Bupe Help! I think Suboxone is rotting my teeth!

[tremours]

if you want to call weed a drug, than pretty much anything you injest is a drug, like soda, coffee, food. they all contain drugs who gives a fuck, everyone takes drugs to some extent

 

[Bluntsandingers]

most people with opiate/methadone/suboxone problems have dental hygeine problems because they are lazy. perhaps you should brush two-three times a day and buy a expensive and well reviewed toothpaste.

 

[i are spectre]

key is floss, mouthwash, then brush. in that order. dont eat or drink anything for at least 15 minutes after you have brushed.

you want the toothpaste to remain on your teeth for as long as possible.

 

[StAy HiGh]

most people with opiate/methadone/suboxone problems have dental hygeine problems because they are lazy. perhaps you should brush two-three times a day and buy a expensive and well reviewed toothpaste.

No one likes a troll. If you read my original post thoroughly, you wouldn't have made such an ignorant comment. If you judge people suffering from addiction, get off bluelight !

 

[StAy HiGh]

SwimmingDancer- THANK YOU! thank you for agreeing about the dumb comment made by my doctor and thank you for sharing your personal experience. I hope I caught it in time! I am sooo soo scared i could cry. Cant focus on anything Im just stressing about my teeth and wtf im going to do. What type of subs would be "sugar free" lol subutex? I am down to 12mg so I still will probably be on subs until the early winter i think (at the latest I hope). I am sorry you had to suffer through this same ordeal. If it is doing this to my teeth, i cant imagine the damage it must have done to my bones and body overall. I do feel some joint stiffness (only in early 20s) but I hope its not permanent.

Insane that the medicine im using to get off drugs is causing more damage (to my body) than the drug that I was actually on.

Maybe I should buy like a mouth gaurd and wear it while i take my medicine lmao ya never kno

 

[StAy HiGh]

Just to add, as mentioned, I brush 3x a day and floss at night. I have only had ONE cavity in my entire life. My diet has not changed, if anything I eat less sugar now (since Im not junky skinny anymore lol) so I am pretty positive the tooth decay (omfg) is coming from the suboxone directly. This is not listed as a side effect on the suboxone website or pamphlet etc but not enough research or studies have been done about this drug and IMO its irresponsible of the manufacturers to distribute it w.o warning people of the side effects. I digress, just a quick reply to say I DO take very good care of my teeth and that I am 99.9% the medicine is to blame

anyone else experience this? cant wait for my dentist appointment, ill feel a weight lifted at least knowing whats going on.

 

[axe battler]

weed is a drug. it pisses me off too when people say that, but some of my best friends do so i've learned to live with it.

good luck with your teeth! and, as someone else said, don't stress! try and get a preparation that's as small as poss.

AND YOU CAN PLUG SUBOXONE! the naxalone has no effect at all to the effects! you can shoot it too, but dont do that for obvious reasons.

 

[thelastclubkid]

methadone/suboxone does not damage your bones so you dont have to worry about that but there is a correlation between opoid use and tooth problems but its not as simple as the reasons that have been laid out...

its a combination of a number of factors:

1. opoid users neglect their health.. typically many opoid users havent been to the dentist in a while
2. any long term opoid use has the side effect of causing chronic pain relief.. often this manifests as you not feeling tooth pain until the nerve has been well compromised by decay...
3. opoids (methadone in particular) is known to cause sugar cravings... i was on MM for years and while i stayed drug free, i did get kinda fat as a result (thankfully my ED put a stop to that...)
4. methadone has not been proven AFAIK to increase acidity (at least not in the same way smoking meth does) but it does cause metabolism to slow and one of the effects that has been reported is decreased saliva production which in turn allow the bacteria to proliferate..

now on to the dentist stuff... first you dont need to tell your dentist that you used or about the suboxone.. all that does is keep them from giving you proper medication when you *actually* need it... secondly get to the dentist sooner rather than later... even with *alot* of decay most teeth can be saved... its expensive either way but like anything else, some dentists try to sell you alot more work that you really need: your choices are going to be as follows depending on how bad the decay is: you will likely need root canal work: when the decay gets bad your choice is get a root canal and then have a crown eventually put on the tooth or get the tooth pulled and then get an implant... canal/crown is preferable because even though implants are getting better (and cheaper) they are still basically a ceramic tooth thats secured to a post that has been drilled into your jaw or skull; sometimes the post comes loose and the tooth spins and stuff... with canal/crown the worst outcome is the underlying tooth breaks again or the crown comes off but this happens rarely.. also you dont have to go around a month or two without a tooth in the spot while you wait for the post/gum to heal up... implants cost like 2-3K each while canal crown is like 1200-2000...

at any rate start planning and saving... i know it sucks but if you catch it now you'll be better off... ive had root canals done on every molar in my mouth but 2 but i still have all my original teeth except for one (it cracked at the base so thats getting an implant)...

