.

I’m going to explain how to use CBD oil not only to calm dental anxiety but also for pain, inflammation, better sleep, and even faster healing after dental procedures.

What is CBD oil?

CBD, or cannabidiol, is one of the two major compounds found in cannabis and hemp plants. THC is the major compound in cannabis that causes the “high” of marijuana. On the other hand, CBD is non-psychoactive, which means it doesn’t cause a “high.”

It can help with mental function, though. That’s why many people take CBD oil for anxiety and depression.

Testing cannabidiol is pretty complicated for scientists because of legal roadblocks. Even so, there are some exciting studies on what CBD can do—and the results are astounding.

Taking CBD oil for anxiety can also help with inflammation, pain, neurological issues, and more. ( 2 )

CBD is an oil extract, but it’s not strongly antibacterial like most essential oil products . That’s why I love it! (Killing all the bacteria in your mouth might sound like a good idea, but it’s not. You can wreck your oral microbiome that way, which will lead to more oral and dental woes down the road.)

Besides relieving “going to the dentist anxiety,” I suggest my patients use CBD oil for pain, which is often caused by inflammation from dental work. CBD is one of the most powerful anti-inflammatory compounds in the world and generally causes zero side effects. You can’t say that about any medication prescribed for pain!

You might see CBD oil labeled “hemp oil.” It’s available in several forms like capsules, sprays, and oil extracts.

6 CBD Oil Benefits For Better Dental and Oral Health

You might want to try CBD oil if you have:

    • Symptoms of anxiety about dental procedures or visits (even dental phobia)
    • Poor sleep quality
    • Chronic dental/oral pain
    • Teeth sensitivity to hot and cold
    • Digestive problems after using anesthesia or numbing agents
    • Receding gums
    • Gum disease (periodontitis, gingivitis, etc.)

Let’s look at some of the benefits of CBD for dental anxiety and other conditions related to the health of your mouth and teeth.

1. Take CBD Oil for Anxiety to Reduce Fear at the Dentist

Does CBD relieve anxiety?

Several studies have found that both CBD oil and full cannabis help reduce anxiety. ( 3 , 4 , 5 , 6 )

Statistics tell us many people are scared of the dentist. That’s why CBD for dental anxiety has become my go-to remedy. I’ve seen the improvements my patients experience after taking CBD for dental anxiety.

If you’re wondering how to deal with dental anxiety, CBD may benefit you.

CBD Oil Dosage for Anxiety at the Dentist:

For adult patients: Take 1.5 milligrams of CBD oil in capsule form for every 10 pounds you weigh the night before a procedure. Repeat the same amount the morning of your procedure. Most people will take between 15-30 milligrams. For children: take between 8-10 drops of CBD oil in spray form the morning of the procedure.

2. CBD Improves Sleep Quality

Several studies show CBD oil might help you sleep better. ( 7 )

If you’re getting eight hours of sleep a lot but your sleep ability sucks, your body is aging faster than it should. Bad sleep ability equals more disease, worse immunity, and a lot of other nasty stuff.

But what does that have to do with your oral and dental health?

It turns out… a lot.

One of the ways poor sleep causes problems in the mouth is by interrupted breathing. You can mouth tape for better sleep , which can help you avoid mouth breathing. Yet, many of us actually sleep with our mouths wide open—a major cause of cavities and a red flag for sleep apnea. You might also notice your teeth look yellower over time, a result of fast-aging teeth.

Try using CBD oil under the tongue or in tablets before bed. Not only will you sleep more soundly, you can also cut down on cavities, gum disease, and teeth discoloration. If you’re not sure you sleep well, try using a home sleep test app to find out.

3. CBD Relieves Pain

Do you struggle with chronic tooth pain? If you’re overly sensitive to hot and cold or find yourself massaging aching jaws, give CBD a try.

To be clear: Pain in your teeth and mouth may equal the need for a trip to the dentist. But does CBD help with tooth pain for people who just have more sensitive teeth? It does!

