CBD Oil for TMJ Disorders - April 2024

Why People Are Using CBD for TMJ Disorders

People with temporomandibular joint disorders (TMJ disorders) are prescribed with over-the-counter painkillers, antidepressants, and muscle relaxants for TMJ pain and other symptoms of TMJ disorders⁽⁵⁾.

However, these medications may have side effects on some individuals. Antidepressants may cause constipation, difficulty breathing, decreased blood pressure, anorexia, dizziness, and insomnia⁽⁶⁾.

Meanwhile, muscle relaxants may cause drowsiness, drug dependence, dry mouth, constipation, urine discoloration. 

Some of these drugs should be used with caution, particularly individuals with liver problems⁽⁷⁾.

CBD may be a safer treatment option. It has a favorable safety profile with manageable side effects, including changes in weight or appetite, diarrhea, and tiredness⁽⁸⁾.

A 2019 randomized, double-blind trial published in the Journal of Clinical Medicine found that CBD had myorelaxant (muscle-relaxing) effects on temporomandibular disorders (TMD)⁽⁹⁾.

TMJ is the joint itself, while TMD pertains to any disorder affecting the TMJ.

Sixty patients with TMD participated in the study. The authors measured the activity of the masseter muscle on days 0 and 14 using electromyography.

Electromyography is a procedure that measures electrical activity in response to muscle stimulation⁽¹⁰⁾.

The researchers found that CBD’s transdermal application diminished the activity of masseter muscles and improved the condition of patients with myofascial pain.

Masseter muscles are involved in chewing and jaw clenching. TMD is triggered by pain in this muscle type⁽¹¹⁾.

Meanwhile, myofascial pain is a debilitating disease that affects muscles and associated soft tissues⁽¹²⁾.

CBD has properties that may offer pain relief for people with TMJ disorders and related symptoms.

CBD for Pain

A 2020 study published in the journal Current Pharmaceutical Biotechnology examined topical CBD’s effects on neuropathic pain. Twenty-nine patients with symptomatic peripheral neuropathy were given CBD or a placebo⁽¹³⁾.

The participants who received CBD oil transdermally reported that their intense pain and cold, itchy sensations were significantly reduced. No test subject experienced adverse effects during the study.

Another study archived in the European Journal of Pharmacology stated that CBD had properties that might effectively treat chronic inflammatory and neuropathic pain. The study was conducted on mice models⁽¹⁴⁾.

Peripheral neuropathy is caused by damage to the nerves outside the brain and spinal cord. It commonly affects the hands, feet, and other areas of the body⁽¹⁵⁾.

A preliminary controlled study in the journal Clinical Rehabilitation investigated the effects of CBD, tetrahydrocannabinol (THC), a combination of CBD and THC in a spray formulation, and placebo on patients with intractable neurogenic symptoms⁽¹⁶⁾.

Intractable neurogenic conditions are ailments related to the nervous system that are hard to control. 

In the study, the patients had multiple sclerosis, spinal cord injury, limb amputation, and brachial plexus damage (injury to the nerves at the base of the neck and armpits).

The researchers discovered that the CBD and THC treatment was superior to placebo. Some patients reported improvements in their bladder control, muscle spasms, and spasticity (muscle-tightening).

However, the authors noted that some patients experienced low blood pressure and intoxication with THC’s rapid initial dosing. 

THC is the cannabis plant’s active ingredient that has mind-altering effects on users. 

CBD is also extracted from the Cannabis sativa plant. However, unlike THC, CBD does not have high-inducing properties.

CBD for Arthritis

Currently, the causes of TMD are unknown. However, some factors may increase an individual’s risk of developing the disorder, such as arthritis⁽¹⁷⁾. 

Research found in the European Journal of Pain showed that the use of CBD topicals might be an effective treatment for the inflammation and pain of arthritic mice. 

After four consecutive days of administering CBD as an arthritis treatment, the authors observed reduced joint swelling and improvement of spontaneous pain⁽¹⁸⁾.