 

[Swimmingdancer]

methadone/suboxone does not damage your bones

I think that it does:

Study conclusions: We found that more than three quarters of Methadone Maintenance Therapy patients had abnormally low bone density. http://www.cof.org.cn/pdf/2006/11/Low bone density in patients receiving methadone.pdf

Prescription opioid users had reduced total hip bone density (BMD) compared with nonusers in the third National Health and Nutrition Examination Survey, with a trend toward longer term prescription opioid users having lower BMD than shorter term users. A cross-sectional study in a methadone maintenance treatment program found that more than three quarters of the patients met the WHO criteria for osteoporosis or osteopenia despite a median age of only 42 years, including an unexpectedly high proportion of the men studied having osteopenia and osteoporosis. Opioids may contribute to lowered BMD by directly interfering with bone formation. Studies have documented large concentrations of opioid receptors in osteoblasts; inhibition of the growth of human osteoblast tissue cultures by small concentrations of opioids; lowered serum levels of bone formation markers; and inhibition of osteocalcin production by morphine in osteoblast tissue cultures. An effect of opioids on calcium-regulating hormones has also been reported, in addition to other mechanisms relating to altered bone metabolism. Another study found a reduction in lumbar BMD in opioid users, lower levels of parathyroid hormone, LH, and testosterone.

Study conclusions: Methadone use was associated with BMD decline, and should be considered when evaluating women for osteoporosis risk. http://www.sciencedirect.com/science/article/pii/S0378512211002945

83% of patients in a MMT program had low BMD. Efforts to increase awareness of low BMD in MMT patients should be considered so that effective treatment may be employed to lower future fracture risk. http://www.sciencedirect.com/science/article/pii/S0376871606002213

Edit: Note that these studies were all about either methadone or opioids in general. It is believed that the naloxone in Suboxone might help mitigate some of the of the bone damage. I think more studies are definitely needed as patients are not being warned of this and are in fact are instead being told that they only imagine their bones are being damaged because opioid withdrawal causes bone aches.

 

[Swimmingdancer]

there is a correlation between opoid use and tooth problems but its not as simple as the reasons that have been laid out...

Did you read my posts? I said almost the same thing as you, that it was due to a number of factors. The only ones I left out were the assumption that maintenance opioid users do not have good dental hygiene, as that is only an assumption and varies greatly from person to person, and that opioids make you not feel the pain as much and therefore not notice until the decay is severe, as that is not a cause of decay (and is not what is going on in the OP), plus tooth decay doesn't hurt anyone until it affects the pulp (nerves) anyway. Personally I don't find methadone in stable long-term maintenance doses (aside from the first month or 2) to be an effective painkiller in the least. If one was going to blame it on not feeling the pain and therefore not noticing the decay until it's too late I would find it more likely that it could be that while people are using heroin it is masking the pain and when they switch to methadone or bupe they start feeling the pain.

Not trying to sound argumentative, just felt as if you were "correcting" me so I wanted to explain

 

[opiatekrzy]

my doctor said the "acids: in the suboxone can damage ur teeth as u taking it sublingually and it saturates ur mouth on a daily basis

 

[HYDRO_CHRONIC]

ive never heard of opiates rotting your teeth,i abused the fuck out of methadone for a good while and while my teeth arent great ,i would never blame the drugs for how they are

 

[thisisabsurd]

I'm not a doctor but I do have some knowledge based on my own research...
Opiates suppress the body (and mind), can include everything from your breathing to digestion and that includes activity in the brain centers responsible for digestion (namely salivation and intestinal peristalsis). This equals the dreaded dry mouth we all know very well!
Have you ever tried Biotene products? They can be pricey but they have a whole line of products for dry mouth that might help. I have seen them help patients who suffer from dry mouth for reasons other than opiates. Now that I think about it, there just might be some less expensive alternatives to the Biotene line since it is such an up and coming market (read: profitable!). Congrats on your sobriety and keep at it. Stay well-hydrated and take your vitamins.

 

[thisisabsurd]

Oops, didn't finish my thought (sorry, haven't had my meds in a few days) 8(

Dry mouth leads to tooth decay because of the decreased saliva (which I think has some antimicrobial properties that literally create a "wash" for your teeth and gums?). So yeah, try to treat the dry mouth and you could lessen your chance of having tooth issues. I don't think the subs or any other opiate have any compounds in them that cause tooth decay directly, but I might be wrong.

