Oral Cannabidiol for Acute Post-Extraction Pain: A Randomized Pilot Study.

Area of Science:

• Oral surgery and pain management
• Pharmacology of cannabinoids

Background:

• Postoperative pain is a common concern after dental extractions.
• Cannabidiol (CBD), a non-intoxicating cannabinoid, shows potential analgesic and anti-inflammatory properties.
• CBD is being explored as an adjunct therapy for acute dental pain.

Purpose of the Study:

• To evaluate the preliminary efficacy and safety of oral CBD for pain management after simple dental extractions.
• To compare two CBD concentrations (17 mg/mL and 37 mg/mL) against placebo and standard non-opioid therapy (ibuprofen/acetaminophen).

Main Methods:

• A pilot randomized trial (SWAP trial) with 8 adults in four arms (n=2 per arm): CBD 17 mg/mL, CBD 37 mg/mL, placebo, or treatment-as-usual (TAU).
• Participants received study medication as needed for 7 days.
• Primary endpoint: pain intensity measured by ecological momentary assessment (EMA) over 72 hours.

Main Results:

• All participants completed follow-up with high EMA adherence (>75%).
• Due to the small sample size, results are descriptive and preliminary.
• The 37 mg/mL CBD group showed pain ratings comparable to the TAU group, while the 17 mg/mL CBD and placebo groups showed limited efficacy.

Conclusions:

• Higher concentration CBD (37 mg/mL) may offer analgesia comparable to standard non-opioid therapy for post-extraction pain.
• Findings are exploratory and suggest a potential role for higher-concentration CBD in pain management.
• A larger, powered randomized trial is warranted to confirm these preliminary findings.