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 Post subject: Suboxone & Tooth Decay?
PostPosted: Fri Mar 05, 2010 10:28 am 
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Now I know this is a very debatable subject here but because I know at least 4 people personally as well as countless others I have met via the internet, I feel like this is the best place I can share my story as well as get some feedback from any others who may or may not be or have experienced problems w/ their teeth while taking Suboxone.
First, I want everyone reading this to know that it is a fact that almost EVERY narcotic medication can cause “dry mouth”. Dry mouth stops the normal flow of saliva in the mouth. Saliva is one of our biggest natural defense against bacteria in the mouth which is why dry mouth can lead to cavities, infection, cracks, breaks, holes, plaque, biofilm buildup and more. My point is I am NOT trying to deter anyone from taking Suboxone or Methadone or trying to sway anyone into taking one over the other. Rather I am just telling my story that is very similar to many other Suboxone/Methadone users so that we can help each other with advice, remedies, and any other info that might have a positive effect on our lives.
My name is James S. I am 25 years old and I live in Milwaukee, Wisconsin. (hooray for milk & cheese:) About 2 years ago I was prescribed and began taking Suboxone. I was not warned about any long term side effects and the only short term side effects I was warned about was occasional drowsiness. I started out taking 3-8mg tablets (24mg) a day (I am currently down to a half a tablet a day-4mg) Now about a year ago I began to notice that I had a few cavities in my mouth, nothing serious but since I had never had a cavity before and I do NOT have dental insurance, I was a little annoyed. I have always taken very good care of my teeth by eating a healthy diet, little to no soda, brushing, flossing, and using mouthwash. But now that I had these cavities I began to brush, floss, and rinse even more.
Overtime, though I was taking GREAT care of my teeth I noticed a RAPID decline in the health of my teeth. (More cavities, plaque buildup, and even cavities turning into holes) I tried to cut all sugars out of my diet and even went to see the dentist who gave me a cleaning, a list of work that my teeth needed, and an outrageous price it would all co$t, THAT’S IT. I realized then that the only constant in my diet was my Suboxone. I mean I take it orally once or twice a day EVERY DAY under my tongue. I did some research online and found hundreds if not thousands of reports of people all over the world dealing with the same thing- Suboxone/Methadone related tooth decay. When asked, my prescribing Dr. & pharmacist both denied any knowledge of Sub and tooth decay.
So, fast forward to a few months ago when I got my first tooth abscess/infection and had to take antibiotics and get 2 of my teeth pulled. Now I also find out that all the extra brushing and rinsing my mouth out with Listerine could be making my problem worse. Regular toothpaste & Listerine contain alcohol which will make people suffering from medication related dry mouth’s problems worse by drying out your mouth more. Great I thought. Here I went out of my way to brush the HELL out of my teeth an I was just making things worse…Greeeeat.
Today my teeth are still screwed up but now I know more about my problem which I hope will help me. Most people I talk to say “Why don’t you just get off the damn stuff!”, yea if they only knew. Anyone who is on Sub knows just how hard that can be. BUT, and that’s a big but, currently there is no “PROOF” that long-term sub use causes tooth decay. It is even harder to prove sub users that suffer from tooth decay didn’t get their problems from when they were using their drug of choice. That is because narcotic’s of all kind also cause dry mouth and tooth problems. My point is I didn’t even have a CAVITY until a year into taking my suboxone.
If anyone out there is suffering from the same problems It would be cool for you to reply to this post and give any info you can on this subject. Also I will be posting natural inexpensive ways to take care of your teeth as well as the references on where I got the info to back it up. Most people don’t have dental insurance in which case having tooth problems can be a pain in the butt. Thanks’ for reading and I hope to hear from anyone out there that has anything to say whether it is with, or against this.


