CBD for Tooth Extraction Pain: A Tiny Pilot Trial Shows It's Feasible to Study

Randomized pilot trial (SWAP trial). 8 adults undergoing simple tooth extraction randomized equally to 4 arms (n=2 per arm): CBD 17 mg/mL, CBD 37 mg/mL, placebo, or treatment-as-usual (ibuprofen/acetaminophen). CBD/placebo: 0.5 mL every 4-6 hours as needed for 7 days. Primary endpoint: pain intensity (0-10 NRS) via ecological momentary assessment over 72 hours. Secondary: worst pain, rescue medication use.

The opioid crisis has created urgent demand for non-opioid pain management options, and dental procedures are one of the most common entry points for opioid prescriptions. If CBD could provide meaningful dental pain relief, the impact would be enormous. But first someone has to prove the trial design works — that's what this pilot did.

This is the dental-specific entry in the broader CBD-for-pain cluster. RTHC-00099 (chronic pain patient experiences) showed patients finding medical cannabis helpful for pain, and RTHC-00098 (CBD and innate immunity) provided the mechanistic basis for anti-inflammatory effects. This pilot takes the first step toward controlled clinical evidence in a specific, common pain scenario. The ecological momentary assessment method connects to RTHC-00089 (standard THC units), which used the same real-time tracking approach for a different purpose.

The study was designed for feasibility, not efficacy — 8 patients across 4 groups provides zero statistical power for comparing treatments. Simple extractions may not represent the full range of dental pain (surgical extractions, impacted teeth). The 72-hour assessment window captures only acute pain, not the full recovery period. CBD dosing was not based on established pharmacokinetic data for dental pain specifically. No blood levels measured to confirm CBD absorption.