Why Does Suboxone Rot Your Teeth? [2024 Update]

Suboxone and Rotting Teeth Overview

The manufacturer of Suboxone, Indivior, Inc., is facing lawsuits after plaintiffs allege the company failed to warn consumers about the potential for severe dental issues associated with using the product. Legal documents and reports to the U.S. Food and Drug Administration note that Suboxone users faced rotting teeth, cavities, and increased instances of gum disease. These lawsuits further allege that the company only alerted consumers after the FDA required an updated warning label in June 2022. 

Suboxone, a prescription medication used to treat opioid dependence by reducing withdrawal symptoms and cravings, combines the drugs buprenorphine and naloxone. It has been used extensively in addiction treatment programs throughout the U.S. Recent studies have increased concerns over the safety of prolonged use of the drug, particularly due to the potential for severe tooth decay and other long-term oral health complications.

Research Linking Suboxone to Rotted, Cracked, and Broken Teeth

April 2024: A clinical report published in the Journal of the American Dental Association (JADA) informs dental care providers about the potential oral effects associated with buprenorphine use. The article notes that the drug is under scrutiny because of its potential link to xerostomia (dry mouth) and caries. 

August 2023: A research article published in Current Drug Safety analyzed the public adverse event reports (AERs) submitted to the FDA regarding buprenorphine use and dental issues. The data showed that there was a “significantly disproportionate reporting of dental disorders” among individuals using medicines containing buprenorphine that is administered sublingually, buccally, or orally.

December 2022: An article published in the Journal of the American Medical Association (JAMA) discusses the association between exposure to sublingual buprenorphine/naloxone and dental disease. The study, which looked at over 21,000 patients using the medication, found an increased risk of dental problems associated with the sublingual use of the drug.

January 2022: The U.S. Food and Drug Administration (FDA) issued a warning about dental problems associated with buprenorphine medicines used to treat opioid use disorder and pain that are dissolved in the mouth. At the time, the FDA had identified over 300 reports of dental problems associated with buprenorphine use, 131 of which were severe.

About Suboxone and Rotting Teeth:

Can Suboxone Rot Your Teeth?

Research shows that Suboxone use may increase a person’s risk of rotting teeth. The drug’s tendency to reduce saliva production, causing xerostomia or dry mouth, may lead to a higher risk of oral bacteria growth, leading to tooth decay and other dental problems. Additionally, sublingual Suboxone can dissolve into an acidic environment in the mouth, further eroding tooth enamel and causing oral health problems. 

Individuals with opioid use disorder may also have other risk factors like neglect and poor diet that can increase the risk of dental problems, and the use of drug-related tools can further harm the teeth, gums, and mouth. It is strongly recommended that Suboxone users engage in regular dental checkups and cleanings. They are also encouraged to maintain rigorous oral hygiene by brushing, flossing, and using fluoride mouthwash. Drinking plenty of water may help to combat certain symptoms caused by Suboxone use, such as dry mouth, and chewing sugar-free gum may help to stimulate saliva production, warding off bacteria growth. 

Before you begin taking the medication, it is crucial to discuss the risks and benefits of Suboxone with a healthcare provider, balancing addiction treatment with dental health.

How Does Suboxone Rot Your Teeth?

Research shows that the prolonged use of Suboxone sublingual films may contribute to rotting teeth by creating an acidic environment when it dissolves in the mouth. The acidity erodes tooth enamel, which makes the teeth more vulnerable to decay.

Suboxone can also cause dry mouth (xerostomia) by reducing saliva production. Saliva plays an essential role in oral health, neutralizing acids, washing away food particles, and protecting enamel. When saliva is reduced, it can increase acidity and lead to a higher risk of tooth decay. 

The combination of Suboxone’s acidic nature and its side effect of dry mouth creates an environment that is harmful to tooth enamel, leading to an increased risk of tooth decay and other dental issues. Suboxone users should exercise proper oral hygiene to help mitigate these risks. Individuals who experience dental problems after taking Suboxone are encouraged to seek legal counsel about the potential for compensation.

Dry Mouth (Xerostomia)

As reported by the National Institute of Dental and Craniofacial Research (NIDCR), dry mouth, also known as xerostomia, can increase the risk of tooth decay and other dental problems. Dry mouth is a condition in which saliva production is significantly reduced. 

Saliva is critical to keeping germs away by washing away food particles, preventing plaque formation, and helping to neutralize acids produced by bacteria, which prevents tooth enamel erosion and the formation of cavities. It also provides calcium and phosphate to strengthen tooth enamel and repair early tooth decay. Dry mouth may also cause bad breath and lead to discomfort in speaking and swallowing due to reduced lubrication in the mouth. 