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PostPosted: Fri Mar 05, 2010 4:51 pm 
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Hey there yeah I'm seeing the same thing. I'm 30 and have never had a cavity until my last check up and I had 4! Everyday I wake up and my teeth hurt a little bit. I am down to .3mgs/day of sub but I still feel like it's having an effect on my teeth. I know that while i was on pills I ate way more sugar and drank more pop and other acidic beverages so that had some effect I'm sure. But I really feel like there is something more going on that hasn't been tested or researched yet. I don't know what we can do about it except get off the damn stuff as your friends say and yeah if they only freaking knew. Someday I will be off it and I hope my teeth hold up till then.


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PostPosted: Fri Mar 05, 2010 5:04 pm 
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I haven't noticed any change in my teeth since starting suboxone 15 months ago.

I do recall reading somewhere that Dr. J said suboxone has not effect on one's teeth. Like you said, it's the dry mouth that does it. His blog entry on that subject is here: http://suboxonetalkzone.com/?p=780.

Oh, maybe that special mouthwash for dry-mouth will help?

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PostPosted: Fri Mar 05, 2010 7:19 pm 
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hawker1 wrote:
Hey there yeah I'm seeing the same thing. I'm 30 and have never had a cavity until my last check up and I had 4! Everyday I wake up and my teeth hurt a little bit. I am down to .3mgs/day of sub but I still feel like it's having an effect on my teeth. I know that while i was on pills I ate way more sugar and drank more pop and other acidic beverages so that had some effect I'm sure. But I really feel like there is something more going on that hasn't been tested or researched yet. I don't know what we can do about it except get off the damn stuff as your friends say and yeah if they only freaking knew. Someday I will be off it and I hope my teeth hold up till then.


Hawker1,

First, thanks for your reply. I only posted that topic this morning and already a reply so again thanks. I have asked my sub doc & pharmacist if they know anything about sub and tooth decay... They both know nothing. I think even though there is no concrete "proof" on the matter it is very seriouse because once your teeth go you never get them back. Not to mention the pain an infected tooth can cause which for us sub users is dangerous obviously because taking pain RX is very risky for us. Personally I think that while sub is a "miracle drug" they should at the very least post a WARNING stating the fact that taking Soboxone can lead to dry mouth which can then lead to problems with your teeth. Personally I know that Sub has led to my teeth problems and I would have at least thought twice before deciding to start my suboxone regiment knowing it had even the slightest risk in tooth decay or "dry mouth".
But you are right I need to just get off the sub since it has been giving me problems. But the major problem is, if your not ready to get off Soboxone, you are faced with Drug Addiction vs. Healthy Teeth...
I will be posting a link to an AMAZING website that gives you advice on how to help remedy tooth problems as well as prevent further damage from happening via vitamins, herbs, organic foods, dieting as well as other stuff that myself and others I have heard from say helps. Thanks Hawker and GL!


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PostPosted: Fri Mar 05, 2010 8:05 pm 
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I have only been on Suboxone for a bit over 8 months, but I have yet to see a difference in my teeth from the Suboxone. I am no doctor or expert, but I did a quick search for side effects of Buprenorphine in Wikipedia and this is what they said....

Quote:
Common adverse drug reactions associated with the use of buprenorphine are similar to those of other opioids and include: nausea and vomiting, drowsiness, dizziness, headache, itch, dry mouth, miosis, orthostatic hypotension, male ejaculatory difficulty, decreased libido, and urinary retention. Constipation and CNS effects are seen less frequently than with morphine.


Click HERE to check it out. Best of luck to you and I hope someone who knows more than I do can help you out. Take Care!

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PostPosted: Fri Mar 05, 2010 9:29 pm 
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I have been on sub for a year, and my teeth are the same as ever. My head's a lot better though.


