Does Buprenorphine Cause Dental Problems?
Vložit
- čas přidán 30. 06. 2023
- @andyberkowskimd of ReLACS Health evaluates the concerns of buprenorphine and its relationship to dental disease in this week's informational video.
Buprenorphine is an opioid (narcotic) medication most commonly used for opioid use disorder (OUD) and secondarily, chronic pain. However, it is now increasingly prescribed by specialists for the treatment of moderate to severe restless legs syndrome (RLS) in which opioids have been used for a few centuries and are considered a consensus second-line therapy. For an introduction to buprenorphine for RLS, watch here:
• Buprenorphine for Rest...
In 2022, the FDA released a communication on concerns of dental problems arising from forms of buprenorphine that are dissolved in the mouth. To read the FDA's communication about dental problems with forms of buprenorphine that dissolve in the mouth, click here:
www.fda.gov/sa...
The notice includes brand names of buprenorphine-naloxone like Suboxone® and Zubsolv® and other dissolving buprenorphine tablets or films that are placed under the tongue or cheek such as Subutex® and Belbuca®. Here is a video on the forms of buprenorphine used for RLS:
• In 2024, What Are the ...
A pharmacy database study from the Journal of the American Medical Association (JAMA) in late 2022 looked into the frequency of dental problems with buprenorphine-naloxone compared to other treatments for OUD such as oral naltrexone and transdermal buprenorphine (through a patch on the skin) and found a 1.7X and 1.4X risk of dental problems respectively. However, the absolute risk was only 1% more than the control groups with an annual risk of about 2%. You can read the study here:
www.ncbi.nlm.n...
Buprenorphine has tremendous advantages over other opioids with a unique chemical effect leading to minimal risk of causing breathing problems that could lead to death, which is the most feared risk of regular opioids and why taking too strong a dose of opioids may lead to impairment, coma, and even death. Buprenorphine also does not typically cause an individual to "get high" (euphoria) making the risk of drug abuse with long-term use greatly reduced. This is why forms of buprenorphine like Suboxone® are now commonly used for opioid use disorder, to help people with opioid dependence and avoid the risk of an opioid poisoning. It is also why RLS clinicians are reaching for the buprenorphine prescription over other opioids like methadone and oxycodone for RLS.
@andyberkowskimd and colleagues published this conference abstract at SLEEP 2023 on buprenorphine effectiveness in severe RLS:
academic.oup.c...
Per the FDA and other sources, after the medication dissolves for 5-10 minutes, one can rinse out the mouth with water to improve the acidity and dryness that may occur from the medication, which could be the reason for increase in dental cavities, infection, and tooth loss. Those on a form of buprenorphine by mouth should brush their teeth regularly, but NOT immediately after taking the medication because the medication can soften the enamel and make the teeth vulnerable to wear and tear from brushing. A person should see their dentist regularly and make them aware of the reports of dental problems with buprenorphine so they can be monitored more closely.
The most important thing with any treatment is to weigh all of the risks and benefits of treatment when making a medical decision with the guidance of a licensed medical professional.
You may read A ReLACSing Blog #21 to learn why doctors have become so unwilling to prescribe opioids including for RLS (and it is not because of dental problems):
www.relacsheal...
These videos are for general medical information, but those who live in or near Michigan, Ohio, or Florida can hire @andyberkowskimd of ReLACS Health for consultation regarding treatment of RLS as well as any sleep disorder that requires a little more time and expertise. Go to www.relacsheal... for more information.
Buprenorphine sublingual form has destroyed nearly all of my teeth. I have a clean diet - no soda. Have also found hundreds of others online with severe dental damage. Are we the unlucky 2% ? Or or is this just now becoming a recognized side effect due to the large number is incidents. Or has this just been underreported ?
I’m furious about the issues Ive had to deal with & the pain I’m in from the tooth loss. This is a nightmare & no one ever shared this info when I started taking this med.
The problem was enough for the FDA to issue a statement about it. We will have to see further studies in upcoming years as the drug is used increasingly more for opioid use disorder, chronic pain, and RLS. My experience in RLS patients has been 2% or less but I have not systematically surveyed all the patients who have been on buprenorphine so it is possible some have not mentioned it or weren't asked.
Same here!!! I had great teeth until soboxone got introduced!
Did you use opiates prior to bupe? Opiates cause dry mouth, dry mouth causes tooth decay. I’m just an idiot on the internet but my mom’s a dentist. I asked her if she’s noticed this in her practice. Most people are not forthcoming about the medications/ drugs they take to their dentist, to no one’s surprise.
@@NotJessH of course I did. That's why I'm on bupe. But I didn't have any issues until AFTER. It all started once bupe was introduced.
