New ways to treat dental pain?
Featured Products Promotional FeaturesPosted by: Dental Design 8th March 2024
No matter what we do as dental professionals, there is no way of avoiding the fact that our patients experience some pain or discomfort before, during or after treatment. There are various ways to minimise the severity and longevity of patients’ pain as a result of procedures, which include the techniques and technologies we employ, as well as our own professional training and skill level. However, I was interested to come across a new study recently that considered the potential of cannabidiol (CBD) as an alternative analgesic for acute dental pain.
The study[i] considered 64 subjects between 18- and 75-years-old, testing Epidiolex (an FDA-approved CBD oral solution) against a placebo control group. The Epidiolex group was split into two, assessing a 10-mg//kg single dose (CBD10 group) and a 20-mg/kg single dose (CBD20 group) to evaluate rhe strength of dose needed for maximum effect.
The results showed that CBD10 participants started to experience relief from moderate to severe odontogenic pain approximately 30 minutes after drug administration. The CBD20 group felt relief around 15 minutes after administration. Pain levels were reported to reduce in both groups over time, halving in 60 minutes and 120 minutes post-administration for CBD10 and CBD20 participants respectively. As expected, there was no significant decrease in pain intensity or time for the placebo group.
Cannabis-derived products are being more widely used across healthcare in the UK, including for indications relating to epilepsy, multiple sclerosis and chemotherapy.[ii] CBD oils at a lower concentration are also available over-the-counter for individuals who wish to use them without a prescription.
One of the main reasons that the rollout has been slow is due to concerns about the possible side effects of the drug. Cannabis in its raw form contains the chemical THC, which is what ‘gets people high’ and this is linked to psychosis and dependency. Medical grade CBD, however, is devoid of THC, rendering it much safer for use.
The aforementioned study looked at the safety outcomes of CBD for the two test groups, finding that a single dose of CBD did not cause any significant psychoactive or mood effects. Both led to sedative effects – calming and anxiolytic, not drowsy – with only relatively minor abdominal symptoms that were easily rectified with over-the-counter medication (which are not uncommon for many pain relievers). Epidiolex was, therefore, considered to be safe and effective for managing dental pain.
The next step would be to complete more robust testing with a larger sample size to confirm validity of CBD oil for dental indications. From here, changes would have to be implemented to give dentists the ability to prescribe such medications and manage their patients safely. Though we’re a little way off such changes, it is interesting to consider CBD as an effective new way of helping patients to manage their dental pain.
Dr Michael Sultan Bio:
EndoCare, led by Dr Michael Sultan, is one of the UK’s most trusted Specialist Endodontist practices. Through the use of the latest technologies and techniques, the highly-trained team can offer exceptional standards of care – always putting the patient first. What’s more, EndoCare is a dependable referral centre, to which dentists from across the country send their patients for the best in specialist endodontic treatment.
[i] 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
[ii] NHS. Medical cannabis (and cannabis oils). https://www.nhs.uk/conditions/medical-cannabis/#:~:text=A%20hospital%20specialist%20might%20consider,for%20this%20are%20not%20helping [Accessed November 2023]
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