Cannabis use linked to dental pulp stones in exploratory study

This exploratory study investigated the associations between cannabis use, methylphenidate (MPH) exposure, demographic factors, and radiographically detected pulp stones. A retrospective case-control study was conducted to analyze the records of 200 adults (100 with pulp stones and 100 controls) treated at a university dental clinic (2020-2023). The variables included age, sex, cannabis use, MPH use, tobacco smoking, and clenching/grinding behaviors. Analyses included Fisher's exact test, Mann-Whitney U test, and multivariable logistic regression with Benjamini-Hochberg (BH) correction. Cannabis use showed the strongest independent association with radiographic pulp stones (OR = 6.54, 95% CI: 1.95-21.95; BH-corrected p = 0.012). Age was also independently associated (OR = 1.08/year; BH-corrected p = 0.035). MPH use was associated with pulp stones on unadjusted analysis (OR = 2.3, p = 0.042), but not after adjustment (OR = 1.72; BH-corrected p = 0.232). MPH users demonstrated significantly higher rates of documented clenching/grinding behaviors than nonusers (41.7% vs. 23.8%; p = 0.038). Tobacco smoking was not associated with the presence of pulp stones. Cannabis use was the strongest independent factor associated with radiographically detected pulp stones. MPH users showed higher rates of clenching/grinding behaviors, supporting a possible mechanistic relationship between psychostimulant exposure and parafunctional activity. The findings should be considered exploratory and hypothesis-generating. Pulp stones may be radiographic indicators of underlying parafunctional activity and behavioral risk factors, supporting more comprehensive dental history-taking and monitoring strategies.