is anyone else who is taking Temgesic suffering with teeth and gum problems? I have been on Temgesic about 7 months now, but my gums are already very sore especially at the base of my back teeth. Is there anything I can do about it while I wait for a dental appt.?
I rinse my mouth first with water then with medicated mouthwash after taking tablet, anything else? . I feel at the moment I shall never lick all the problems associated with RLS. Thank you in advance to all who are kind enough to answer.
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bedith6
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Dear Bedith6 - I have been thinking about you recently and wondering how you are getting along. Apart from the sore gums are you getting help from the Temgesic? I was taking up to 700 (sometimes 800) mcg. daily in divided doses. I could not take it all during the evening as some are able to do. If I did then the next morning I was straight into withdrawal symptoms and Professor Walker told me to spread it throughout the day. The downside of that is that you have the acid in your mouth four times daily!
For the last few weeks I have become increasingly hoarse with slight difficulty swallowing something dry. I am awaiting investigation of this but my GP hopes it is not too serious and I feel it is from the Temgesic. My mouth is dry all the time, day and night, and although I use various potions for this the effect is only temporary.
Anyhow I did not want increase the dosage any further and was still having breakthrough RLS so I decided (rightly or wrongly) to go back on to oxycodone as Longtec 20 mg. twice daily. Professor Walker said if I could not stand the temgesic then I could try back on oxycodone again. It will at least be easier to take and no tooth or mouth worries. My GP is getting me to change very slowly between the two. Unfortunately buprenorphine is stronger and if I make a direct change I will get severe withdrawal, so I am easing down on BUP whilst reintroducing oxycodone. It will take perhaps a few weeks or so - I do not really know but I shall keep plodding on.
One of the others on the site with whom I correspond is having lots of little blisters in her mouth and again thinks it is the side effect of Temgesic.
Another point is that I remember you feeling very depressed and that is how Temgesic made me feel. I have been over two years on buprenorphine - first patches and then sublingual tablets and all during that time I have suffered depression and anxiety. I was always a happy person and hate how I am now. Dr. Buchfuhrer told me that Temgesic was not for everyone and some people did suffer from depression with it.
I am so glad for those people for whom it works. I thought it was going to be great for me and could not wait to start it. It sounded the perfect answer to a horrible ailment.
Anyhow this has become quite a dissertation so I will finish now. Do let me know how things are going and even private message me if you like. Good Wishes.
I saw Prof Walker for the first time earlier this week. What a wonderful, kind and knowledgeable man. In amongst the treatment plan he set out for me he said he wouldn’t recommend Temgesic now because, though there is no doubt it works for RLS there are now emerging lots of reports about teeth & mouth problems in those taking it. He advised if needed one an alternative opiate in form of Targinact ( also contains Naloxone ), saying it is the only one with an actual licence for RLS so hopefully easier to get a prescription though it is expensive -however it is looking like the folk that ok the cost effectiveness etc of medicines have not accepted its use in Scotland where I live.
It's not just Scotland: some NHS authorities in England are also refusing to prescribe Targinact because it's considered to be less suitable for prescribing due to higher cost and "lack of evidence to suggest oxycodone plus naloxone has any clinical advantages over oxycodone or morphine sulfate plus laxative"
Hello Bedith and all the other responders. Jelbea here again. I am transferring on to Longtec which is just oxycodone without naloxone. It is cheaper. Professor Walker wanted me to take Targinact as he said the naloxone helped counteract constipation. However, I had a short trial on this and did not find any difference to taking Longtec. I was on Longtec for two years but two years ago my GP would notme allow 20 mg daily and I was on an uneven dosage of 15 mg which I either took as 3 x 5 mg doses or one 5 mg and one 10 mg. dose daily. I was changed to buprenorphine patches at that time. My GP now is allowing me 20 mg. daily in two doses of Longtec.
I agree that buprenorphine certainly seems to be causing some people trouble with mouth and teeth and certainly I always got break-through RLS.
I do not know how I will fare when my complete changeover to Longtec is finished but shall keep my fingers crossed.
(Ps I did not think the naloxone agreed with me and prefer not to take it as it is just another drug to be avoided if possible).
Hello Jelbea. Thank you for your reply and helpful information. I’m in such a dilemma now I don’t know which way to turn. Except for first thing in the morning my mouth isn’t particularly dry and it’s always been dry in the morning because I know I sleep with my mouth open. However my teeth now feel very “chalky” which must mean the enamel is being eroded and of course this is very worrying . I am going to try to speak to Dr.Bagery, but I know this will be difficult as he is so busy. Unless he has any suggestions what do I ask to try, I’ve tried so many meds and all have failed one way or another and I am getting tired of the struggle. For now I have registered with a dentist and hope for an appointment soon, maybe he has some helpful suggestions.
In the meantime I hope you have some success with Longtec, please let us know how you get on with it. Best Wishes.
