Many people enrolled in medication-assisted treatment for addiction have found great success with buprenorphine and naloxone, also known by its brand name Suboxone®. This medication is a partial opioid-agonist and antagonist approved by the FDA to treat opioid use disorder that has worked particularly well in highly motivated patients. It is often prescribed as a sublingual film or tablet that dissolves under the tongue or against the cheek, taken anywhere from one to three times daily. Because of the method of ingestion, some patients have found that it can impact their dental health due to fluctuating acidity levels in the mouth. Thankfully, there are simple steps to prevent severe long-term damage and maintain a healthy smile.
Factors that can Impact Teeth when taking Buprenorphine
The sublingual strips and tablet formulations of buprenorphine must be dissolved in the mouth for the medication to work correctly. This means that it’s in close contact with soft tissues in the mouth at least once a day which can cause the following issues:
Fluctuations in acidity: Buprenorphine and naloxone medications have an acidity level of 3.4pH when dissolved in water, which is higher than usual in the mouth. Much like when eating too much sugar or drinking beverages like soda and coffee, the acidity can wear away at tooth enamel, making them more prone to bacteria, cavities, and decay.
Dry mouth: Medications that dissolve in the mouth can impact the body’s ability to produce enough saliva to maintain a preferred environment to keep teeth coated and moist and wash away debris from food and other bacteria. This means particles stay impacted in the teeth for longer, which can cause bacteria to grow and lead to cavities and gum decay.
Untreated dental conditions: If a patient taking buprenorphine and naloxone already has neglected oral health and poor dental hygiene due to substance use disorder, the medication can amplify progressive conditions that are already occurring in the mouth, such as tooth decay, cavities, gum recession, infections, and tooth loss.
Preventing Dental Issues while taking Buprenorphine
With improved daily habits and awareness, patients can continue taking life-saving medication for opioid use disorder without compromising their oral health.
Take the medication as directed. Some patients require more strips or tablets than others for each dose. In these cases, taking both doses at once rather than splitting them can reduce the acid exposure to teeth by half. Patients are encouraged to speak with their prescriber or medical provider about the proper technique, especially with sublingual films, to ensure they don’t overlap before dissolving.
Rinse after each dose. Once the medication has fully dissolved, taking large sips of water and swishing it inside the mouth, and swallowing can help wash away residual acidity that may be lingering. It’s important to swallow the water rather than spit it out in case any remaining undissolved medicine is still in the mouth.
Wait a while to brush. Just as dentists recommend to everyone, wait at least half an hour to an hour after eating or drinking before brushing teeth. When teeth are exposed to food and drink, or in this case, acidic medication, the enamel is softened temporarily. Brushing while enamel is in this state repeatedly can wear it down, and it doesn’t grow back! For those taking buprenorphine, waiting an hour after ingesting the medication is the best practice.
Maintain good oral hygiene. Addiction can take a toll on the body from head to toe, and teeth are often neglected as substance use take priority. Seeing a dentist regularly while in treatment can help correct problems caused by drug use and also prevent future issues while in medication-assisted treatment. Brushing twice daily and flossing always helps too!
Recovery Services of New Mexico offers medication-assisted treatment for opioid use disorder in a convenient outpatient clinic setting. Patients are consulted by specialized medical providers and nursing staff that understand the needs of those with substance use disorder. To learn more about the treatment programs available, message or call a local RSONM office today.