Studies show that the buprenorphine in Suboxone can affect the autonomic nervous system, reducing the amount of saliva a person produces and leading to dry mouth. It is believed that this side effect may be one of the reasons Suboxone users have a higher rate of dental issues. The reduced saliva may also cause plaque to accumulate in the mouth resulting in gum disease known as gingivitis and progressing to periodontitis. 

Acidic pH of Suboxone

Suboxone’s tendency to cause dry mouth may also cause a more acidic environment. Without adequate saliva, there is less neutralization of acid in the mouth, which may allow harmful bacteria to thrive. The combination of decreased saliva and increased bacterial activity leads to a more acidic environment, accelerating enamel erosion and increasing the risk of cavities.

The increase in acidity can erode the enamel on a tooth, leading to increased sensitivity and leaving it vulnerable to decay. As the enamel further erodes, teeth become even more prone to cavities due to the acidic environment and increased bacterial growth. The acidic environment also promotes plaque buildup, leading to gum inflammation and disease.

Suboxone users are encouraged to drink water frequently to help neutralize acids and reduce mouth acidity. They should also use fluoride toothpaste and mouthwash to help strengthen enamel and protect teeth from acid erosion. While using Suboxone, patients may want to limit the intake of acidic foods and drinks and chew gum with xylitol (sugar-free gum) to help stimulate saliva production. Finally, it is recommended that all people using buprenorphine medications use regular brushing, flossing, and alcohol-free mouthwash to help control acid-producing bacteria and maintain oral health.

Suboxone Dosing Frequency

Suboxone is typically prescribed once daily but can be taken in split doses or as needed, depending on the treatment plan and severity of opioid dependence. It is usually dissolved under the tongue (sublingual), allowing the medication to stay in the mouth and potentially affect oral health. 

Frequent dosing of Suboxone may lead to prolonged episodes of dry mouth, accelerating enamel erosion and tooth decay over time as saliva production decreases, particularly if oral hygiene is not maintained between doses. Suboxone users who take multiple doses per day may be less likely to brush after each dose, further impacting oral health. 

The repeated sublingual administration also exposes teeth and gums to the medication and its acidic components, exacerbating enamel erosion and decay. In order to mitigate these impacts, patients taking Suboxone should rinse their mouth with water after each dose to help wash away residue and reduce acidity in the mouth, protecting against tooth decay and other dental problems. 

Prolonged Use of Suboxone

It is not only the frequency with which Suboxone is used that may cause dental health problems but also the amount of time. Prolonged use of the drug can lead to chronic dry mouth, increased bacterial growth, cumulative acid exposure, and challenges in maintaining oral hygiene. All of these can significantly raise the risk of enamel erosion, cavities, and severe tooth decay. 

Prolonged use of Suboxone may cause:

• Chronic dry mouth: Prolonged use of Suboxone consistently reduces saliva production, causing persistent dry mouth and diminishing saliva’s protective functions. Reduced saliva allows bacteria to multiply, producing more acids that erode tooth enamel over time, increasing the risk of cavities and tooth decay.
• A more acidic environment: Extended exposure to an acidic oral environment, worsened by dry mouth, leads to significant enamel erosion, leaving teeth more vulnerable to decay and sensitivity. As enamel erodes, the underlying dentin becomes exposed, accelerating decay and increasing the likelihood of cavities and tooth rot.

Individuals on long-term Suboxone therapy may also struggle with maintaining oral hygiene. This can lead to dry mouth and increased acid exposure, eventually causing severe dental problems. Challenges in maintaining regular dental visits and rigorous oral hygiene practices over time can further exacerbate the risk of tooth decay.

Additional Factors Contributing to Teeth Rotting

Other factors, including diet, poor oral hygiene, genetics, tobacco use, and stress, may also contribute to the risk of tooth decay for Suboxone users. 

