Suboxone is a life-saving medication for many people recovering from opioid use disorder. It helps reduce cravings and withdrawal symptoms, allowing individuals to regain control over their lives. However, a growing number of patients and healthcare providers have raised concerns about an unexpected side effect: tooth decay.
In January 2022, the U.S. Food and Drug Administration (FDA) issued a public warning acknowledging reports of serious dental problems linked to buprenorphine medications like Suboxone, especially those taken as oral dissolvable films or tablets. Let’s explore why this happens, what you can do to protect your oral health, and how to safely continue your treatment.
What Is Suboxone?
Suboxone is a combination of buprenorphine and naloxone used to treat opioid dependence. It’s commonly administered as a sublingual film or tablet that dissolves under the tongue or in the cheek. This method helps the body absorb the medication more effectively—but it also exposes teeth to prolonged contact with its ingredients, which may lead to dental complications.
The Link Between Suboxone and Tooth Decay
When Suboxone dissolves in the mouth, it creates an acidic environment. Saliva production can be reduced, and the sugar alcohols used to bind the medication can contribute to the growth of harmful oral bacteria. Over time, this combination weakens tooth enamel, leading to:
- Cavities
- Tooth sensitivity
- Cracked or broken teeth
- Infections
- Tooth loss
The FDA has received hundreds of reports involving severe dental problems, sometimes occurring just a few months after starting treatment. Both people with a history of good oral hygiene and those with pre-existing issues were affected.
Why Was This Noticed Only Recently?
Suboxone has been in use for decades, so why are we just now hearing about this side effect?
The problem became more evident as long-term treatment became more common. Previously, Suboxone was used for short-term detox; now, many patients use it for months or even years to manage opioid use disorder, leading to cumulative effects on dental health.
The shift toward film and tablet formulations, which stay in the mouth longer than other delivery methods (like injections), also contributed to increased risks.
FDA Warning and Label Update
In early 2022, the FDA required manufacturers to update the labeling on buprenorphine medications to include dental warnings. The revised label now recommends:
- Rinsing your mouth with water after each dose
- Avoiding brushing your teeth for at least 1 hour after taking Suboxone to prevent abrasive damage to softened enamel
- Regular dental check-ups to monitor for early signs of decay
Protecting Your Teeth While on Suboxone
Stopping Suboxone is not the answer. It’s an essential tool in addiction recovery, and for many, the benefits outweigh the risks. But there are steps you can take to reduce dental harm:
1. Rinse, Don’t Brush Immediately
Always rinse your mouth thoroughly with water after the film or tablet dissolves. Wait at least 30–60 minutes before brushing, as your enamel is temporarily softened.
2. Use Fluoride Toothpaste or Rinses
Fluoride helps remineralize enamel and prevent decay. Consider using a fluoride rinse in addition to toothpaste, or ask your dentist about prescription-strength fluoride treatments.
3. Maintain Regular Dental Visits
Visit your dentist every 6 months, or more often if recommended. Early detection of enamel erosion or decay can prevent more serious issues later.
4. Drink Water Often
Staying hydrated helps your mouth produce more saliva, which is critical for neutralizing acids and washing away food particles.
5. Avoid Sugary or Acidic Foods and Drinks
Limit your intake of sodas, juices, and candy, which can compound the acidic effect of Suboxone and feed harmful bacteria in the mouth.
Are There Alternatives to Sublingual Suboxone?
If dental issues become severe, talk to your healthcare provider about switching to an alternative form of buprenorphine, such as:
- Sublocade – a monthly injection
- Probuphine – a subdermal implant (limited use)
- Transdermal patches – sometimes used off-label
These options bypass the mouth altogether and reduce dental risks, though they may not be suitable for everyone.
Advocacy and Support
Many individuals feel blindsided by these dental issues—especially after working so hard to get clean. It’s important to speak up. Let your doctors, counselors, and dentists know what you’re experiencing. You may even consider filing a MedWatch report with the FDA to contribute to better safety monitoring.
If dental damage has already occurred, you may need restorative treatment such as crowns, root canals, or implants. While expensive, many dental providers work with patients to arrange payment plans or sliding scale fees.
Final Thoughts
Suboxone remains one of the most effective tools for treating opioid addiction. But like any medication, it’s not without side effects. By staying informed and proactive, patients can protect their dental health while continuing their recovery journey.
If you’re currently taking Suboxone and experiencing dental pain, sensitivity, or decay, don’t wait—contact your dentist and your prescriber right away. Early action can prevent further damage and help you stay on track toward long-term recovery. Also, bear in mind that you may be able to join a suboxone tooth decay lawsuit – if interested, please speak with our friends at Garrett, Walker, Aycoth & Olson, Attorneys at Law.
