Suboxone can cause dental problems in some instances with long term use, although this is still quite unusual.
Suboxone comes in a dissolving format, and you’re encouraged to keep pills and strips in close contact with your teeth and gums until the substance melts away. Sometimes, that method can lead to tooth decay, usually only after many months or years of using this medication.
Suboxone’s benefits largely outweigh the risks of tooth decay. What’s more, there are some simple steps you can use to protect your oral health while on Suboxone. Your dentist can educate you about what you can do to maintain optimal oral hygiene while you work on your opioid use disorder (OUD).
How Can Suboxone Harm My Dental Health?
Suboxone can potentially harm your oral health in a few ways. One of the side effects of Suboxone is xerostomia (decreased saliva), frequently causing dry mouth. A dry mouth can lead to cavities since saliva helps prevent tooth decay by washing away food and bacteria and decreasing the acidity level within your mouth. Suboxone formulations are acidic, which can affect tooth integrity and also cause other side effects like a pain or redness of the tongue.
Signs of Dental Health Issues
Some people use Suboxone for years with no problems at all. But if you experience oral health changes, you might experience:
- Tooth decay
- Oral infections
- Tooth loss
Of people with Suboxone dental health changes, almost 55% reported tooth pain, although this may be due more to poor oral health regimen prior to starting Suboxone or also secondary to other drug use. 
How Can I Protect My Dental Health While Taking Suboxone?
You can take Suboxone safely. But you’ll need to pay special attention to your oral health and dental care.
After Taking Suboxone
Allow your medication to dissolve completely. Then, follow these self-care steps:
- Take a large drink of water.
- Swish the fluid around your teeth and gums.
- Wait at least one hour before brushing your teeth.
Throughout Your Day
Take good care of your teeth by brushing twice daily, flossing before bed, and drinking plenty of water. Eat a low-sugar diet, and avoid tobacco products too.
Partner with a dentist you trust, and set up a personalized care plan. Your dentist can help you protect your teeth from Suboxone damage.
Report dental or oral symptoms to your dentist, such as these:
- Bleeding or swollen gums when brushing or flossing
- Chronic bad breath
- Dry mouth
- Loose, cracked, or broken teeth
- Ulcers or sores in the mouth that do not heal
- Sudden sensitivity to hot, cold, or sweet foods and beverages
- Toothache or pain
The Benefits of Suboxone Outweigh the Risks
Suboxone is proven to reduce your risk of infectious disease, opioid overdoses, and criminal justice involvement. Your medication is a critical part of your recovery plan, and it’s too important to skip doses.
If you’re concerned about Suboxone’s impact on your oral health, talk with your doctor and your dentist. With a good oral health regimen, you can avoid any dental complications of long term Suboxone use while still treating your opioid use disorder.
- Buprenorphine: Drug Safety Communication—FDA Warns About Dental Problems with Buprenorphine Medicines Dissolved in the Mouth to Treat Opioid Use Disorder and Pain. U.S. Food and Drug Administration. https://www.fda.gov/safety/medical-product-safety-information/buprenorphine-drug-safety-communication-fda-warns-about-dental-problems-buprenorphine-medicines. January 2022. Accessed July 2022.
- Sublingual Buprenorphine and Dental Problems: A Case Series. The Primary Care Companion for CNS Disorders. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3907320/. October 2013. Accessed July 2022.
- Statement from SAMHSA Leader on FDA’s Drug Safety Alert on Buprenorphine and Risk for Tooth Decay. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/newsroom/statements/2022/fda-drug-safety-buprenorphine-risk-tooth-decay. April 2022. Accessed July 2022.
- Home Oral Care. American Dental Association. https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/home-care. July 2020. Accessed July 2022.
- How Effective Are Medications to Treat Opioid Use Disorder? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/medications-to-treat-opioid-addiction/efficacy-medications-opioid-use-disorder. December 2021. Accessed July 2022.
Medically Reviewed By: Elena Hill, MD, MPH
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