In a pilot trial with just 8 patients, oral CBD after tooth extraction was feasible and well-tolerated — but with only 2 patients per group, the study was designed to test the method, not whether CBD actually works for dental pain.
Read this if you're interested in CBD for pain — it's a proof-of-concept for studying CBD in dental settings, not evidence that CBD works for tooth pain.
What the researchers found
Dental extractions are one of the most common surgeries worldwide, and post-operative pain management typically relies on ibuprofen, acetaminophen, or opioids. Could CBD offer a non-opioid alternative? This pilot trial was designed to find out whether that question is even testable — not to answer it.
Eight adults undergoing simple tooth extraction were randomized to four groups of 2 patients each: low-dose CBD (17 mg/mL), high-dose CBD (37 mg/mL), placebo, or standard treatment (ibuprofen/acetaminophen). CBD and placebo groups received 0.5 mL doses every 4-6 hours as needed for 7 days. Pain was tracked using a 0-10 scale via ecological momentary assessment over 72 hours.
With only 2 patients per group, no meaningful efficacy comparisons are possible — this was never the point. The study established that the trial protocol works: patients were successfully randomized, dosed, and assessed using phone-based pain tracking. CBD was well-tolerated with no serious adverse events.
The value of this study is entirely methodological. It lays the groundwork for a properly powered randomized controlled trial that could determine whether CBD has a role in dental pain management. For a field desperate for non-opioid pain alternatives, establishing that the clinical trial infrastructure works is a necessary first step.
Why it matters
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.
The numbers in context
8 patients total. 4 groups of 2. CBD doses: 17 mg/mL and 37 mg/mL, 0.5 mL per dose. Pain tracked over 72 hours via ecological momentary assessment. No serious adverse events reported. Study was powered for feasibility, not efficacy.
How the study worked
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.
Who was studied
N=8 adults, all participants underwent dental extractions.
What this study cannot tell us
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.
How to read the evidence
Pilot feasibility trial with 2 patients per arm. No efficacy conclusions can be drawn. The study's value is entirely in establishing methodology for a future adequately powered trial.
When this study was published
Published in 2025. A larger follow-up trial may be in development based on this pilot.
The bigger picture
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.
Replication
Not stated in abstract.
Funding
Not reported in abstract.
Conflicts of interest
Not reported in abstract.
Questions still open
- Will the full-scale RCT show CBD is effective for dental pain? What CBD dose would be needed to match ibuprofen/acetaminophen efficacy? Could CBD reduce the need for opioid prescriptions after dental surgery? Would topical CBD application directly to the extraction site work differently than oral dosing?
Read the original research
Oral Cannabidiol for Acute Post-Extraction Pain: A Randomized Pilot Study.
Pharmaceuticals (Basel, Switzerland), 18(12)
Pharmaceuticals is a peer-reviewed journal focusing on drug development and therapeutic applications.
Citation
Abidi, Ammaar H; Kassan, Modar; Derefinko, Karen. (2025). Oral Cannabidiol for Acute Post-Extraction Pain: A Randomized Pilot Study.. Pharmaceuticals (Basel, Switzerland), 18(12). https://doi.org/10.3390/ph18121792
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