Does Suboxone Rot Your Teeth?

Suboxone is a widely used medication in the treatment of opioid use disorder, but one side effect that does not always get enough attention is its potential impact on dental health. The acidity of Suboxone, particularly the sublingual film or tablet that dissolves under the tongue, can create an oral environment that accelerates tooth decay over time. Dentists across the country have reported noticing a pattern of new or worsening dental problems in patients who begin using the medication.

The dental issues associated with Suboxone use range from mild to more serious, depending on the individual and how long they have been using the medication. Common complaints include increased tooth sensitivity, dry mouth, cavities, and in some cases more significant decay or tooth loss. While these side effects do not affect every person who takes Suboxone, understanding the risks to dental health is important for anyone using Suboxone.

Learn more about the side effects of taking Suboxone for opioid addiction

What Causes Tooth Decay With Suboxone?

The most common factor that produces acids in the mouth is the activity of bacteria in the mouth. Tooth decay and cavities develop when teeth are exposed to an acidic environment. Suboxone has a low pH of 3.4, meaning it’s very acidic. Suboxone strips are designed to be placed under the tongue or in the cheek and held in place until fully dissolved for about five to 10 minutes.

Holding the medicine in the mouth and allowing it to sit on the teeth for up to 10 minutes every day leads to greater contact between the teeth and Suboxone. And for many patients, up to three doses of Suboxone may be administered every day, which continues to increase the exposure of teeth to the acidic substance.

How Suboxone Effects Teeth And Mouth

Dentists most often find decay along the gumline. And this acidity can affect the mouth in a number of different ways, not just tooth decay. The acidity in Suboxone makes the mouth a perfect habitat for multiple, unwanted issues.

A few of these include:

• tooth decay
• dry mouth
• cavities
• chalky plaque buildup on the teeth
• gum disease
• abscesses
• dental fillings
• cracked teeth

How Common Is Tooth Decay From Suboxone?

A 2013 study assessed the connection between sublingual buprenorphine and dental problems. The patients in the case study had been taking Suboxone for nearly four years, took the medication three times a day, and held it in the mouth, on average, nine minutes. The majority of the participants complained of toothaches and tooth decay. And other studies have revealed similar findings, making Suboxone a common culprit of tooth decay.

However, the results are still unclear, because many of the participants also smoked, regularly drank soda, used other medications that negatively impact dental health, and more. While Suboxone has been linked to dental issues, it’s difficult to know whether it is inevitable. Many of those who use Suboxone also do other things to negatively impact their teeth.

Tips To Prevent Tooth Decay From Suboxone

There are many ways to protect dental and oral health while using Suboxone. The possible effects on teeth should not be a reason to stop using Suboxone, and there are ways to prevent oral and dental damage.

Take Suboxone Doses All At Once

If more than one dose of Suboxone is needed, try to take them all at one time. As long as your prescribing doctor has approved it, Suboxone can usually be taken at the same time. This will limit the number of times the teeth and mouth are being exposed to the acidity in Suboxone, decreasing the chances of tooth decay and other issues.

Here’s how to take multiple Suboxone pills together:

• If two pills are needed, place them both under the tongue on opposite sides and avoid overlap as much as possible.
• If three pills are needed, you may place all three under the tongue and avoid overlap as much as possible.
• If this is uncomfortable, allow the first two to dissolve completely, then place the third one under the tongue and let that dissolve.

Here’s how to take multiple Suboxone strips together:

• If two strips are needed, place one strip on the inside of each cheek. Allow the medication to fully dissolve.
• If a third strip is needed, do not place three in the mouth at once. Allow the first two to dissolve, and then place the final strip in one of the cheeks and let that dissolve.

Brush Your Teeth After Using Suboxone

In order to prevent tooth decay, brush your teeth after the Suboxone has completely dissolved. Do not brush your teeth or use mouthwash while the Suboxone is still dissolving. Choose a fluoride toothpaste and brush after eating and drinking. Ideally, brush your teeth with fluoride toothpaste after every meal. If this isn’t possible, brush at least twice a day.

Have Regular Dentist Visits

Because Suboxone is known to produce negative effects on the teeth, it’s very important to maintain regular dental care. For those who don’t often go to the dentist and are starting on Suboxone, go ahead and schedule a dentist visit.

Speak with your dentist about the frequency of visits you might want to maintain, and keep a regularly scheduled appointment.

Lifestyle Adjustments To Prevent Tooth Decay

There are a few ways a person using Suboxone can adjust their daily routines and habits to encourage better dental health while on Suboxone.

A few suggestions are:

• Avoid frequent snacking and drinking. Eating foods and drinks (other than water) constantly is going to encourage the bacteria in the mouth to create more acids that destroy tooth enamel.
• Eat foods that are good for your teeth. Some of these include fresh fruits and vegetables, nuts, cheese, yogurt, and fish.
• Use an antibacterial mouthwash. This will help to kill the harmful bacteria in the mouth that leads to tooth decay.

Should Suboxone Dental Side Effects Stop You From Taking It?

For most people, the answer is no. Suboxone is an effective and potentially life-saving medication for those recovering from opioid addiction, and the risk of dental side effects should not be a reason to avoid it or stop taking it without consulting a doctor. The consequences of untreated opioid addiction are far more serious than the dental issues that may come with Suboxone use, and most of the oral health risks associated with the medication can be managed with proper dental hygiene and regular dentist visits.

That said, it is worth having an open conversation with both your prescribing doctor and your dentist about your Suboxone use so that a proactive plan can be put in place to protect your teeth. Being upfront with your dentist allows them to monitor for early signs of decay and recommend the best course of action before problems become more serious.

Get Suboxone Treatment For Opioid Addiction

Suboxone is one of the most effective treatment measures for opioid use disorder. If you or someone you love want to stop using opioids, Suboxone treatment might be right for you. Browse our directory or reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) for more information about addiction recovery.

Written by the Addiction Resource Editorial Staff