Cannabidiol promising and relatively fast-acting analgesic option for acute dental pain

Odontogenic pain can be debilitating, and nonopioid analgesic options are limited. This randomised placebo-controlled clinical trial aimed to assess the effectiveness and safety of cannabidiol (CBD) as an analgesic for patients with emergency acute dental pain. Sixty-one patients with moderate to severe toothache were randomised into 3 groups: cannabidiol 10 (CBD 10 mg/kg), cannabidiol 20 (CBD 20 mg/kg), and placebo. We administered a single dose of respective oral solution and monitored the subjects for 3 h. The primary outcome measure was the numerical pain differences using a visual analogue scale (VAS) from baseline within and among the groups. Secondary outcome measures included ordinal pain intensity differences, the onset of significant pain relief, maximum pain relief, changes in bite force within and among the groups, psychoactive effects, mood changes, and other adverse events. Both cannabidiol groups resulted in significant VAS pain reduction compared to their baseline and the placebo group, with a maximum median VAS pain reduction of 73% from baseline pain at the 180-minute time point (P < 0.05). Cannabidiol 20 experienced a faster onset of significant pain relief than cannabidiol 10 (15 versus 30 min after drug administration), and both groups reached maximum pain relief at 180 min. The number needed to treat was 3.1 for cannabidiol 10 and 2.4 for cannabidiol 20. Intragroup comparisons showed a significant increase in bite forces in both cannabidiol groups (P < 0.05) but not in the placebo group (P > 0.05). cannabidiol 20 resulted in a significant difference in mean per cent bite force change in the 90- and 180-min time points compared to the placebo group (P < 0.05). Compared to placebo, sedation, diarrhoea, and abdominal pain were significantly associated with the cannabidiol groups (P < 0.05). There were no other significant psychoactive or mood change effects. This randomized trial provides the first clinical evidence that oral cannabidiol can be an effective and safe analgesic for dental pain.

Reference:

Chrepa V, Villasenor S, Mauney A, Kotsakis G, Macpherson L. Cannabidiol as an Alternative Analgesic for Acute Dental Pain. Journal of Dental Research. 2023;0(0). doi:10.1177/00220345231200814

Keywords:

Cannabidiol, fast-acting analgesic, acute dental pain, Chrepa V, Villasenor S, Mauney A, Kotsakis G, Macpherson L