The researchers also noted that 6.2mg and 62mg of CBD per day were the most effective doses. CBD did not affect the test subjects’ higher brain function.

A study archived in the journal Pain revealed that CBD had anti-inflammatory and neuroprotective properties that blocked osteoarthritis pain in rodents⁽¹⁹⁾. 

The researchers also suggested that CBD might help prevent the development of pain and nerve damage in the mice’s osteoarthritic joints. 

Osteoarthritis occurs when the protective cartilage cushioning the end of the bones wears down over time⁽²⁰⁾.

These animal studies have yet to prove if CBD has the same purported benefits on humans. However, these findings are useful for future research involving human test subjects.

How CBD Works to Alleviate Symptoms of TMJ Disorders

Humans and animals, except insects, have an endocannabinoid system (ECS) that maintains natural harmony in the body despite changes in the external environment⁽²¹⁾.

Cannabinoids interact with cannabinoid receptors and help the ECS with this vital function. These cannabinoids may come from the body, from the Cannabis sativa plant, such as CBD and THC, or laboratories.

According to the study conducted on TMD patients, CBD’s analgesic effects on muscle pain disorders might be caused by the substance’s interaction with cannabinoid (CB) receptors 1 and 2⁽²²⁾.

However, the authors believe that CBD might be difficult to administer to the CB1 and CB2 receptors. Thus, they chose a transdermal administration.

The researchers believe that transdermal application had advantages over oral forms of CBD. According to them, transdermally applied CBD avoids the first-pass metabolism effect, resulting in an improved bioavailability of CBD.

They reported that the transdermal route allows the consistent application of CBD at the targeted site for a longer time. 

A transdermal application also minimizes the severe side effects that could come from higher CBD concentrations. 

The first pass effect refers to a phenomenon in which a drug gets metabolized at a particular location in the body, resulting in a reduced concentration of the active drug when it reaches the site of action⁽²³⁾.

Meanwhile, bioavailability is the rate at which drugs are absorbed into the living system and made available at the site of action⁽²⁴⁾.

The Pros and Cons of CBD Oil for TMJ Disorders

The Pros

• As previously mentioned, clinical trials and other studies on humans and animals suggest that CBD might help with neck pain, jaw pain, and other symptoms associated with TMD.
• Unlike antidepressants and muscle relaxants, CBD’s safety profile may be more favorable⁽²⁵⁾.
• If CBD use is legal in a state, CBD products may be bought over-the-counter and without a prescription,

The Cons

• More conclusive research is needed to determine CBD’s effects on jaw muscles and TMD.
• Some individuals may still experience CBD’s commonly reported side effects, including diarrhea, tiredness, and changes in weight or appetite⁽²⁶⁾. 
• The United States Food and Drug Administration (US FDA) has not yet approved CBD as a potential treatment for TMJ disorders.

How CBD Oil Compares to Alternative Treatments for TMJ Disorders

Aside from surgeries and therapies, an alternative remedy for TMD is acupuncture.

A 2017 review in the journal Medicine concluded that acupuncture might be useful in attenuating the chronic pain of TMD patients, particularly those with myofascial pain symptoms⁽²⁷⁾.

A 2018 study in the Journal of Depression and Anxiety stated that a group with chronic TMD had higher levels of depression and anxiety than the general population. The researchers recommend that screening for other comorbidities in TMD patients should be done⁽²⁸⁾.

Aside from its pain-relieving properties, acupuncture may also help with anxiety and depression⁽²⁹⁾.

Similarly, CBD has been found to have anxiolytic (anxiety-reducing) and antidepressant effects⁽³⁰⁾.

How to Choose the Right CBD for TMJ Disorders

CBD combined with THC may have significant analgesic effects⁽³¹⁾. However, medical marijuana use is not legal in all US states⁽³²⁾.

Federal laws allow the use of less than 0.30% of THC amounts in some CBD product types. The CBD type that utilizes all the ingredients of the cannabis plant is known as full-spectrum CBD. 