 

[thisisabsurd]

Swimmingdancer:
Damn, I just saw your post with all of the studies on methadone/opiates. Had no idea that it can affect bone density. I'm really gonna have to rethink my pain management regimen.

 

[opiatekrzy]

my suboxone doctor may be wrong, according to him the "acids" in the suboxone cause damage to your teeth from daily sublingual use. idk if its true

 

[thelastclubkid]

Did you read my posts? I said almost the same thing as you, that it was due to a number of factors. The only ones I left out were the assumption that maintenance opioid users do not have good dental hygiene, as that is only an assumption and varies greatly from person to person, and that opioids make you not feel the pain as much and therefore not notice until the decay is severe, as that is not a cause of decay (and is not what is going on in the OP), plus tooth decay doesn't hurt anyone until it affects the pulp (nerves) anyway. Personally I don't find methadone in stable long-term maintenance doses (aside from the first month or 2) to be an effective painkiller in the least. If one was going to blame it on not feeling the pain and therefore not noticing the decay until it's too late I would find it more likely that it could be that while people are using heroin it is masking the pain and when they switch to methadone or bupe they start feeling the pain.

Not trying to sound argumentative, just felt as if you were "correcting" me so I wanted to explain

sorry about that... i wasnt trying to correct you.. i actually missed your post on that... as far as the pain perception i can attest that i have seen a number of people who were on higher doses of methadone (80mg and up) and when they started to decrease they started feeling pain in places that they never did before but no WD symptoms... my GF in particular has back problems (herniated disc) and never had any pain when she was above 120mg but now that she is at 65mg it is a constant issue... when doctors discuss this the magic number ssems to be the same as the blocking dose.. e.g 80 mg but i have noticed pain reduction at even lower doses; it wasnt until i was below 30-35mg that i started noticing little pains here and there from daily life... this is a similar experience with my teeth... all while i was on methadone i had a number of teeth where the nerve was fully compromised and i never felt a thing... when the dentists looked at it they said something to the effect of "we dont know how you havent felt pain from this..."

the bone density study is interesting... i had never heard about that before.. thx for the info... i wonder how much of the bone density reduction can be attributed to inactivity.. e.g. it is well understood that people on long term MMT tend to be less physically active overall... that in itself will cause lower bone density.. i see they have outlined a number of possible mechanisms that can cause this from a physiological standpoint.. i want to see if any hard evidence is there to confirm any of these...

 

[ReversiblePulpitis]

As a Dental student about to graduate and as the son of a Dentist, the misinformation that exists about oral health, specifically tooth decay in a opiate user, blows me away. I'm not calling anyone ignorant, but there is an obvious lack of public education in this area. Someone above did a good job of nailing the high points of the conditions most likely contributory to greater incidence of decay in a user, but to reiterate the main problem coincident with opiate use is solely xerostomia or dry mouth. Even that varies from person to person with or without opiates, and even then it's a condition that can be easily overcome with proper preventative measures. This mostly includes brushing consistently 2-3x a day as well as flossing. with that said, the main idea is to keep sugar and acid from soaking into your teeth for the least amount of time as possible. Acid demineralizes teeth on the short term, which makes them susceptible to bacterial attack and stain accumulation. If this occurs frequently enough, it can lead to long term demineralization which in turn makes the susceptibility to bacterial attack or decay and stain accumulation that much easier. even swishing with water or running a brush even without toothpaste over your teeth after sugar or acid intake is enough to help intervene in the process of decay as again, the point is to intervene when acid or sugar has come in contact with your teeth. Sugar is the substrate or food for the bad bacteria which cause decay, and these bacteria thrive in acidic environment. So, combine acid and sugar like with soda, and the perfect storm is created... The enamel is softened, and food is provided to bacteria to eat away at the softened enamel.
bone density and bone loss in an adult are NOT related to a loss of tooth structure. Not only are the components of teeth NOT formed by osteoblasts (try ameloblasts for enamel for example), but tooth formation is completed n early childhood, which is why you receive flourish treatments only as a child on a regular basis... Which is to provide fluoride to the enamel matrix while it's still in development or mineralization. Things that cause bone loss do not cause tooth structure loss in adults. And that's that.
Methadone is on par with any other opiate with its potential for harm to the teeth, which is again revolved around xerostomia and nothing else. It does not cause greater saliva acidity.
The saliva not only physically washes the teeth, but it's a ph buffer, acting to neutralize acid. It also contains elements of our innate immune system, immunoglobulin that activates the immune system as well as good bacteria that inhibit the formation of bad bacteria. There are numerous kinds of this bad bacteria, different kinds for different types of cavities, as well as the bacteria that causes the formation of plaque and subsequently tartar, and subsequently periodontal disease which is a different bear in itself. Naturally, some folks don't provide adequate good bacteria or even the proper immune response. These are the folks who battle tooth decay and perio disease despite their efforts otherwise.
It's generally a combination of things that allows the perception that there is a greater incidence of tooth decay in say methadone patients. For one, they dose everyday so there is a guaranteed constant bombardment of xerostomia. Preparations with sugar don't help, but the amount is so little that to blame it on the sugar preps is a little naive. Sugar cravings, smoking, poor diet, poor hygiene, lack of dental visits, and xerostomia.... Those are the culprits involved with opiate use.