Although THC is the compound most people associate with pain relief, CBD calms certain pain receptors, too. CBD is great for pain, in part, because it reduces inflammation. (7)

I like to recommend patients take CBD oil for pain while recovering from dental work or surgery. Many medications prescribed as treatment options after major dental work are extremely addictive and come with a long list of side effects. Especially for manageable pain, it’s not always worth the risk.

Instead, take CBD oil! It’s one of the safest ways to effectively treat pain after you’ve been to the dentist.

4. CBD Minimizes Tummy Troubles

Nausea is a common issue immediately following dental work, particularly if you need anesthesia. Taking CBD can reduce nausea and prevent some vomiting. ( 8 )

If you’re receiving anesthesia, like for wisdom tooth removal, take CBD oil in capsules or under your tongue beforehand. It shouldn’t interact with anything you’re given to be put under.

5. CBD Might Help Heal Gum Disease

The research here is limited, but CBD oil may help your gums stay healthy.

It’s only been tested in animals so far, but during periodontitis, CBD prevents severe inflammation and some bone loss. ( 9 ) Add CBD oil to your daily dental routine if you struggle with inflamed or receding gums.

6. Other Benefits of CBD

The mouth is a mirror of what’s happening in the rest of your body. For example, people with diabetes have a much higher risk for gum disease. ( 10 ) That’s just one way the health of your mouth and teeth are connected.

Since that’s true, it’s valuable to know what else CBD may be able to do for your health.

CBD has shown promise for treating or improving symptoms of:

  • Rheumatoid arthritis
  • Diabetes ( 11 )
  • Epilepsy
  • Schizophrenia (2)
  • Cancer ( 12 )
  • Huntington’s disease
  • Colitis
  • Heart disease ( 13 )

Types of CBD You Can Try

There are five basic forms of CBD, with the first three being most common: ( 14 )

  • CBD oil
  • CBD isolate
  • CBD wax
  • CBD crystals
  • CBD e-liquids (for vape pens)

Some of these are included in various types of tinctures, gels, capsules, or creams.

Depending on how you take it, CBD is bioavailable at various levels. Bioavailability means how effectively and for how long your body can use a particular substance.

With ingestion, you may not experience the effects of CBD for dental anxiety for a few hours. You can use spray or put the oil directly under your tongue (holding for about 30 seconds) for much quicker absorption. This CBD oil gets into the bloodstream via your mucous membranes.

CBD wax and isolate are extremely concentrated forms of CBD, typically used by people in heavy chronic pain. Various methods of using CBD isolate or wax is thought to give a quicker result.

I prefer CBD oil, as it’s easier to find a reputable brand and it’s such a versatile form of the product. To ingest it, put 15-30 milligrams in an empty supplement capsule or buy pre-capsuled CBD oil.

Some companies have begun to produce CBD water, gum, or toothpaste. There’s very little research here, but they may be other helpful ways to use CBD for dental anxiety. One company created a mouthwash with CBD which may help reduce inflammation in the mouth.

How to Choose the Right CBD Oil for Anxiety

With so many options, it can get overwhelming to pick the right CBD for dental anxiety. Make sure to do your research before buying CBD.

Not sure what to ask? Here are some of the questions I like to ask a vendor about my CBD oil:

  • Is your product made from 100% USDA-certified organic hemp? I only buy CBD from organic hemp. That way, you don’t risk unnecessary exposure to pesticides.
  • Who produces your CBD product? Reputable sellers should be able to provide the names of their CBD manufacturers.
  • How much of this product is actually CBD?Avoid fillers . Make sure you get something that is 100% CBD. Some brands add a tiny amount of peppermint extract or other flavors, but that should barely dilute the CBD. You don’t want to get a CBD oil with other essential oils in it or diluted with carrier oils.
  • Who performs your third-party testing? This is a key question to ask. Because supplements can be produced by any company, there are shoddy products on the market. Ask for the name of the third-party testing company and do a quick web search to verify it’s an authentic testing facility.
  • What dosage do you recommend? This will vary by product. However, I like to use a product that lists exactly how much CBD oil I should be using. That shows me they’re confident in the amount of CBD in the product and its potency.
  • Is your hemp grown in the United States? Sourcing matters with CBD oil. You might pay extra for a US-grown variety, but the standards of American growers tend to be higher (or at least more transparent) than elsewhere.