Hello bedith6 - One thing you did not say in your original post is how you are faring on the Temgesic. Is it covering your restless legs and are you getting more sleep? I suppose this is the type of thing you need to discuss with Dr. Bagery. I do hope you can get speaking to him soon and that your appointment with the dentist is also very soon.
I will let you know how Longtec goes although it will probably be a few weeks as my GP wants me to go slowly with the changeover. I am not overly happy about it but I have nowhere else to go with this awful RLS. Good Wishes to you and let us know the outcome of your talk with the doctor.
Hello Jelbea. I think I am faring much like you. The Temgesic has never covered my symptoms 100%. I get breakthroughs all the time, sometimes during the day and always at night so that although the RLS is better than it was I still have quite disturbed nights and still can’t always watch tv or read for long. I think I should be on a higher dose but Dr Bagary says no higher and now that I am aware of the problem with teeth and gums I am reluctant myself to take any more. I feel I will never achieve any peace in my lifetime because even if I get to speak to Dr Bagary I don’t know what to ask him for any more. Any suggestions? Thank you for your helpful replies. Good wishes
Hi. I feel you, as I have the option of using BUP for RLS but right now I am choosing to use kratom. This whole teeth thing is just awful...as if things aren't tough enough for all of us, I can't imagine my teeth crumbling or falling out!
I feel your despondency and just wanted to mention that you could use red vein kratom as a backup yourself. It will stop the rls and allow you to get that sleep and watch tv. kraatje.eu
I have to say I’m a bit worried about taking something like Kratom. It is illegal in the UK where I live. If I did decide to take it do you know if the Capsules are as beneficial?
Yes, they are-they just take a bit longer to work. I use both. You can order it as tea from that website; I know it is illegal there and that is why I gave you that netherlands website (thanks to Joolsg). I can't imagine getting caught in your own home and with such a small amount of kratom but I guess you aren't desperate enough. Which is good.
Hello again - I am so sorry to hear that you are having so much RLS while on 1,000 mcg Temgesic. That is equivalent to l mg and I know some people do take more than that. However, if Dr. Bagary says "no higher" he must have his reasons. Perhaps it age-related. Some of the others who take higher doses are much younger than us and perhaps their systems can take it better.
I do not know what to suggest that you ask the doctor. Perhaps tell him exactly what you have said here about all the breakthrough and ask what else he might suggest. Do you have anything in particular wrong with your spine? Pressure in the spine can cause restless legs and I sometimes think this is what makes mine so bad. I have spinal stenosis and do suffer low back pain and sciatica. Although saying that I have had RLS since at least my teens.
I can understand why you are worried about taking Temgesic because of dental problems and I feel the same. What have you taken for RLS in the past? Have you ever been on a different opioid treatment? Some folk on the site are on oxycodone and managing well. Perhaps list all the things you have tried and why they have failed - although the Dr. Bagary probably has all this information already. How do you get to speak to him - is it a telephone appointment or do you see him?
Do let us know what other things you have tried to give us a better idea how to help. Best Wishes
Hello Jelbea. The first medication I was offered was ropinirol but it made me feel very unwell then came another DA which had the same result(felt faint and sick all the time). I tried the Neupro patch next which was really good for 6 months until I developed the most terrible rash all over my trunk.
Then my gp suggested Gabapentin and this did nothing at all so I went on to Pregabalin and that also didn’t work. I asked if I could try Tramadol and that worked about 75% of the time for four years until it stopped working. At this point my GP referred me to Dr. Bagary who prescribed Clonazapam. These made me so unsteady that I was afraid of falling so came off them and requested Temgesic which of course is what I am still taking. As you can see I have tried practically everything out there and I’m still tortured with RLS with the additional worry now of teeth problems. I think if it wasn’t for the worry about my teeth I would try to persuade DrBagary to let me have a higher dose because I feel my RLS is so aggressive I need about the same as Shumba to get any real results. Perhaps I will ask her if she has any tooth or gum problems. Best Wishes
Hello again Jelbea. When I looked again at your post I realised I hadn’t answered all your questions. The appointments with Dr Bagary have always been telephone conversations despite me always asking for face to face. He did say during the last appt. that he is willing for me to change to Buprenorphine rather than Temgesic, however he wants me to wait 6 months , why? he didn’t say. The reason I want to change is that the buprenorphine have a longer half life than Temgesic and I thought because of that they would cover the symptoms better, I would value your opinion on that. I have at least been fortunate in having a strong back with no problems there. I do however have stomach and bladder problems but I don’t think either of these would have any ill effects on the RLS. I do intend to ask for an appointment with Dr. Bagary very soon but want to wait until I have spoken to my dentist about the problem. I have an appointment in 10 days time. Thank you for past as well as any future advice you can give me. Best Wishes
Sorry for not getting back to you sooner. I have a few health problems at present and was at doctor to-day. You have certainly been around the medications for RLS.
You were saying that Dr. Bagary was willing for you to change to buprenorphine from Temgesic and you say that buprenorphine has a much longer half life. I am sorry I cannot advise you there as I understood they were just the same.
