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The role of cannabidiol in modulating chronic neuropathic orofacial pain

From Volume 50, Issue 6, June 2023 | Pages 512-515

Authors

Ronan Lee

BDS, BSc (hons), AKC

Foundation Dentist, Combined Primary and Secondary London Scheme

Articles by Ronan Lee

Email Ronan Lee

Tara Renton

BDS, MDSc, PhD

Professor of Oral Surgery, King's College London; Honorary Consultant in Oral Surgery, King's College Hospital NHS Foundation Trust and Guy's and St Thomas' NHS Foundation Trust, London

Articles by Tara Renton

Abstract

Chronic neuropathic orofacial pain is an extremely debilitating disorder that poses a burden to patients as well as the economy. Although a common condition, the management and treatment for those affected remains limited. Cannabidiol is a safe, non-psychoactive compound derived from the Cannabis sativa plant, which possesses properties that can modulate pain, including anti-neuropathic, anti-nociception and anti-inflammatory capacities. Although research is limited, cannabidiol may be able to treat chronic orofacial pain in some neurological, neurovascular and idiopathic conditions. This article aims to increase awareness of cannabidiol, and its possible use for future treatment of chronic neuropathic orofacial pain.

CPD/Clinical Relevance: Cannabidiol may be useful as a treatment for chronic neuropathic orofacial pain.

Article

Chronic pain can be defined as persistent pain after an inflammatory response to an acute cause has stopped.1 The prevalence of chronic pain among the UK population is high, with a meta-analysis estimating that chronic pain affects between 33.3% and 50% of the UK population, of whom 10.4% and 14.3% report ‘moderate’ or ‘severely’ disabling limitations associated with chronic pain.2 Furthermore, chronic pain is an economic burden, costing the UK economy £10 billion yearly.3

Chronic orofacial pain makes up 20–25% of chronic pain conditions.4,5 Chronic orofacial pain can be felt along the sensory nerve supply of the trigeminal system, affecting regions of the face, mouth and anterior scalp. Chronic pain falls into two classes: pain that is derived from nerves (neuropathic pain); and persistent inflammatory pain. Hapak and colleagues divide neuropathic pain into neurovascular (eg chronic migraine headaches and cluster headaches), neurological (eg primary and secondary neuropathies) and idiopathic origin (eg burning mouth syndrome).6

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