Any type of natural product carries risks, as the supplement industry isn’t as tightly regulated as medications and food. Be cautious as you purchase CBD products.

I also like to find good user reviews. Seeing many people happy with their results helps me know I’m getting something that works .

How to Deal With Dental Anxiety

I understand that many people avoid the dentist because of anxiety and fear. Using CBD for dental anxiety is one great way to reduce this burden, but there are a few other options you can try.

First, go to the dentist regularly . The longer you go between cleanings, the more creative your mind can get about what might happen. Keeping yourself accountable to keep up with visits will desensitize you from anxiety about the dentist.

Make sure you floss at home . Many of my patients have fear of pain from flossing. If you floss at home on a normal basis, you’ll discover the pain is negligible! I tell patients who haven’t been to the dentist in awhile to floss at least one tooth before they come in to get used to the sensation.

Choose the right dentist for you . Feel free to ask as many questions as you need and don’t let anyone bully you. You have the right to any second opinions or dentist transfers you want. If your dentist makes you feel guilty or anxious, it’s probably time to look elsewhere.

When I have a patient with dental anxiety, I practice compassion, communication, and distraction.

A good dentist should be gentle and compassionate in response to your fear. S/he will give you details about what’s happening and answer any questions you ask with helpful answers. Your dentist should also know how to distract you from the major cause of your fear and draw your focus to something to keep you calm.

If you struggle with full dental phobia, you may want to pick a dentist who uses therapy dogs . This can be something that makes you want to go back to the dentist!

Caution For Using CBD for Dental Anxiety

Limited available research suggests that CBD causes few side effects. THC, the psychoactive compound in cannabis, does come with some dangers. However, using products very low in THC and high in CBD aren’t known to be dangerous.

Dosing also matters—with CBD, dosage depends on the condition you’re looking to treat. For general use, you may be happy with the 15-30 milligrams I prescribe my patients for dental anxiety. For other kinds of anxiety, up to 600 milligrams may be warranted, while for insomnia the dosage should be around 160 milligrams before bed.

In brain-related conditions like schizophrenia and seizures, dosages can exceed 1,000 milligrams per day.

Let’s look at the legal side of CBD. Then, I’ll take you through a way to test for CBD allergy, possible side effects to be aware of, and the few potential drug interactions with CBD oil.

But I heard that CBD isn’t legal for use in some states?

The states who have “officially” legalized CBD all approve its use for people of any age. ( 15 ) High-quality CBD oil is safe for most children and adults.

Some sources claim that cannabidiol (CBD) is a form of cannabis and is, therefore, a “Schedule I” drug. However, the Agricultural Act of 2014 protects farmers, manufacturers, and sellers in the US to grow and distribute hemp products, including CBD, to the public. It is 100% legal to buy or sell CBD oil from hemp in any state in the US, regardless of state laws regarding cannabis.

How to Test for CBD Allergy

As with any substance, there is a small chance you could be allergic to CBD. Typically, this reaction would show up as contact dermatitis, an allergic skin reaction. ( 16 )

Try a patch test on your skin: Put one or two drops of CBD oil on the skin of your upper thigh, then wait 24 hours. After a day has passed, check for raised bumps or other signs of allergic reaction.

Doing this before you use CBD oil for anxiety for the first time ensures that you don’t have this (extremely rare) allergy.

Possible Side Effects of CBD Oil

Throughout the years CBD has been researched, there are a few side effects to watch out for. Keep in mind, many of these side effects occurred in patients with severe health issues such as epilepsy and/or people taking massive doses of CBD oil (several hundred milligrams each day).

