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The pharmacological use of cannabidiol in recurrent aphthous ulcers can be an alternative and potent therapy.

CBD can be used as an alternative therapy for mouth sores due to its analgesic and anti-inflammatory effects. However, there have not been any significant clinical efficacy or safety trials for this use. This randomized, parallel, double-blind controlled trial was published in the journal BMC Complementary Medicine and Therapies and assessed CBD’s efficacy in treating recurrent aphthous ulcers (RAU). Seventy-two RAU patients were randomly allocated to 0.1% CBD, 0.1% triamcinolone acetonide (TA), or placebo in equal ratios.

Outcomes of Interventions on Ulcer Size 

The extent of the ulcers relative to their initial size (100%) was converted to a percentage. An analysis of ulcer size reduction for the three interventions revealed that the pseudomembranous ulcer size was nearly 100 percent smaller in the CBD group on day 5, and the erythematous border size was 40 percent smaller in the CBD group on day 2 compared to the placebo group. In contrast, the average ulcer size in the placebo group grew by approximately 175% on day 5 and 140% on day 7 relative to its initial size. Utilizing CBD and TA decreased the extent of the pseudomembranous ulcers.

Analysis of Pain Reduction

The pain levels associated with ulcers were assessed using the visual analog scale (VAS) and converted to a percentage in contrast to the baseline (100%). A comparison of the three therapies’ daily pain ratings revealed that topical CBD and TA were effective in reducing pain levels from day 1, whereas the placebo caused an increase in pain levels on days 1 and 2, followed by a steady decline on day 3. TA was considerably more effective than placebo in lowering pain levels on days 4,5, and 7. CBD only showed a lower pain level than the placebo group on day 5. However, there were no significant differences in pain reduction between the CBD and TA interventions.

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Satisfaction Scores 

The participants who received topical TA and CBD treatments reported greater satisfaction with the interventions, with average satisfaction scores of 8.32 and 7.48, respectively, compared to the placebo group, whose average satisfaction score was 6.17 (p > 0.05 for both). Although there was no significant difference between the CBD and TA interventions in terms of satisfaction.

Evaluation of Quality of Life 

The study found that all three treatments (CBD, TA, and placebo) improved oral quality of life (QoL) markedly, with higher scores indicating poorer QoL. CBD recipients reported the highest improvement in QoL, followed closely by TA recipients, and then placebo recipients. Nevertheless, the improvement in QoL was comparable across all three interventions.

Safety of CBD Treatment in Clinical Trials

CBD treatment did not cause adverse reactions or contact dermatitis. In the second phase of the clinical trial, which tested CBD’s safety on normal oral mucosa, no individuals had adverse responses. No respiratory or circulatory anaphylactic reactions or liver dysfunction symptoms (nausea, vomiting, jaundice, upper right quadrant abdominal discomfort, or dark urine) were noted. Pre- and post-CBD intervention vital signs and blood parameters were stable.


Umpreecha, C., Bhalang, K., Charnvanich, D., & Luckanagul, J. (2023). Efficacy and safety of topical 0.1% cannabidiol for managing recurrent aphthous ulcers: a randomized controlled trial. BMC Complementary Medicine and Therapies, 23(1). https://doi.org/10.1186/s12906-023-03886-0