Buprenorphine SL vs transdermal, ? tooth damage

[Dr.Placebo]

Hi all. My doctor prescribed SL Suboxone tablets when I was doing poorly on methadone. I then read all about the FDA warnings about serious tooth damage from the SL films and tabs so I requested and got the 5 mcg patch instead. It seemed to work pretty well but I found I was having breakthrough RLS motor symptoms (twitching and spasms, mostly of my torso) so I was supplementing with little doses of methadone. Long story after that (went up to 7.5 mcg and actually got worse, so I let the patch run itself out over 2 weeks and then ended up back on methadone), but what I am wondering now is if anyone had had any tooth problems with SL buprenorphine or if it is working well, because I considering giving it a try. I am at the end of options and doing very poorly in terms of sleep , cognitive function and mood. About ready to give up but have heard some people getting good response to SL bupro so...???

[Dr.Placebo]

Hi. just re-posting this to see if anyone has any experience or knowledge about the risk of tooth decay with sublingual buprenorphine. Anyone doing well on it with no problems?

[Polar Bear]

I'm sorry your original post wasn't acknowledged. Apologies for that.
Just to say I'm unaware of tooth damage from buprenorphine. I don't recall having heard of this.

[Dr.Placebo]

Thanks for responding. Actually I did find an old thread on this forum discussing this phenomenon. His teeth were crumbling and it did turn out to be secondary to the Bupro. He, or someone else on this forum, said the cause was decreased saliva production due to the medication and that using "Biotene" products to increase saliva was somewhat protective. Also, carefully rinsing the mouth after using the sublingual film or sublingual tablet is now recommended.

The US FDA has issued a strongly worded warning about it, basically saying only use it if the benefit outweighs the risk. Since the drug is usually prescribed to recovering heroin addicts I was wondering if maybe the results were skewed by a population with poor dental hygiene (not wanting to "profile", but medicine is all about profiling in order to put people into risk categories). Anyway, I have pretty good dental hygiene so I am hoping if I keep it that way I won't have problems.

Lastly, I think I would be happy to give up all my teeth for a treatment that could give me my life back.

Dr. Placebo ;0)

[Polar Bear]

Thank you for providing this information. I was aware that a dry mouth could have a negative impact on teeth.

Not really funny but you did make me laugh at being willing to give up your teeth for a successful treatment. Me too.

[Lissa496]

I have also read that it is important to tell your dentist you are on this medication. I have read it is becoming standard to see your dentist four times a year for cleanings and to ensure your teeth and gums are doing fine and are not damaged due to this medication.

In the chronic pain community, this medication has caused a lot of issues with tooth decay and tooth loss, so it is not just addicts. If you do go on it please make sure you talk with your dentist and follow all care instructions for your teeth and mouth.

In all fairness, I am not on this medication but as someone who has run through all the recommended RLS treatments, I am currently on oxycodone, I know I may be on it sooner than later so I am doing as much research as possible!

Best of luck! Lissa

[SleepyCharlie]

No problems with teeth so far, have been on buprenorphine SL films for 10 months. Do worry about unexplained weight gain and belly fat. Sleepycharlie