If you have searched for “Suboxone teeth,” you have probably found some alarming stories. Tooth decay. Broken teeth. Dental infections. In some cases, people describe extensive dental work after starting buprenorphine.
The concern is real. The FDA has warned about dental problems associated with buprenorphine medicines that dissolve in the mouth, including Suboxone, but the warning does not mean that everyone taking Suboxone will develop dental problems or that you should stop treatment on your own.
What the FDA warning about Suboxone teeth actually says
The warning is real
In January 2022, the FDA added a warning about dental problems to the prescribing information for buprenorphine medicines that dissolve under the tongue or against the inside of the cheek, including Suboxone.
The reported problems include cavities, tooth decay, oral infections, tooth erosion, fractures, and tooth loss, and some cases involved people who had no previous history of dental problems. The FDA reviewed 305 reported cases at the time, including 131 that were classified as serious.
That sounds frightening. There is an important distinction, though: these were reported cases, not proof that Suboxone directly caused every dental problem that was reported.
The FDA's position is also clear that buprenorphine remains an important treatment for opioid use disorder and that its benefits outweigh these risks. The agency recommends taking steps to protect your teeth rather than abruptly stopping treatment.
It does not mean you should stop Suboxone
Stopping suddenly can create its own problems. Withdrawal, cravings, and a return to opioid use can increase the risk of serious harm, including overdose.
So do not make a medication change based on a frightening headline or an internet post. Talk with your prescriber first, particularly if Suboxone has helped stabilize your opioid use.
Why can Suboxone affect dental health?
What happens when buprenorphine dissolves in the mouth
Suboxone is taken in the mouth, where the medication dissolves and buprenorphine is absorbed through the oral tissues.
The FDA has suggested that exposure to the medication in the mouth, along with changes in the oral environment, may contribute to dental problems, although the exact mechanism is not completely established. Dry mouth can also increase the risk of cavities because saliva plays an important role in protecting teeth.
The issue is therefore not simply that Suboxone is an opioid medication. The concern is particularly associated with buprenorphine formulations that dissolve in the mouth.
The risk is specific to certain formulations
This distinction matters. The FDA warning concerns transmucosal buprenorphine, meaning formulations placed under the tongue or against the cheek.
The FDA has not identified the same dental concern with buprenorphine delivered through other routes, such as injections or skin patches.
For someone taking Suboxone, that means oral care deserves attention. It does not mean the medication itself is inherently unsafe.
What dental problems have been reported?
Cavities and tooth decay
Tooth decay is one of the primary concerns behind the FDA warning.
Some reported patients developed extensive decay, sometimes affecting several teeth. The FDA reported that dental problems could appear relatively early in some cases, while other cases were identified much later after treatment had begun.
That variation matters. There is no single timeline that tells you when dental problems will occur, or whether they will occur at all.
If you notice new sensitivity, pain, discoloration, changes around your gums, or a tooth that feels different, do not wait for the problem to become severe before having it checked.
Infections, erosion, and tooth loss
The reports reviewed by the FDA were not limited to cavities. They included oral infections, tooth erosion, broken or damaged teeth, and cases involving tooth extraction.
Some patients required significant dental treatment, including root canals, crowns, implants, or removal of teeth.
That is why dental prevention belongs in the conversation about long-term Suboxone treatment. A few simple habits can give you another layer of protection.
How much should you worry about Suboxone dental problems?
What newer research tells us
The evidence has continued to develop since the original FDA warning.
A large 2025 retrospective cohort study published in JAMA Network Open included more than 721,000 adults with opioid use disorder and found that people prescribed transmucosal buprenorphine had a modestly higher adjusted risk of newly diagnosed oral health problems than matched controls. The researchers emphasized that the findings support further research and patient counseling, not avoidance of an evidence-based OUD treatment.
Another recent retrospective study found a higher rate of dental adverse events among oral buprenorphine users than controls, although the absolute difference was relatively small: 2.17% compared with 1.66% over the study's follow-up period.
Those findings are useful. They also have limits.
Observational studies can identify an association, but they cannot establish that buprenorphine was the sole cause of every dental problem. People with opioid use disorder may also have other factors affecting oral health, including previous dental disease, nutrition, smoking, dry mouth, access to dental care, and other medications.
Why the research does not mean everyone taking Suboxone will have dental problems
Risk is not certainty.
Some people take Suboxone for years without developing significant dental problems, while others may be more vulnerable because of their existing oral health or other risk factors.
The practical response is not panic. It is prevention.
How to protect your teeth while taking Suboxone
Rinse after the medication dissolves
The FDA recommends an easy step after the medication has completely dissolved: take a large sip of water, gently swish it around your teeth and gums, and swallow.
Do not rinse aggressively. The goal is to help clear medication residue from your mouth after the dose has dissolved.
Wait before brushing
There is another detail people often miss.
The FDA recommends waiting at least one hour after the medicine has dissolved before brushing your teeth. This gives the mouth time to return toward its normal state and may reduce the possibility of mechanical damage from brushing immediately after the medication.
Follow your prescriber's and dentist's instructions if they differ based on your individual circumstances.
Keep regular dental appointments
If you take Suboxone, tell your dentist.
That information can help your dentist assess your individual risk and create a prevention plan. The FDA recommends a dental evaluation soon after starting transmucosal buprenorphine and regular dental checkups while taking it.
This is especially useful if you already have cavities, gum disease, sensitive teeth, or another oral health concern.
Should you stop Suboxone because of dental concerns?
Talk with your prescriber first
If your teeth are changing, your gums hurt, or your dentist has raised concerns about your medication, bring that information to the physician managing your Suboxone treatment.
Do not stop abruptly. The FDA specifically advises patients not to suddenly discontinue buprenorphine because withdrawal and a return to opioid misuse can carry serious risks.
There may be ways to address the dental concern while continuing appropriate treatment for opioid use disorder. That conversation should be individualized.
Treat the dental risk without abandoning OUD treatment
Suboxone can play an important role in reducing opioid cravings and withdrawal, and treatment should account for the full picture of your health.
At Addiction TeleMD, whole-person care includes concerns that can accompany opioid use disorder, including chronic pain, sleep problems, anxiety, and depression. Dental health deserves the same kind of attention when it becomes part of the treatment picture.
If you want to understand what to expect when beginning treatment, Addiction TeleMD's guide to your first Suboxone telehealth visit explains how the initial appointment and treatment process work.
A dental warning should not become a treatment warning
Getting help with Suboxone treatment
The FDA warning about Suboxone teeth is worth taking seriously. It is also worth putting into context.
Protect your teeth. Keep your dental appointments. Tell both your dentist and your Suboxone prescriber about changes in your oral health. Most importantly, do not make a sudden medication decision because you are frightened by what you read online.
If you are considering Suboxone treatment or have concerns about your current medication, you can contact Addiction TeleMD to discuss your situation with Dr. Kevin Passer and determine what next steps may be appropriate.
One conversation is enough to start. You do not have to figure out the entire treatment plan before reaching out.