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PostPosted: Sat Mar 06, 2010 2:48 pm 
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I know just what you are talking about my teeth have gotten really bad 2 of my teeth have holes now my mouth always hurts and my teeth are getting very brittle none of this started until i started taking suboxone

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PostPosted: Sun Mar 07, 2010 1:48 am 
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I'm having some serious dental issues as well. I brush, gargle, and floss right after I eat or drink anything, right after I take the Suboxone, and only use sugarless mints, but the decay continues. My dentist doesn't know I'm on Suboxone, and I'm sure not going to tell him. During my last visit, he was shaking his head - he said, "...it's obvious you're taking care of your teeth, in fact, from what you say, you may brushing too much and removing some of the enamel!" I have to come up with 2k by the end of the month, and he still has more work to do.

Maybe by holding the Sub in my mouth for an hour or so per day is causing my mouth to produce more corrosive acids than it normally would. I just don't know. It could be that I'm just an old broken down wreck who's body is finally revolting from all the abuse heaped upon it after all these years. :)


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PostPosted: Sun Mar 07, 2010 2:15 pm 
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Hi Milwaukee -

I hope you read the replies, and drop us a note.

I've been thinking about this thread for a while, and finally had a few minutes to put my thoughts on the forum.

I'm intending to address anyone *NEW* or a *LURKER/VISITOR* who reads this thread or others similar.

First, let me say the side effects of suboxone exist. I think some people, maybe some reading this now - who are struggling with active addiction, and trying to see what 'may' happen to them if they start suboxone - might get the wrong impression.

I read a lot about suboxone well before I decided to enter a treatment program and face my addiction.

I hope to provide some insights for anyone who reads about side effects, or effects in general from suboxone or buprenorphine.

You (like me) are already engaged in opiates. Without that basic background, you would not be here on the forum (unless you are doing a research project or bored reading forum entries from opiates addicts in recover :) :) )

When we took that step into opiate dependence, regardless if we were tramadol addicts to heroin/IV addicts - we inherited a bunch of side effects. What we tend to do as addicts, though, is NOT to think like that. In active addiction (for 8-9 years in my case) - we simply deny most side effects - because we are addicted - and addicted people need their next fix (or pill in my case) to feel OK.

When we get into treatment, and begin to look at the damage we have done to ourselves, others, financially, legally, relationally, it's quite a wake up call. Again, if you are new(er) here you probably need to understand that buprenorphine treatment (suboxone mainly) is a treatment, but not a cure. We mentally, all want a cure, take this medication for a week, and then everything returns to 'how you were before...." This is simply not the case! Buprenorphine has side effects - every chemical taken into the body does. We all have to keep perspective though. What are we comparing the side effect of buprenorphine/suboxone to? Most of us conveniently skipped worrying too much about taking opiates (over 100mg's a day of oxy in my case) - BUT - now that I'm in recovery on buprenorphine, I'm worried I have a dry mouth, or I have a muscle cramp I didn't seem to have before. Sure I do.... but wondering about that, dealing with that, and really having that make decisions for me needs to be couched in 'compared to what?'.... Here's an example (sarcasm is probably in this) -

'Well, let me see... I can keep chasing tolerance, taking tens of pills every day of oxycodone/percocet - and anything else I can, not worrying about my body hardly at all.... OR.... I could take suboxone - stop the cravings and withdrawal, and deal with irritations that it may bring forward, like a muscle twitch, or sweating easier, or dry mouth. One one hand - I just blindly forge on with my active addicion blindly mentally blocking any side effect, or I could start suboxone and as I get more 'normal' realize I probably had all sorts of other side effects with my opiate drug of choice, but now on suboxone - I finally care."

We are all different this way - but I can tell you this example that I think is more common than not.

"If I were getting a root canal dental procedure done when on active addiction - I DID NOT think - wow, my oxycodone use is probably a contributing factor to my already hereditary bad teeth - guess I'll just quit oxycodones. BUT NOW I am on suboxone, and I'm in the dentist getting a new crown on, and I'm thinking - wow- I wonder if suboxone is making this worse than if I were not on it, maybe I should quit suboxone."