Side effects of CBD oil may include: ( 17 , 18 , 19 , 20 , 21 )

  • Sleepiness/drowsiness
  • Dry mouth
  • Decreased appetite
  • Reduction in blood pressure
  • Lightheadedness
  • Diarrhea
  • Vomiting
  • Fever
  • Abnormal liver function tests

There are a few groups of people who should use caution with CBD oil because of how it could interact with other conditions they have.

Results aren’t always consistent, because lower doses of CBD may actually help with some of these conditions, but huge doses might have the opposite effect.

If you have any of the following, consult with your doctor before starting CBD, particularly if you want to take a high dose: ( 22 , 21)

  • HIV/AIDS
  • Tumors
  • Parkinson’s disease

In the past, the American Academy of Pediatrics (AAP) has discouraged parents from using any cannabis products because of the limited information available about possible side effects. Plus, less research has been done on CBD for children than adults.

However, their most recent review (in late 2017) found that CBD seems to be safe for children, with the same possible side effects seen in adults. Again, these effects are seen mostly when kids are given large doses of hundreds of milligrams each day, for several days in a row. ( 23 )

Potential Drug Interactions with CBD Oil

Because CBD acts on so many different systems of the body, there are some medications that interact with CBD. If you take medicines like those I list below, talk to your doctor before taking CBD.

Sleep aids/sedatives: Taking CBD oil with sedatives or medicines that induce sleep may enhance their effects. This could happen with supplements as well, like ashwagandha, SAMe, valerian root, and melatonin—but this has never been observed in a study.

Anti-epilepsy drugs: CBD can significantly reduce seizures in some patients, but that’s partly because it interacts with the same receptors as anti-epilepsy drugs. Taking CBD with anti-seizure medications can increase the amount of these medicines in your blood and potentially cause problems with your liver. ( 24 )

Blood thinners: Drugs like Warfarin can be enhanced by CBD, too. If you take blood-thinning medication, talk to your doctor before starting CBD. S/he will likely recommend INR monitoring (whether at home or at the doctor’s office). ( 25 )

Ketoconazole: If you take this antifungal medication, it may increase how much CBD circulates in your blood. ( 26 )

Rifampicin (Rifadin): In the opposite way of ketoconazole, this antibiotic could decrease the CBD in your system. (26)

CYP3A4, CYP3A5, and CYP2D6 enzyme drugs: Several drugs that act on these three enzymes could be affected when you take CBD. Talk to your physician if you take any of these medications: ( 27 , 28 , 29 )

    • Biaxin (clarithomycin)
    • Zithromax (azithromycin)
    • Sandimmune (cyclosporine)
    • Viagra (sildenafil)
    • Antihistamines (Claritin, Zyrtec, Benadryl, etc.)
    • Haldol (haliperidol)
    • Lipitor (atorvastatin)
    • Zocor (simvastatin)
    • Testosterone
    • Progesterone
    • Procardia XL (nifedipine)
    • Lopressor (metoprolol)
    • Prilosec (omeprazole)
    • Risperdal (risperidone)
    • Zofran (ondansetron)
    • Paxil (paroxetine)
    • Tambocor (flecainide)

The Bottom Line: CBD for dental anxiety works.

Finally, there’s a natural solution to the question: “How can I calm my anxiety before going to the dentist?”

CBD oil for anxiety is an amazing way to help reduce fear before a dental procedure. It’s safe for kids and adults and is associated with no known side effects.

In addition, CBD may help keep your tummy calm after undergoing anesthesia. It also improves sleep quality, which is important for good dental and oral health. CBD is a major anti-inflammatory and is great for many types of pain, both acute and chronic.

When looking for CBD oil, search for a product that is 100% CBD with no fillers. Purchase only organically sourced products, grown in the USA, accompanied by third-party testing certifications.

From cavities to tooth pain to a fear of the dentist, CBD is an incredible addition to any healthy dental care routine. Find out how CBD eases dental woes.