@@NotJessH also bupe sits under your tongue....it just makes sense. All that crap floating around in your mouth waiting to dissolve.....
I have an active lawsuit going right now because of sublingual buprenorphine causing me to have all my teeth pulled. Buprenorphine literally caused all my teeth to start breaking apart and falling out. I had a few bad teeth before i started taking Suboxone, but after i started taking 2 a day is when i noticed my teeth literally falling out of my head. I just signed the lawyer agreement yesterday and i couldn't be more happy. I've been living without teeth for over a year now.
I am just like you and have a active lawsuit going as well I have also lost all my teeth and it happened just as you described with my teeth breaking apart and have also been without teeth and dentures for over a year now I started taking suboxone film form in 2015 8/2 mg 3 times a day and still on the tablet form today
I knew it but was assured over and over it doesn’t ruin your teeth, I finally quit and within a month it was amazing how strong my nails and hair got . It’s rotting you
thank you ver nuch for your effort an a very comprehensive site
Yes! Luckily have dental but 70% of my teeth deteriorated over 4-5 yrs. Had to get crowns and that was painful.
I have been on suboxone for over a year an my teeth have had such a bad decay happening an I have been telling my doctor about it but I don't know what to do
If it didn’t do anything to your teeth, then why is there a huge lawsuit against the company over this. I know because I’ve receipts.
Can you give me any case studies done with people who had bacterial infections, and what antibiotics you can use?
I'm not sure you'll find any studies. Dental infections are generally treated based on the evaluation of the dentist or doctor and probably not differently in those with buprenorphine versus anyone else. An exception would be that if a unique bacteria is found among those using buprenorphine, specific antibiotics for that pathogen could be tried.
Yes yes yes I’ve no teeth left, it’s ruined my smile and has caused seriously severe emotional distress and anxiety over this.
Can we discuss the generic tablets? I've been on suboxone films, tablets... before the generics came up then after generics I've taken alternative with a vanilla methol like flavor, then switched back by insurance preferred brands, and since I've been on the generic sublingual tablets again, the top of my been molars especially on the right side lower and top have an opening from the tooth decay and i can only assume it's from the med. That's the only thing that causes some discomfort during every dose until i take an 800 ibuprofen beforehand. This shit is destroying me and i can't stop taking it unless i want to be sick for weeks to months when i have young kids to take care of.
Also, I would like to say that I gargle with water after about five minutes. Then I use mouthwash about a minute after that. And yes, if I were to brush my teeth immediately after , it would be painful. So that is something that I just never did anyway. Always end up using a mouthwash and a get a good brushing hour after (internet researched) because I could tell immediately that it was doing something weird to my teeth.
As I commonly say in these videos, the treatment benefits must outweigh the adverse effects and the balance of two varies tremendous among individuals. In the case of buprenorphine, depending on the condition being treated, there are many other forms (e.g. transdermal-patch, subdermal implant, subcutaneous extended-release injection, etc.) that can avoid dental problems in some who have them from a sublingual preparation.
@@andyberkowskimd I’m trying to decide if I’m going to switch to the patch. I’ve had Pain Care for about 12 years now. Two or three years using buprenorphine and now I think I want to switch it to the patch.
I'LL BET THIS DOCTOR DIDN'T OPENLY INFORM HIS PATENTS ABOUT THE FDA WARNING. NOW, IF YOU LOST YOUR TEETH AND YOUR SUBOXONE DOCTOR DIDN'T DISCUSS THE FDA WARNING, LEGAL LIABILITY! IM ATTACKING MINE!!!
The sublingual is completely massacring my teeth. They’re all so sensitive and I never had cavities before. And I’m in my 40s.
Me too, man. I've now got periodontal disease. I'm 43. My mom is 74 and has no evidence of it and hasn't been to a dentist in 20 years. I go twice a year.
How? It's a film that goes under ur tongue not teeth
@@Infamous41 the film is even worse. My Pain Care provider said that she has a patient that lost all of the teeth that were above to the film. She said the patient always complained that it was damaging the teeth above it. She said at the time she thought it was a coincidence, but now they are educated about the damage that it does to the teeth. Her patient ended up losing those teeth.
Mine is a pill. 2mg. It’s a problem because it doesn’t completely dissolve. It gets inside the saliva. Imagine putting a sugar cube underneath your tongue and leaving it there and letting the contents dissolve into your mouth. When we eat or drink soda generally we have enough saliva to have it pass our teeth without sitting there baking into our teeth.
I was told to not brush my teeth until an hour afterwards. Now I gargle mouthwash immediately after and also put in mouth guards when my teeth get sensitive.. It just makes my teeth way too sensitive if it somehow ends up touching a spot on my tooth that I don’t properly clean right after.
