An interesting article titled “Cannabidiol as an Alternative Analgesic for Acute Dental Pain” written by V. Chrepa and et. al. was published November 1, 2023 in the Journal of Dental Research. The article sought to assess the effectiveness and safety of cannabidiol (CBD) as an analgesic for patients with acute dental pain.
The study showed that CBD, a non-addictive and non-psychoactive component of Cannabis sativa, demonstrated potential as a therapeutic analgesic for acute dental pain. CBD may offer a safer and equally efficacious alternative to opioid-based medications. This is believed to be the first randomized clinical trial testing CBD for the management of dental pain.
Currently dentists and oral surgeons have switched to anti-inflammatories such as acetaminophen and ibuprofen as the first line of defense for dental pain, see for example the post Nonsteroidal anti-inflammatory drugs better than opioids for pain after dental extractions. Some patients can’t take these over-the-counter anti-inflammatories or find them to provide enough relief. Thus dentists and oral surgeons continue to prescribe addictive opioids although the amount has been reducing in recent years, see for example Oral Surgeon Opioid Prescribing Habits in the US during 2016 to 2019.
To rigorously investigate the effectiveness of CBD for dental pain, researchers conducted a double-blind, placebo-controlled study. Sixty one participants with severe toothaches were randomly assigned to receive either one or two doses of Epidiolex, a pure CBD oral solution, or a placebo. Pain levels were assessed for 3 hours using a visual analog scale (VAS), a standard tool for assessing pain intensity.
Image by Mohamed Hassan from Pixabay
Participants receiving either one or two CBD doses demonstrated statistically significant pain reduction compared to the placebo group. It was shown that 85% of CBD recipients reported at least a 50% decrease in their initial pain, culminating in a peak median reduction of 73% after three hours. The authors did observe a higher incidence of side effects, including sedation, diarrhea, and abdominal pain, within the CBD groups compared to the placebo group.
The study had limitations, including that age- and sex-related differences couldn’t be assessed because of a small sample size.
The authors state:
“This study showed for the first time that pure CBD could provide more than 70% analgesia to patients with emergency dental pain….This novel study can catalyze the use of CBD as an alternative analgesic to opioids for acute inflammatory pain conditions, which could ultimately help to address the opioid epidemic.”
In a future clincial trial, the researchers would ike to include factors known to affect pain perception, like social and psychological factors, in a study with Epidiolex or other pure CBD solutions to use for dental pain management.