WHAT? I am a strange bird, but I think many of us are like this. As we enter into recovery and feel more normal - we realize the damages we have done, and want to fix them immediately. FORGETTING - how to compare what we are thinking about rationally. Without suboxone for me personally, I'd not be reading about side effects of medications. I could care less. I'd just find more pills, and do whatever it took to keep up the tolerance chase. Ugly.

I hope this makes sense, especially to someone thinking about taking suboxone as a treatment. Yes, there are plenty of side effects you "may" experience on suboxone. BUT, please try and realize that active opiate addiction has TONS of side effects that IMO are worse - but mostly ignored in our lives at that stage of our addiction.

I believe that the evidence is pretty strong in the research field, that buprenorphine has less severe side effects than most of our 'Drugs Of Choice (DOC)" do. No free lunch, but don't let our discussions (valid I might add) about side effects of suboxone stop you from getting help! Suboxone, for the person who want's out of opiate addiction is a GREAT CHOICE. I know it saved me money, marriages, relationships, jobs, self respect, and on - and - on.

The side effects, IMO, are much less harsh than staying the course of full agonist opiates (our DOC).

/end-ramble


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PostPosted: Sun Mar 07, 2010 4:47 pm 
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<b>Lathedude</b> - Very well said! Whatever side effects Suboxone has, or seems to have, it is still much better than having to take any full agonist on a daily basis to stave off withdrawal. It is night and day as far as quality of life, and anyone who is trying to decide whether to continue abusing your drug of choice or to switch over to Suboxone should not be detered by some of these threads.

On the other hand, I don't think there's anything wrong with people who are prescribed medications discussing their side effects, because others may have possible solutions regarding some of these problems.


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PostPosted: Sun Mar 07, 2010 5:45 pm 
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Well said LatheDude.


I know I posted the link for side effects, that said they are compareable to other opiates/opioids, but I am not trying to say that they are the same. Indeed, every single drug has some sort of 'side effect', but for the most part many never experience any side effects (not always the case of course). I was trying to say that yes, buprenorphine is an opioid, a partial agonist not a full agonist, and bupe may have similar side effects as other opioids/opiates. That does not mean that you will have the side effects no matter what. Also, depending on the drug of choice and previous usage, the side effects of bupe (IF ANY) could be a fraction of what we had while in active addiction dowing all types of narcotics....just like if someone was taking 15mg of hydrocodone per day for 2 months and then started on 24mg of suboxone, well the side effects would probably be a bit intensified (in my non-expert opinion). I hope I am making sense, sometimes my thoughts get lost in the keyboard somewhere....

Soooooo, what my rambiling is supposed to be saying is that if you are having addiction problems with opiates and need help and are looking into Suboxone, PLEASE know that for the vast majority of us (me included) it has been an excellent tool for our recovery and my only regret is not starting Suboxone maintainence sooner. I don't have any major/noticeable side effects. In fact, I know my constipation (lovely I know) was really bad when I was in active addiction. Even with drinking a bunch of water and eating lots of fiber I was always clogged up. On Suboxone I am normal in that department. Just like now, I feel normal on Suboxone, not high like when I was on full agonists. I could go on and on and on.... My life has changed for the better just like so many others. Good luck and take care.

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 Post subject: Slippery Slopes...
PostPosted: Mon Mar 08, 2010 10:09 am 
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Hey all,

Like I said this is a VERY slippery slope. There are so many factors here that PROOF is hard to have. BUT like I said in my original post. I AM NOT trying to sway anyone or discourage anyone into any medical direction or against any specific drug. I believe that Sub Saved me from ALOT of potential damage I was causing to myself that went BEYOND teeth. I agree that genetics, diet, habits, smoking, ect ect can also have an adverse effect on a persons teeth and that while on sub these problems can worsen or even just plain pop up.

But my main point in this is to ONE, see if there are others out there that feel that Sub is having a negative effect on their teeth and TWO, if so give/take advice on how to HELP each other with successfull dieting, oral habits, toothpastes, solutions, organics, ect.