Factors that may contribute to tooth decay in Suboxone users:

• Diet and nutrition: A diet high in sugary foods and drinks fuels bacteria, leading to acid production, enamel erosion, and cavities. Additionally, frequent consumption of acidic items like citrus fruits, coffee, and sodas directly erodes enamel, weakening teeth.
• Poor oral hygiene: Neglecting regular brushing and flossing allows plaque buildup, which produces acids that attack enamel. Irregular dental visits can result in untreated dental issues worsening tooth decay over time.
• Mouth breathing: Mouth breathing, especially during sleep, dries out the mouth, contributing to tooth decay.
• Genetics and family history: Genetic factors can lead to weaker enamel, making individuals more prone to decay. A history of dental issues in the family can also increase your risk of similar problems.
• Age: Aging can lead to receding gums and increased dry mouth, both of which heighten the risk of decay. On the other hand, younger individuals are particularly susceptible to cavities due to developing teeth and frequent sugary snack consumption.
• Smoking and tobacco use: Smoking and smokeless tobacco reduce saliva production, leading to gum disease and tooth decay.
• Chronic conditions: Certain chronic conditions may affect dental health. For example, diabetes can increase a person’s risk of gum disease and decay due to higher sugar content in saliva, and acid reflux from GERD can erode enamel, increasing decay risk.
• Alcohol and drug use: Alcohol consumption contributes to dry mouth and an acidic oral environment, leading to decay. Drugs like methamphetamine cause severe dry mouth, sugar cravings, and poor oral hygiene, accelerating tooth decay.
• Stress and mental health: High stress can lead to teeth grinding, wearing down enamel, and increasing decay risk. Conditions like depression can also impair oral hygiene, heightening the risk of decay.

Does Suboxone Make Your Teeth Fall Out?

Multiple studies have tied Suboxone to tooth loss. In January 2022, the FDA warned about dental risks, including teeth falling out, linked to sublingual Suboxone; a label update in 2023 emphasized these risks. Prior to issuing the warning, the FDA had received over 300 reports of dental problems associated with buprenorphine medications that are dissolved in the mouth. Over 130 of the reports were classified as serious, and 26 involved patients with no prior history of dental problems. Tooth extraction or removal was the most common treatment for the reported dental issues. 

How Suboxone leads to tooth loss:

• Tooth decay: Suboxone can reduce saliva production, causing dry mouth and leading to bacterial growth, acid production, and cavities. Untreated cavities can then progress into infections, potentially requiring tooth extraction. 
• Gum disease: Dry mouth increases plaque buildup in the mouth, leading to gum disease, which begins as gingivitis and then becomes periodontitis. Periodontitis is an advanced gum disease that can cause bone and tissue breakdown, resulting in tooth loss.
• Enamel erosion: Suboxone increases mouth acidity, eroding enamel, and weakening teeth, risking cracks and tooth loss.
• Oral hygiene neglect: Poor hygiene due to lifestyle or mental health issues worsens dental problems, raising the risk for tooth loss.

What Else Does Suboxone Do to Your Teeth?

Extensive research shows that Suboxone not only has the potential to lead to tooth decay but it can also cause increased tooth sensitivity, gum disease, bad breath, mouth sores, difficulty swallowing and speaking, tooth discoloration, and a higher risk of cracked teeth, abscesses, receding gums, and lost fillings. Individuals taking Suboxone should engage in routine dental checkups and notify their provider about any medications they are taking. 

Additional oral health issues potentially caused by Suboxone:

• Increased Tooth Sensitivity: Erosion of enamel exposes dentin, leading to heightened sensitivity to temperature and certain foods.
  
• Gum Disease: Dry mouth increases plaque buildup, leading to gum inflammation (gingivitis) and potentially severe gum disease (periodontitis), which can damage tissues and bone, risking tooth loss.
• Bacterial Growth: Reduced saliva allows bacteria to thrive, causing foul-smelling compounds.
• Food Particles: Less saliva results in food particles remaining in the mouth, contributing to bad breath.
• Bad Breath (Halitosis): Persistent dry mouth caused by Suboxone may lead to halitosis or bad breath due to the increase in bacterial growth and an inadequate supply of saliva to wash away food particles.
• Oral Thrush: Dry mouth increases the risk of fungal infections like oral thrush.
• Sores & Ulcers: A lack of moisture can lead to painful mouth sores or ulcers.
• Difficulty in Swallowing and Speaking: Reduced saliva makes swallowing and speaking difficult and uncomfortable due to a lack of lubrication.
• Discoloration of Teeth: Suboxone use, combined with poor oral hygiene and certain foods/drinks, can lead to staining or tooth discoloration.
• Cracked or Broken Teeth: Enamel erosion weakens teeth, increasing the risk of cracking or breaking.
• Tooth Abscesses: Reduced saliva increases the risk of bacterial infiltration, leading to abscesses.
• Receding Gums: Gums may pull away from teeth, increasing sensitivity and decay risk.
• Fillings Falling Out: Weakened teeth can lead to fillings falling out, fractures, and other dental problems.

