Clinical Update quiz
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November Clinical Update
Cannabidiol as an alternative analgesic for acute dental pain
Chrepa V, Villasenor S, Mauney A, Kotsakis G, Macpherson L. Cannabidiol as an Alternative Analgesic for Acute Dental Pain. Journal of Dental Research. 2024;103(3):235-242.
Compiled by Dr Nirav Bhatia
Introduction
Toothache represents the number one most “avoidable” emergency department (ED) visit concern, defined as a visit that did not receive care and patients were discharged home. When it is mild to moderate in strength, it can be managed with nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, or acetaminophen (APAP), with success. However, certain patients with health limitations cannot take NSAIDs or acetaminophen, or these analgesics may not be as effective in specific patient cohorts.
In patients who require alternatives to NSAIDs and APAP, synthetic opioids are typically the following line of defence. To minimise the opioid crisis, health care providers need access to alternative nonopioid analgesics to manage dental pain.
Cannabinoids could be promising opioid alternatives. Clinical trials on cancer and chronic and neuropathic pain have used tetrahydrocannabinol (THC) combined with cannabidiol (CBD), the 2 primary compounds of cannabis, with successful outcomes. Nonetheless, their combined use as analgesics is still limited as THC is psychoactive.
CBD is nonpsychoactive and nonaddictive and has shown promising results as an analgesic alternative. Limited clinical evidence suggests CBD’s analgesic efficacy against peripheral neuropathy and chronic pain. There are no published clinical data using CBD as an analgesic for acute dental pain. This study aims to assess the effectiveness and safety of a Food and Drug Administration (FDA)–approved CBD drug against emergency dental pain in a phase IIA proof-of-principle study. We hypothesised that CBD would provide a minimum of 30% pain reduction from the preoperative measurements for patients with an emergency toothache. This effect size is comparable to 400 mg ibuprofen for acute odontogenic pain.
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September 2024 Clinical Update | pdf
October 2024 Clinical Update | pdf
