In 20 adults with chronic temporomandibular disorder pain, 90 days of sublingual THC/CBD therapy (1:1 ratio, up to 10 mg/day) reduced pain scores from 7.35 to 3.50, increased mouth opening, and nearly eliminated allodynia and hyperalgesia, with large effect sizes.
People with chronic jaw pain or TMD, and dentists or pain specialists considering cannabinoid therapy.
Pain scores dropped from 7.35 to 3.50 with ~90% reduction in functional pain
What the researchers found
THC/CBD improved all outcomes versus both baseline and post-placebo (p < 0.05). VAS pain decreased from 7.35 to 3.50. Mouth opening increased from 45.9 mm to 49.9 mm. Functional pain dropped by approximately 90%. Allodynia and hyperalgesia were nearly eliminated. Effect sizes exceeded 0.8 (large). Placebo effects were minimal.
Why it matters
Temporomandibular disorder affects up to 12% of the population and causes chronic orofacial pain that often responds poorly to conventional treatments. This study provides clinical evidence for THC/CBD therapy with large effect sizes and measurable functional improvements, not just subjective pain reduction.
The numbers in context
20 participants, 90-day treatment. THC/CBD 1:1, titrated to 10 mg/day sublingual. VAS pain: 7.35 to 3.50. Mouth opening: 45.9 to 49.9 mm. Functional pain reduced ~90%. Allodynia and hyperalgesia nearly eliminated. Effect sizes >0.8. Minimal placebo response.
How the study worked
Blinded, crossover, non-randomized study of 20 adults with chronic myofascial TMD pain (DC/TMD diagnosis). Two consecutive 90-day phases: placebo followed by THC/CBD (1:1 ratio, starting at 2 mg/day, titrating to 10 mg/day sublingually over 5 weeks). Outcomes: VAS pain, algometry, mandibular function, and pain sensitivity. Linear mixed models used for analysis.
What this study cannot tell us
Non-randomized crossover without washout between placebo and active phases means carryover or order effects cannot be excluded. Small sample (n=20). Single-site study. The blinding may have been compromised by THC psychoactive effects. No long-term follow-up beyond 90 days.
How to read the evidence
Crossover study with objective functional measures and large effect sizes, but non-randomized, no washout, and small sample.
When this study was published
Published in 2026.
The bigger picture
The near-elimination of allodynia and hyperalgesia is particularly noteworthy, as these pain sensitization phenomena are central to chronic pain conditions and are difficult to treat with standard analgesics. The sublingual delivery route and low total dose (10 mg/day) suggest this approach may be practical for clinical implementation.
Questions still open
- Would a randomized design with washout confirm these results? Is the 1:1 THC/CBD ratio optimal, or would other ratios work? How does this compare to standard TMD treatments? Would benefits persist after stopping treatment?
Common questions
How much THC/CBD was used?
Did the placebo work?
Read the original research
Effect of Δ9-tetrahydrocannabinol and cannabidiol on myofascial pain modulation in patients with temporomandibular disorder: a prospective crossover study.
Clinics (Sao Paulo, Brazil), 81, 100885
Citation
Schinko, Francisco Gomes Bonetto; Paranhos, Luiz Renato; Gonçalves de Sousa, Lucas; Phelipe de Paula Santos, Gabriel; de Mello Rode, Sigmar; Sergio Guimarães, Antonio; Cama Ramacciato, Juliana. (2026). Effect of Δ9-tetrahydrocannabinol and cannabidiol on myofascial pain modulation in patients with temporomandibular disorder: a prospective crossover study.. Clinics (Sao Paulo, Brazil), 81, 100885. https://doi.org/10.1016/j.clinsp.2026.100885
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