Suboxone Side Effects for Teeth, Gums, and Mouth

Research has consistently linked Suboxone to teeth, gum, and mouth side effects, such as tooth decay, enamel erosion, gum disease, dry mouth, bad breath, and oral infections. Suboxone users are strongly encouraged to maintain good oral hygiene and have regular dental care to help mitigate the effects of the drug. 

Potential side effects of Suboxone on teeth:

• Tooth Decay: Dry mouth from Suboxone reduces saliva, increasing mouth acidity and the risk of cavities.
• Enamel Erosion: The acidic environment caused by dry mouth erodes enamel, making teeth more susceptible to decay and sensitivity.
• Tooth Sensitivity: Exposed dentin from enamel erosion leads to heightened sensitivity to temperature and certain foods.
• Tooth Discoloration: Prolonged Suboxone use, especially with poor oral hygiene, can cause staining and discoloration.
• Cracked or Broken Teeth: Weakened enamel increases the likelihood of teeth cracking or breaking.

Potential side effects of Suboxone on gums:

• Gum Disease: Dry mouth leads to plaque buildup, which causes gingivitis and potentially progresses to periodontitis and gum recession.
• Gingivitis: Inflammation of the gums, often caused by dry mouth, can lead to redness, swelling, and bleeding.

Potential side effects of Suboxone on the mouth:

• Dry Mouth (Xerostomia): Reduced saliva causes difficulty swallowing and speaking and increases the risk of oral infections and decay.
• Bad Breath (Halitosis): Bacterial growth due to dry mouth contributes to persistent bad breath.
• Mouth Sores and Ulcers: Lack of moisture can irritate soft tissues, leading to sores, ulcers, or cuts that heal slowly.
• Oral Thrush (Candidiasis): Dry mouth increases the risk of fungal infections, such as oral thrush, which causes white patches and discomfort.
• Difficulty Swallowing and Speaking: Reduced saliva makes these activities uncomfortable and challenging.

To mitigate the oral health side effects of Suboxone, all users should maintain rigorous oral hygiene, stay hydrated, use saliva substitutes, and regularly visit a dentist. Affected individuals may be eligible for compensation by taking legal action and should contact an experienced attorney to determine if they meet the filing requirements.

Other Reported Suboxone Teeth Problems and Issues

Suboxone use can lead to additional dental problems such as cracked teeth, chattering, grinding, extractions, tooth loss, and pain, all of which are often linked to the drug’s effects on enamel, gum health, and stress-related factors.

Additional Dental Issues Linked to Suboxone Use:

• Cracked Teeth: The acidic environment created by Suboxone weakens enamel, making teeth prone to cracking, especially when chewing or biting hard foods.
• Teeth Chattering: Involuntary movements linked to anxiety, withdrawal, or neurological effects can lead to wear and potential damage to teeth.
• Tooth Extraction and Removal: In cases of advanced decay or gum disease, tooth extraction may be required due to irreparable damage or infection.
• Tooth Grinding (Bruxism): A stress and anxiety disorder common among Suboxone users, leading to enamel wear, cracks, and fractures.
• Teeth Falling Out: Progressive gum disease or severe decay can cause teeth to become loose and fall out.
• Tooth Pain: Erosion of enamel and untreated cavities can cause significant pain and discomfort, often requiring dental intervention.

Suboxone use can lead to serious dental issues beyond tooth decay and dry mouth, including cracked teeth, chattering, grinding, extractions, and tooth loss, often exacerbated by the drug’s effects on oral health and related stress factors.

Why Suboxone Sublingual Films Rot Your Teeth

Suboxone sublingual films dissolve in the mouth, either beneath the tongue or along the inside of the cheek. These films create an acidic environment in the mouth, and one of their primary side effects is reduced saliva production. Over time, the combination of these factors can significantly contribute to tooth decay, leading to tooth loss and the need for tooth extractions.

The proper method for using Suboxone sublingual films further highlights the risk of significant tooth decay. Given the close contact with the teeth, the acidic environment it generates in the mouth, and the dry mouth side effects, this medication creates an ideal scenario for detrimental oral health conditions.