To the OP ... What you describe sounds like calculus to me. This is mineralized plaque, and forms most frequently on lower anterior or front teeth, and generally in between them. It can easily accumulate stain. Calculus can only be removed by a dentist, so if you haven't had a cleaning in awhile... Tis is most likely what you are seeing. So, go get your teeth cleaned!

Edit: the same goes for suboxone use. There is no mechanism of the drug or delivery system that causes tooth decay... Refer to above. Sugar found in delivery system is trivial, but if you dose with it regularly, then it's worth your effort to take a brush to your teeth after its dissolved. If its inconvenient to brush (remember even without dentifrice aka toothpaste is fine, as the goal is to disrupt bacterial attachment) at random times after you dose or eat/drink sugar or acid, then do those things only at times when it is convenient to brush right afterward.

And before someone even thinks it, no brushing after acid intake is not harmful to your teeth. I've heard people laughably think that brushing after acid can cause you to physically remove enamel. Not true. Brushing after acid has softened enamel is the most ideal time to brush, as it will aid in more quickly remineralizing enamel and neutralizing ph.

 

[ReversiblePulpitis]

Consider the consultation free of charge. I'll tack it on to the 200,000$ in tuition that I've paid... Let's not talk about what that'll turn into after interest is paid over the next ten years.

 

[Swimmingdancer]

sorry about that... i wasnt trying to correct you.. i actually missed your post on that... as far as the pain perception i can attest that i have seen a number of people who were on higher doses of methadone (80mg and up) and when they started to decrease they started feeling pain in places that they never did before but no WD symptoms...

Yeah, that's true, I should have said in low stable maintenance doses - for people who are on higher doses or haven't been on methadone for a long time there is usually greater analgesia. Where I live it is rare for people to be on high doses and maybe I'm a little sensitive because I have chronic pain and people are always assuming methadone maintenance is an effective analgesic and I shouldn't need any other painkillers

the bone density study is interesting... i had never heard about that before.. thx for the info... i wonder how much of the bone density reduction can be attributed to inactivity.. e.g. it is well understood that people on long term MMT tend to be less physically active overall... that in itself will cause lower bone density.. i see they have outlined a number of possible mechanisms that can cause this from a physiological standpoint.. i want to see if any hard evidence is there to confirm any of these...

Yeah, there are increased risk factors such as lack of exercise, higher incidence of smoking and, in some, lacking nutrition, in MMT patients, so it's hard to determine exactly what portion of the decrease in bone density is caused solely by the methadone, but the incidence of abnormally low bone density does seem to be much higher than it normally is in people with the same risk factors who aren't on methadone. I think it's hard to get research done on this because methadone is such a big business and no one wants to believe it could be damaging. I would really like to see more research being done on this. I have definitely experienced problems with my bones that are abnormal for someone my age. I think that if people were aware about this issue then maybe the problem could be partially mitigated by taking supplements of vitamin D and calcium - if more doctors knew that opioids caused bone loss and prescribed supplements along with strongly recommending people quit smoking, exercise more, get treatment for hormonal imbalances and not take any other medications that cause bone loss then perhaps that could make a big difference.

I can look for more studies if people are interested.

bone density and bone loss in an adult are NOT related to a loss of tooth structure.

No one said they were related. I was just posting that info in response to someone who said opioids don't affect your bones.

Methadone is on par with any other opiate with its potential for harm to the teeth, which is again revolved around xerostomia and nothing else. It does not cause greater saliva acidity.
The saliva not only physically washes the teeth, but it's a ph buffer, acting to neutralize acid.

But wouldn't having less saliva be less alkalinizing, therefore increasing acidity? Also Suboxone contains sugars and acids as inactive ingredients, both of which, as you said contribute to tooth decay. Those sugars/acids are sitting in their mouth for a long period of time and it is interesting that the OP said their decay corresponded with the place that the Suboxone sits in their mouth and that they don't eat much sugar otherwise. I assume it would greatly help to floss, brush and mouthwash right after taking the Suboxone, right? Do you have a particular mouthwash you recommend? Do you think things like rinsing the mouth after eating and chewing gum with xylitol instead of sugar would be helpful?