You were also saying that perhaps a higher dosage (like Shumbah takes) would work for you. This could certainly be the case but again it does not get over the dental problems. Maybe Shumbah could advise you further. She has a contact in New York - Dr. Glen Brooks - who might be willing to advise on your "half-life" questions or Shumbah herself might know.
I am sorry I am not much help. I certainly hope you get sorted in the dentists and I shall keep in touch. Good Wishes
Buprenorphine definitely causes lack of saliva and dry mouth.I know the FDA issued a warning about Buprenorphine and tooth loss and they believe it's caused by acid.
I don't know where or why they came to that conclusion because it's so clear to me that the dry mouth and lack of saliva is causing the issue.
Someone on the Patch reported the same problems so it's not the tablet creating an acid environment in the mouth.
It's easier to sort the daytime problems with chewing gum, drinking water regularly and taking salivix lozenges. But nighttime is difficult. That's when the mouth is very dry.
We should all compile information because I'm convinced the FDA have just leapt to the conclusion it's caused by acid.
My pill is under my tongue twice a day for less than 2 minutes.
Drinking a glass of orange juice would have the same acid creating effect.
So let's all start keeping a diary of when we notice dry mouth. We may as well do our own studies.
There are medications that can help produce saliva and I'll do some research on them.
Hi Joolsg - My mouth and throat are dry 24/7. I always take a drink before I use the tablet. Because my mouth is so dry 200 mcg tablet takes at the very least 10 minutes to dissolve - often more like 15. Half a tablet (100 mcg) takes 6 or 7 minutes. I am doing this four times a day. Bedith6 is taking 1000 mcg daily and I do not know how often she takes it.
I looked up the ph value of buprenorphine and it was given as 3.5. I know if I get the taste of it at all it is quite acid. I read about Subutex that it is much better not to swallow after the tablets melt. They advise spitting out and rinsing your mouth. I always take a small drink of milk after to counteract acidity - I also read this tip.
I have quite a selection of medicaments to help the dryness. I have to use them constantly and I must say the flavour, even if it is very mild, is difficult to take. I have also had two chips broken off teeth since starting which has distressed me as I cannot get them fixed at present. More than that the hoarseness which has been developing since I changed from the Butec patches is very worrying. It may have another cause but GP seemed to think not. Anyhow it should be checked within a month - nurses strikes allowing.
It's very worrying. I still think the lack of saliva and dryness is the main problem.I can't remember who reported that the skin patch was causing the same problems, but Buprenorphine does seem to trigger Sjogrens type symptoms.
My mouth and lips are VERY dry on Buprenorphine.
I am really devastated because it's the only medication that has worked for me.
The only other option is methadone but I can imagine the difficulties I will face getting that in the UK.
But we should keep an update of everyone taking Buprenorphine and their mouth/teeth issues.
I suffer from burning tongue syndrome and Temgesic doesn’t cause me any burning, whereas many vegetables and fruits do. Acid is acid, right? However I have suffered from a dry throat at night that’s exacerbated by snoring. For this reason, I can’t really take more than 500 mcg in one go. I haven’t yet decided wether spreading it out over the course of the night or even the day would be better. All in all I’ve lately taken 600 mcg per day without suffering from day time dryness.
summerhousedetoxcenter.com/... found this article which confirms that Buprenorphine AND methadone cause dry mouth and lack of saliva and that is what causes teeth and gum problems.
That would expain why patients using the Buprenorphine skin patch also experience teeth and gum problems.
Buprenorphine also has the added drawback that it's acidic but that can be remedied by drinking water or milk.
The dryness is much harder to treat.
They advise chewing xylitol gum and avoiding caffeine and sugar.
I have quite a dry mouth now anyway. At first I thought it might be due to codeine I was taking as I think all opiates can give you a dryish mouth but I don’t think the codeine really helps so stopped it a few weeks ago and my mouth is still a bit dry. I’m wondering if eventually a lot of people with RLS get a dry mouth & Temgesic is particularly bad for us in these circumstances. It’s a real shame though but sometimes it takes a while for side effects to emerge
I take Temgesic 0,2 mg , divided in half at appr. 8 pm and 10 pm. Even with that rather small dose I have a very dry mouth during the night. My dentist confirms that the dry mouth without any salvia gives the problems with teeth.
Sleeping with mouth open as I do makes the mouth even drier. I wake every 2 hours because I tend to drink a lot in the evening, so I drink some water every 2 hours and take a spray. But again after waking 2 hours later, my mouth is the same as before, dry dry ...
I am happy with Temgesic but thinking of the dry mouth problems and even more the tiredness during the day, my happiness is not so great any more. But I am not so sure that a change to Methadone would improve those two issues. ?
You're correct. I looked up Methadone and it also causes lack of saliva and dry mouth.I was on Oxycontin for 5 years and that didn't cause mouth dryness. But it didn't help my RLS much at all.
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TEMGESIC AUGMENTING?
Buprenorphine/ Temgesic 