STEPS FOR TAKING SUBOXONE SUBLINGUAL FILM:

1.  Preparation: Wash and dry your hands thoroughly before handling the film to prevent contamination and ensure the film doesn’t stick to your fingers.
2. Open the Package: Carefully tear open the foil package along the marked line; handle the film by the edges to avoid damaging it.
3. Place the Film Under the Tongue (Sublingual): Place the film under your tongue near the base and let it dissolve completely without chewing or swallowing; or
4. Place the File Inside the Cheek (Buccal): If instructed, place the film inside your cheek between the gum and cheek, allowing it to dissolve fully.
5. Dissolve the Film: Keep your mouth closed while the film dissolves, and avoid swallowing saliva immediately to ensure proper absorption.
6. Wait 10 – 15 Minutes: After the film dissolves, wait 10-15 minutes before eating or drinking, and avoid using mouthwash right after taking Suboxone to ensure full absorption.

Suboxone Films Get Stuck on Teeth

In addition to the acidic environment the films create in the mouth, they can also get stuck on your teeth. If the Suboxone film gets stuck on your teeth, there are specific steps you can take to help prevent additional dental damage. For instance, you can let it fully dissolve without moving it, and then gently rinse your mouth afterward. You should avoid picking at the film to protect your teeth. You can also take preventative measures to help ensure the problem does not persist. If the issue continues, it is worth consulting with your healthcare provider to find a suitable alternative. 

What to Do if Suboxone Film Gets Stuck on Your Teeth:

• Let It Dissolve: Allow the film to dissolve as much as possible, even if it’s stuck on your teeth, without moving it with your tongue or fingers.
• Rinse Gently After Dissolution: Once dissolved, gently rinse your mouth with water to remove any residue, but avoid rinsing immediately after placing the film.
• Avoid Picking at the Film: To prevent reducing its effectiveness, refrain from using fingers or objects to dislodge the film.

Proper placement is vital to prevent Suboxone from getting stuck. You should carefully place the film under your tongue or inside your cheek, ensuring it lies flat and doesn’t touch your teeth. Make sure your mouth is relatively dry. Keep your mouth still while the film dissolves to avoid it shifting and sticking to your teeth. If approved and the problem is persistent, you can break the film in half, but you should consult with your doctor before splitting the film into smaller pieces.

Prior to taking Suboxone it is essential to hydrate to reduce dry mouth, but you will want to make sure that your mouth isn’t overly wet when placing the film. If the film frequently sticks or interferes with the medication’s effectiveness, consult your healthcare provider for alternative methods or adjustments.

Can I Sue Suboxone for Ruining My Teeth?

Numerous Suboxone lawsuits claim that the manufacturer, Indivior, Inc., failed to warn consumers about severe dental problems, including tooth decay and loss. The primary argument is that the manufacturer did not provide sufficient information about the dental risks associated with Suboxone use. Individuals who have experienced significant dental issues due to Suboxone may be eligible for a lawsuit.

Suboxone lawsuits may be based on the following:

• Product Liability Claims: Plaintiffs in these claims must prove that Suboxone was defective or that the manufacturer provided inadequate warnings about potential side effects.
  
• Failure to Warn: The lawsuit may argue that the manufacturer failed to sufficiently warn users about the risks of dry mouth, increased acidity, and other dental issues linked to Suboxone.

Suboxone claims, however, may be challenging to prove. For instance, demonstrating that Suboxone specifically caused the dental issues can be complex, especially if other factors like diet or pre-existing conditions are involved. If you had dental problems before using Suboxone, proving the medication directly caused your current issues could be particularly difficult.

Steps to Take if Considering a Lawsuit:

1. Consult an Attorney: Speak with a personal injury or product liability attorney experienced in pharmaceutical litigation to assess your case.
2. Gather Evidence: Collect medical and dental records, including documentation of your dental history before and after taking Suboxone and any relevant communications with healthcare providers.
3. Document Damages: Keep detailed records of dental treatments and related expenses resulting from the issues you believe were caused by Suboxone.

Suboxone Lawsuit Sign-Up for Teeth Damage

If you suffered dental problems after taking Suboxone, you may be eligible for compensation. It is important to discuss your case with an attorney to determine if you meet the eligibility requirements for filing a lawsuit. Suboxone lawsuits can be challenging to prove without the help of an experienced lawyer. Prior to filing, you will need to gather the necessary documents to substantiate your claim, including proof of Suboxone use and detailed records of dental treatments. To get started, you should contact a Suboxone tooth decay lawyer immediately. 

Contact a Suboxone Tooth Decay Lawyer

At King Law, our lawyers are well-versed in handling Suboxone tooth decay lawsuits. We understand the complexities of these claims and will work tirelessly to ensure you get the recovery you deserve. It is important to act quickly as your case may be subject to a statute of limitations that precludes filing after a certain period. Contact our office today to schedule a free initial consultation and determine whether you meet the requirements to take legal action. 

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