It is suggested that active ingredients work together to generate the full therapeutic benefits from the Cannabis sativa plant. This mechanism is called the entourage effect.

Note that some drug tests may still detect the trace amounts of THC in full-spectrum products. 

Individuals who want to avoid these risky situations may opt for broad-spectrum CBD. This CBD type has the same components as a full-spectrum type, except THC.

Individuals who prefer pure cannabidiol may purchase CBD isolates.

Among the CBD types, full-spectrum CBD may be the most beneficial for those with TMJ disorders. 

However, consulting with a doctor is essential before using any CBD product.

CBD Dosage for TMJ Disorders

There is no standard dosage chart for the use of CBD in TMJ-related conditions. However, the primary rule is to begin with low amounts of CBD, following dosing instructions on the product label.

If no adverse effects are observed, individuals may increase their CBD dosage until desired effects are achieved. 

How to Take CBD for TMJ Disorders

CBD may be taken in several formats and formulations. However, based on the 2019 research, a transdermal CBD application may be more optimal in treating TMD⁽³³⁾. 

CBD patches and topicals, such as lotions, balms, salves, and ointments, may be applied to the body’s painful areas. 

Some of these formulations may contain menthol, which may be more soothing for individuals experiencing TMJ-induced pain.

CBD oil and tinctures are other go-to CBD formats. Tinctures (drops) may be applied under the tongue for added efficacy.

 Some CBD oils are combined with essential oils. These formulations combine CBD’s purported health benefits and the added aromatherapy of essential oils. 

These combinations may be more useful to TMD patients instead of using essential oils alone.

Some CBD oils may also be unflavored. Those who dislike the grassy taste of CBD may mix these oils with food and beverages.

For instantaneous effects, CBD may be inhaled via vape pens. However, vaping may cause lung problems in some individuals⁽³⁴⁾.

CBD may also be ingested via CBD gelcaps, soft gels, pills, edibles, and gummies. The advantage of these formats is that users may take consistent doses or monitor how much CBD they have taken.

Understanding TMJ Disorders

TMD is the pain in the jaw joint and muscles responsible for jaw movement. Its causes are unknown. However, it can be absolutely debilitating for patients, and several factors, including genetics, jaw injury, or arthritis, may contribute to its development⁽³⁵⁾. 

Individuals with jaw pain have also been observed to clench their teeth (bruxism). However, not all people who grind their teeth habitually develop TMD⁽³⁶⁾.

Symptoms of TMJ may include the following⁽³⁷⁾:

• Jaw pain
• Temporomandibular joint pain (in one or both jaws)
• Pain inside and around the ear
• Difficulty chewing 
• Locking of the joint
• Facial pain

Conclusion

TMD refers to muscle tension and pain involving the temporomandibular joint. 

The causes of TMJ disorders are unknown. However, it is believed that genetics, arthritis, and jaw injury may increase the risks of an individual developing TMD.

Conventional medications, like painkillers, antidepressants, and muscle relaxants, are prescribed for TMJ. However, these drugs may have side effects detrimental to an individual’s health. 

CBD is generally safe to use. Studies found that CBD might help with TMD and associated symptoms.

Research also suggested that CBD might help in the treatment of arthritis, which is believed to be related to TMD.

CBD combined with THC may be useful in reducing pain and inflammation. However, the use of medical cannabis is not legal in all US states.

Hence, full-spectrum CBD may be used. This CBD type contains legally-approved THC amounts and all the ingredients of the cannabis plant. 

Among CBD’s formats, transdermal or topical CBD is more recommended for TMJ pain. This format ensures the high bioavailability of CBD when it enters the body. 

It is recommended that individuals with TMD, especially first-time CBD users, seek professional advice before using CBD.

