Re: The Dental Patient Who is High, Oral Health – June, 2011

by Dr. Lorne BermanDr. Lorne Berman Sechelt, BC

I was extremely surprised and disappointed by the responses expressed by some of the dentist interviewees, who were surveyed about their attitudes toward treating people who were ‘high’ on alcohol or marijuana. Such a negative, judgmental, harsh, exclusive and defensive stance as expressed by these dentists are completely unfounded, and irrational and are neither welcomed by patients, who are real people whether they smoked a joint, or not – nor are they respected by the more enlightened or, at least realistic professional health care providers.

I have been practicing for more than 35 years in a community where marijuana consumption is common enough in the day-to-day world, as to be considered to some degree a ‘social norm’. Many times over the years, somewhat regularly, in fact, patients have revealed to me that they ‘smoked one’ before their appointment for relaxation, or, I can detect the smell even when I am not informed. And of course, people may ingest marijuana in food, without detection, unless revealed by the patient. In any case, these are people from all ‘walks of life’ and of a wide range of ages. They are fully cognizant of what is going on, indeed, may even be more inquisitive and interested in details of the procedure. At no time, ever, has there been a negative experience with a person who ‘had a few puffs’ before their dental appointment -indeed, at many levels, much to the contrary!

With regard to alcohol, more occasionally a patient admits (or I detect) that he or she had ‘had a drink’ before their appointment, and here, too, there have been no problems. In a few cases, over the years, a person who presents for treatment drunk and belligerent, or unable to comprehend, has been escorted out the door to a waiting taxi or relative, and reappointed at a later date, when sober.

Finally, to the dentist(s) who said that they ‘would not treat a patient on drugs’ – or would ‘kick them out of their office’: the real danger ‘out there’ are the patients who are on a plethora of legal, prescription drugs, prescribed by their physician, either singly or in combination – sleeping pills, antidepressants, anxiolytics, etc. Amongst this group are the people who perhaps should not be driving to or from your office, and may not be ‘all there’ in their capability to give informed consent.

Thank you for the opportunity to comment on this informative article.