I know this thread is VERY new and I would rather not make this be a debate on whether or not sub does really have an adverse effect on ones teeth because that will be "un-fruitful" in my eyes. Dry mouth in itself can cause damage to the teeth and there are 1000's of medications besides Sub that can cause it.

I posted earlier that I will be including a link to a few websites that deal SPECIFICALLY in all natural, at home ways you can remedy tooth pain/damage. I am also currently writing some of my own info I have on what has worked for me and other people I know personally. I will have that up soon. I hope I haven't jumped around to much here I get lost in my keyboard as well... I hope in the future people can say that this helped. I guess we'll have to see...:}

P.S. Thank GOD for this Forum because it has given ME HOPE! I feel better knowing just how many people are going through the same things I am. People on here like "Diary of a Quitter" have given me confidence that I can lower my dosage and make progress. Thank You EVERYONE!!! :)
And that wellness site I was talking about is: paradisenow dot net


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PostPosted: Mon Mar 08, 2010 11:25 am 
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LD -

Wow, great perspective you've given. Thanks for taking the time to put it into words so well. I think the perspective we get from each other is one of the best things about this forum.

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PostPosted: Mon Mar 08, 2010 2:34 pm 
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Hi Everyone,
I have been on Suboxone for 13 months, 16 mgs. a day. I have had NO adverse reaction to my teeth. I do however think this is the right place to share such a problem with others in the addiction community.... I have always had pretty good teeth and that has NOT changed while on Suboxone. I am also a grinder and I am supposed to wear a night guard but can't sleep with it, So it stays on the Night stand?? As usual I just wanted to get my $.02 in :)... I will continue to follow this thread but for now put my check mark in the No Problem Column... LOL Best of luck & continued success in your Recovery...

God Bless
TW


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PostPosted: Mon Sep 12, 2011 10:52 am 
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Hey everyone,
I have been on suboxone now for 21 months. I have problems with my teeth as well but it wasn't until I hit my year mark that I began to notice that something was going on with my teeth. At first it started out as cavities and then I began to notice small holes in some of my teeth and it has progressively gotten worse. My teeth began to chip off in small pieces and now have begun to break off n large pieces, either the whole tooth or half of the tooth. I went to my dentist and he had no knowledge of tooth decay caused by suboxone. He was only able to tell me that most narcotics cause "dry mouth" and that is what leads to tooth decay. So I asked my pharmacist and my prescribing doctor and they too had no knowledge of tooth decay caused by suboxone but only that it can cause dry mouth. So now in my 21 month my teeth are progressively getting worse. Most of the day I am in horrible pain because of my teeth. And like many my dentist says why not just stop taking the suboxone but its not that easy. I started out at 4 8mg a day and now am down to 1 8mg a day. I never had any problems with my teeth until I started taking suboxone. Like many I have no dental insurance and can't afford to have the work done on my teeth that they need (its almost $7000 for the work that my teeth need). I'm not trying to persuade anyone away from taking suboxone because I personally think its a miracle drug because if it weren't for suboxone who knows where I would be right now, I just wish I would have known that there was a chance this could happen to my teeth so I could have been prepared for this. If anyone has any helpful advice on how to slow down the tooth decaying process it would be greatly appreciated! Thanks!!


