Understanding the Risks to Your Teeth When Taking Buprenorphine or Suboxone

Buprenorphine and Suboxone are considered miracle drugs for some who struggle with opiate addiction. Buprenorphine is a single medication that comes in tablet form and Suboxone is a dual medication containing buprenorphine and naloxone that comes in film and tablet form. Both are dissolved in the mouth, mostly sublingual, and work well for controlling withdrawal symptoms and cravings. There are also buprenorphine products that are prescribed primarily for pain. Last year the FDA announced these medications have been found to cause cavities, tooth decay, loss of teeth and oral infections (Research, 2022). The dental issues were found to occur anywhere from 2 weeks to 2 years after starting treatment. The primary reason is the medication is acidic and when taken sublingually is required to be held under the tongue for as long as 10 minutes to promote absorption (Etminan et al., 2022).

Should I Stop Taking My Medication?

There is no need to be alarmed and stop taking buprenorphine containing products based on the research available today. The benefits of continuing a buprenorphine containing product outweighs the risk of dental issues. Stopping buprenorphine containing products could mean potential relapse and subsequent overdose (Research, 2022). Instead, the recommendation would be to rinse with water immediately and to brush teeth an hour after taking the medication. In addition, it is very important to see a dentist on a regular basis.

How Do I Decide What to Do?

Treatment decisions are based on risk versus benefits and in the worst-case scenario most people would rather increase their awareness of their dental health to prevent problems than risk relapsing or overdose. For those who decide they do not like the risk to their dental health, there are other options for medication assisted treatment. Always speak to your provider about your concerns and options for care. Never stop buprenorphine without consulting your provider. The best outcomes are achieved when working with your provider to decide the most effective treatment that aligns with your goals.

References

Etminan, M., Rezaeianzadeh, R., Kezouh, A., & Aminzadeh, K. (2022). Association Between Sublingual Buprenorphine-Naloxone Exposure and Dental Disease. JAMA, 328(22), 2269. https://doi.org/10.1001/jama.2022.17485

Research, C. for D. E. and. (2022). FDA warns about dental problems with buprenorphine medicines dissolved in the mouth to treat opioid use disorder and pain. FDA. https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-dental-problems-buprenorphine-medicines-dissolved-mouth-treat-opioid-use-disorder