It is unclear if the films change the acidity of the mouth or it is some other cause. Just like with drinking coffee, the teeth may be sensitive to wear and tear from brush so it is not recommended to do this immediately afterward. Rinsing with water but nothing mechanical on the teeth.
I've been on the sublingual tab for 18 years. Around 6 years ago I started losing all my teeth. I'm 47. I also have multiple sclerosis
I began Belbuca two months ago for fibromyalgia and chronic back pain. Being a nurse myself, my first question was, “How is this med going to effect my teeth due to it needing moisture to dissolve? I have Sjogren’s and have severely dry mucus membranes. So far I just add a few drops of water but sometimes a mint is required
Thanks for sharing!
More then that. Lots of people have lost teeth.
I imagine the small number of affected per year has to do with the lack of knowledge. Initially, when I was bringing this up, my provider had no clue. Now suddenly she’s an expert on it because the literature now backs up what people have been complaining about all along. I would imagine if your provider doesn’t know that it damages teeth that the recipient themselves might think that they are just practicing bad habits.
It is true that if few are aware of a possible side effect, they would not think to report it to their doctor, but some of these studies are looking at objective occurrences of dental problems and looking back to link them with those on buprenorphine so it would be more independent of whether anyone knew they were linked, but your point is well taken.
I just realized my breathing has gotten worse seee I'm c.o.p.d chronic I'm on oxygen 24-7 and IV noticed even with my Oxygen on my brethren has wosenend badly so yes it is bad on breathing thanks for confirming that
Most opioids can negatively effect breathing while one is sleeping. This can be compounded by other drugs and conditions like COPD. The effect is generally dependent on the dose of the drug and it tends not to affect breathing while awake compared to while asleep when the brain is controlling breathing. Buprenorphine does not have the impact on breathing like traditional opioids but not without some risks.
I been on subs for 7-8 years had one root canal right when I got clean due to not seeing a dentist in 3 years honestly I drink soda daily I take 16-24 mg a day I brush my teeth 2 times a day at least and eat lots of dairy idk maybe that’s why I have no issues but I think it’s bad oral hygiene honestly
That's why these studies are difficult because dental problems can be caused by all sorts of things so the studies have to compare two identical groups of people with buprenorphine being the main difference to see if there is an association with buprenorphine. Definitely something to monitor for on this drug.
I had dental problems before i ever got on Suboxone. It hasn't gotten any worse. I still brush my teeth 20 times a day, at least. Way more than the recommended two. It gives you dry mouth. A lot of medications do. It's not the chemicals in the medication.
You have Nice teeth and smile Dr. Worst things for bupe users are bad hygiene, bad dentists or expensive dentist, im not sure bupe has a lot of side effects itself…
Just promoting awareness for a potential side effect that may go unnoticed when everyone is focused on other complexities of opioids
Bupe definitely affects the teeth!!! I had great teeth until getting on suboxone!
the company mislead the public about Buprenorphine. First use was by sub cu injections of 300 micrograms tid for one week then taper in the late 90s. BR then decided it could make billions with sublingual tabs orange flavor, knew about dental problems. Then patent ran out said children will eat the orange tabs we must put in film form with tamper resistant packaging. Got another 7 years to make billions. Remember BR was a household chemical cleaning manufacturer.
I’ve been on suboxone for a decade and no dental issues at all. Not even a cavity. I think some folks just have poor dental hygiene
Just wait, it's coming
Yeah it's coming this shit is eating up my teeth but I'm stuck at 5mg 😭
@@fiverrtopranktipsit’s coming? Like how many decades? It’s already been 12-13 years. How many years were you on it before your teeth started to rot?
@@jakepadgett5569 maybe not idk you might be lucky I've been on it 6years
I think it's people forgetting to brush your teeth. Sine taking subs I almost forget my name sometimes.😅😅
Lower your dose, allow suboxone to let you learn how to be sober. It doesn’t get me high or really affect my brain anymore.
I kind of agree though, I’ve been on it for 5 years and my dental problems haven’t gotten worse, I do take subutex in the pill form. But my Gregg are messed up from prior drug use. That’s why most of us are on it.
I brush after every meal it's the Citric acid on the Suboxone it sticks to the teeth and causes rotting also Suboxone makes you dehydrated that coupled with that has been damaging my teeth ive started using milk to try to lower the pH from the Citric acid. I think the milk might help a little accompanied with brushing my teeth after with toothpaste but I still feel like it's not enough...
@@fiverrtopranktips not citric acid. It's a hydrochloride. Very acidic. It's definitely caused me a lot of dental problems.
I agree m8, a glass of milk may help rebalance the pH in your mouth.