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PostPosted: Mon Sep 12, 2011 11:00 am 
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amytapper1094 wrote:
Hey everyone,
I have been on suboxone now for 21 months. I have problems with my teeth as well but it wasn't until I hit my year mark that I began to notice that something was going on with my teeth. At first it started out as cavities and then I began to notice small holes in some of my teeth and it has progressively gotten worse. My teeth began to chip off in small pieces and now have begun to break off n large pieces, either the whole tooth or half of the tooth. I went to my dentist and he had no knowledge of tooth decay caused by suboxone. He was only able to tell me that most narcotics cause "dry mouth" and that is what leads to tooth decay. So I asked my pharmacist and my prescribing doctor and they too had no knowledge of tooth decay caused by suboxone but only that it can cause dry mouth. So now in my 21 month my teeth are progressively getting worse. Most of the day I am in horrible pain because of my teeth. And like many my dentist says why not just stop taking the suboxone but its not that easy. I started out at 4 8mg a day and now am down to 1 8mg a day. I never had any problems with my teeth until I started taking suboxone. Like many I have no dental insurance and can't afford to have the work done on my teeth that they need (its almost $7000 for the work that my teeth need). I'm not trying to persuade anyone away from taking suboxone because I personally think its a miracle drug because if it weren't for suboxone who knows where I would be right now, I just wish I would have known that there was a chance this could happen to my teeth so I could have been prepared for this. If anyone has any helpful advice on how to slow down the tooth decaying process it would be greatly appreciated! Thanks!!


I don't know how to slow the decay other than trying to address the dry mouth. There must be some way to do that....

I've always had remarkably resilient teeth and thought I was immune to cavities. Not so. However, I have a different theory on this and perhaps it goes hand-in-hand with the dry mouth. I had an insane Sub sweet tooth up until recently. Once comfortable on Sub, I started eating something sugary every dang night, normally ice cream. I'd like to say I always brushed my teeth, because I did. However, I sometimes brushed and then ate ice cream and went to bed, lol. I was shocked to go to the dentist and find out I had four huge cavities and needed oral surgery. Blech. It was expensive as hell too. I think we all need to make sure we are making our dental visits every six months, because I didn't always do that. I'm not sure whether Sub causes tooth problems or not, but it's better to be careful and have yourself checked out.

laddertipper

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PostPosted: Mon Sep 12, 2011 12:24 pm 
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There's a line of products called Biotene that are over-the-counter to treat dry mouth. They have a few different products. You can get them in your local drugstore (Walgreens, CVS, Rite-Aid, etc). My husband has bad dry mouth from some of his meds and he is pleased with the Biotene products.

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 Post subject: me too.
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i have been on the strips for 2 months and i noticed my teeth hurting and so sensitive that i cannot eat anything remotely cold or anything sweet like candy and i did not have this problem before i started taking the sub oxone. and it cant be from my drug of choice cause i had an almost 2 years of sobriety with using aa and na but relapsed for a couple weeks then started suboxone about 2 or so months ago. it helps me alot and i would never say for someone not to take it because of this. im happy im not crazy though its good to here im not alone in this not that i wish this pain on ne 1. thank you guys.


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PostPosted: Sat Jan 14, 2012 4:20 am 
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Some people are more prone to dry mouth from medications than others. Lots of medications can cause dry mouth too - anti-depressants, anti-psychotics, opioids, clonidine. The doctor advised me when I went on methadone that if I got a dry mouth, to chew gum, as it stimulates saliva flow. Maybe that would be worth a try.

I've been on methadone & Suboxone and heroin and speed over the years, and my teeth are fine. But my mouth doesn't get dry very easily.

If tooth decay is a problem from being on Suboxone, maybe weigh up whether staying on Suboxone is worth losing your teeth, and what (if any) other options you may have.


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PostPosted: Sat Jan 14, 2012 8:10 am 
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This is from Dr. Junig's Suboxone/Bupe guide (the guide he used to sell that he gave us all access to for free):

Quote:
For example, one person asked if Suboxone can rot your teeth. I have seen no evidence to that effect, but from a theoretical perspective any medication that causes a decrease in saliva can potentially increase tooth decay, so if opiates including buprenorphine cause you to have a dry mouth, there could be a connection.


Again, opiates along with a lot of other medications can cause dry mouth. I'm guessing since you're on suboxone, you have a long history of using other opiates - those could have-over time-done way more damage to you via a dry mouth than the suboxone has had time to do yet.

See my post above about the Biotene products to help with dry mouth. And remember, even with meds causing a dry mouth, it takes YEARS for one's teeth to show any damage.

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-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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