From the Research
Suboxone films are the preferred formulation for patients with opioid dependence due to their potential lower risk of dental decay compared to tablets, as they dissolve more quickly and have a lower acidity level. When considering the impact of Suboxone on dental health, it's essential to note that both tablets and films contain the same active ingredients (buprenorphine and naloxone) and are equally effective for treating opioid dependence. However, Suboxone films may be less damaging to teeth than tablets because they dissolve more quickly and don't require crushing or extensive contact with teeth. The tablets are more acidic (pH around 3.4-4.2) compared to films, and this acidity can erode tooth enamel over time, especially when the medication is held in the mouth for extended periods 1. To minimize dental decay risk with either formulation, patients should rinse their mouth with water after the medication has fully dissolved, avoid brushing teeth immediately after taking Suboxone (wait at least 30 minutes), maintain good oral hygiene with regular brushing and flossing, stay hydrated to prevent dry mouth, and see a dentist regularly 1. A recent study published in the Journal of the American Dental Association (2024) highlights the importance of dental care professionals being aware of the oral effects of buprenorphine and taking steps to prevent dental issues in patients taking this medication 1. Another study published in Expert Opinion on Drug Safety (2023) found that sublingual/buccal buprenorphine was associated with an overreporting of dental problems compared to other buprenorphine formulations and methadone 2. While the study from the Journal of Substance Abuse Treatment (2018) compared the abuse prevalence and route-of-administration profiles of sublingual buprenorphine/naloxone combination film and tablet, it did not provide conclusive evidence on the dental decay risk associated with each formulation 3. Therefore, based on the most recent and highest-quality evidence, Suboxone films are the preferred formulation for patients with opioid dependence due to their potential lower risk of dental decay compared to tablets. Some key points to consider when prescribing Suboxone include:
- Instructing patients on how to prevent dental issues by rinsing with water and swallowing once the drug has been completely dissolved, followed by toothbrushing at least 1 hour after taking the drug 1
- Prescribing a fluoride supplement to help prevent dental decay 1
- Encouraging patients to maintain good oral hygiene and see a dentist regularly 1
- Being aware of the potential for dental problems and taking steps to prevent them, especially in long-term Suboxone users 1, 2