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2. Xu, D. H., Cullen, B. D., Tang, M., & Fang, Y. (2020). The Effectiveness of Topical Cannabidiol Oil in Symptomatic Relief of Peripheral Neuropathy of the Lower Extremities. Current pharmaceutical biotechnology, 21(5), 390–402. https://doi.org/10.2174/1389201020666191202111534
3. Hammell, D. C., Zhang, L. P., Ma, F., Abshire, S. M., McIlwrath, S. L., Stinchcomb, A. L., & Westlund, K. N. (2016). Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. European journal of pain (London, England), 20(6), 936–948. https://doi.org/10.1002/ejp.818
4. TMJ disorders. (2018, December 28). Retrieved from https://www.mayoclinic.org/diseases-conditions/tmj/diagnosis-treatment/drc-20350945
5. Ibid.
6. Morelli, J., MS, RPh. (n.d.). Pain Relief Medications: OTC, Prescription & Side Effects. Retrieved from https://www.rxlist.com/pain_medications/drug-class.htm
7. Ibid.
8. Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and cannabinoid research, 2(1), 139–154. https://doi.org/10.1089/can.2016.0034
9. Nitecka-Buchta, A. op. cit.
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13. Xu, D. H. op. cit.
14. Costa, B., Trovato, A. E., Comelli, F., Giagnoni, G., & Colleoni, M. (2007). The non-psychoactive cannabis constituent cannabidiol is an orally effective therapeutic agent in rat chronic inflammatory and neuropathic pain. European journal of pharmacology, 556(1-3), 75–83. https://doi.org/10.1016/j.ejphar.2006.11.006
15. Mayo Clinic Staff. (2019, May 22). Peripheral neuropathy. Retrieved from https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061
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17. TMJ disorders. op. cit.
18. Hammell, D. C. op. cit.
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20. Mayo Clinic Staff. (2020, February 22). Osteoarthritis. Retrieved from https://www.mayoclinic.org/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925
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24. Bioavailability. (n.d.). Retrieved from https://www.merriam-webster.com/dictionary/bioavailability
25. Iffland, K. op. cit.
26. Ibid.
27. Wu, J. Y., Zhang, C., Xu, Y. P., Yu, Y. Y., Peng, L., Leng, W. D., Niu, Y. M., & Deng, M. H. (2017). Acupuncture therapy in the management of the clinical outcomes for temporomandibular disorders: A PRISMA-compliant meta-analysis. Medicine, 96(9), e6064. https://doi.org/10.1097/MD.0000000000006064
28. Sruthi, S., Jimsha, V., Srinivasan, S., & Daniel, J. (2018, December 14). Prevalence of Depression, Anxiety and Stress in Chronic Temporomandibular Joint Disorders Patients. Retrieved from https://www.longdom.org/open-access/prevalence-of-depression-anxiety-and-stress-in-chronic-temporomandibular-joint-disorders-patients-2167-1044-1000322.pdf
29. Sniezek, D. P., & Siddiqui, I. J. (2013). Acupuncture for Treating Anxiety and Depression in Women: A Clinical Systematic Review. Medical acupuncture, 25(3), 164–172. https://doi.org/10.1089/acu.2012.0900
30. de Mello Schier, A. R., de Oliveira Ribeiro, N. P., Coutinho, D. S., Machado, S., Arias-Carrión, O., Crippa, J. A., Zuardi, A. W., Nardi, A. E., & Silva, A. C. (2014). Antidepressant-like and anxiolytic-like effects of cannabidiol: a chemical compound of Cannabis sativa. CNS & neurological disorders drug targets, 13(6), 953–960. https://doi.org/10.2174/1871527313666140612114838
31. Wade, D. T. op. cit.
32. States with Legal Cannabidiol (CBD) – Medical Marijuana – ProCon.org. (2020, April 14). Retrieved from https://medicalmarijuana.procon.org/states-with-legal-cannabidiol-cbd/
33. Nitecka-Buchta, A. op. cit.
34. “Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping Products.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 25 Feb. 2020, www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
35. TMJ Disorders. op. cit. 
36. Ibid.
37. Ibid.

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