BUP and Dental problems

[ucdailoi-no-1]

I picked up this little bit of info while I was wallowing in the pleasure of being able to prevent my RL...

I started by allowing the tablet to dissolve under my tongue after going to bed, or even in the early hours of the morning if the problem arose.

Now that I am aware of the damage to my teeth, I will follow the guidelines.

"The FDA is warning that dental problems have been reported with medicines containing buprenorphine that are dissolved in the mouth. The dental problems, including tooth decay, cavities, oral infections, and loss of teeth, can be serious and have been reported even in patients with no history of dental issues. Despite these risks, buprenorphine is an important treatment option for opioid use disorder (OUD) and pain, and the benefits of these medicines clearly outweigh the risks. "

fda.gov/safety/medical-prod...

[Madlegs1]

Yes- that was flagged here a while ago.

Also for the bucal film.

But almost all of the opioids have a bad effect on mouth hygiene, because they tend to make you sleep with the mouth open, leading to dry mouth.

This promotes bad bacteria to flourish at the expense the Goodies .

Having a glass of water beside the bed at night and taking sips ,and rinsing the mouth ,may be helpful.

Also will help in keeping you fit ,as you toddle off to the throne room throughout the night!😂

[SueJohnson in reply to Madlegs1]

My laugh for the day - you never disappoint! toddle off to the throne room🤣🤣🤣

[Yorkie111 in reply to Madlegs1]

Thanks for bringing this issue up again! I just started using Buprenorphine. I did some research before getting a prescription but apparently not enough research. I saw very little about dental problems. Is the pill form easier on the teeth? Most of my teeth have been capped so I am hoping that will make a difference. Even so, I have ordered the orthodontic wax, mouthwash for dry mouth and use a Brillo pad (joking!) on my teeth every morning!

I hope everyone has a peaceful New Years!

[707twitcher]

I have discovered about the dry mouth effect the hard way. Although no dental problems yet (I’ve been using Suboxone for a year now), I developed oral thrush recently. It’s a fungal disease, and can be caused by dry mouth. It’s no fun. So I’m now chewing gum and using a rinse made for dry mouth (Biotene).

[ID158]

I'm surprised this would be an issue for RLS patients, given how little of this stuff we use (relative to OUD users). I've been on it for a few months now and haven't had any issues yet, but will be keeping a close eye on it.

[Joolsg]

Yep. I noticed that Buprenorphine caused really dry mouth. People using the Buprenorphine patch also report teeth issues so I don't believe the reason the FDA give. I don't think it's acid environment.I use chewing gum, biotene toothpaste, mouth wash and sprays for Sjogrens disease. I'll wake up with a really dry mouth and use the mouth gel.or spray.

Just have regular check ups.

I'll happily lose all my teeth using Buprenorphine and get dental implants. The joy of zero RLS beats anything.

[teakabeagle]

My dentist recommended putting Orthodontic wax on the inside of my bottom teeth as a barrier as they get the most exposure. My doctor said to crush the tablet before putting under tongue to decrease time for it to absorb and decrease exposure of the teeth.

Once it has resolved and I can no longer taste it, I rinse immediately with baking soda in water to decrease the acidity. I also use a water pick with baking soda and water at very low pressure to get any out between my teeth. I don’t brush teeth for an hour. I also use a Clinipro toothpaste that I purchase at dentist office. Spit it out don’t rinse.

A bit of a process, but if it helps avoid dental problems, worth it

[ucdailoi-no-1 in reply to teakabeagle]

Good advice on the baking powder..

[intermk]

Although the directions say to dissolve Bupr under the tongue you don't have to do that although it works best if you do. You can swallow the tablets. I've done this for about three months and discovered that it works well but I need about 2 mg more to get the same effect as the sublingual method. I currently take 6 mg sublingual and take 4 mg midday and 2mg in the afternoon to decrease insomnia at night. But I too have extremely dry mouth and Biotene on works for 15-20 minutes in my mouth. So, there are reall challenges with Bupr but I accept them because being without RLS is the most important issue.

NOTE: if you decide to swallow he tablets it works best for me if I do so on an empty stomach.

[teakabeagle in reply to intermk]

Will your Dr. and insurance company allow the extra tablets?

[intermk in reply to teakabeagle]

No problem with insurance. They allow whatever the doctor orders. And I'm already on 6 mg which includes the 2 mg extra for taking orally although that's not what the Rx notes. I had been complaining about breakthrough symptoms after we lowered the original amount to 4 mg from 12 mg (long story). Anyway, when we titrated down we went to far and that was my fault because initially I thought i was doing well on 4 mg. However, I neglected to take into account the my serum Bupr level was still higher and takes a few days to subside and level off at a new dose. So doc just added back 2 mg. These days i do either method. I've been switching back and forth somewhat and trying the dosing at different times of day due to the terrible insomnia Bupr causes me. It seems that this is always the way - fix one thing and the medicine causes another issue almost equally difficult to live with.

[teakabeagle in reply to intermk]

You are lucky. I’ve had to fight with the PHARMACY as well as the insurance company to cover even the small amount I take, because of the off label use. I’d always something!

I’m curious- does the Bup go into effect as fast as when you take it sublingually?

[intermk in reply to teakabeagle]

Sorry for the late reply. I'm only able to get online 2-3 times a week. Are you in the U.S. or UK or elsewhere? I'm in the U.S. and my copay for 90 tabs of 2 mg Bupr costs me $16. It's gone up three times in the past 12 months. No, it does not take effect immediately no matter how you take it. I can tell you though that you don't want to wait until symptoms appear because it's hard to get calm even after you ingest or dissolve Bupr. I should say, that's my situation. I now take my Bupr in the morning because I'm trying to lessen the side effect of insomnia which is bad when you're on more than 2 mg per day. It's a very common side effect. If my symptoms happen to show up in my arms early in the day before taking Bupr, I take it immediately then have to wait at least 20 minutes for my arms or legs to calm down. Fortunately these occurrences are rare these days but happened often before I had permission from my doc to try different dosing times and dosages to suit me. I don't always take the full 6 mg at once. Usually I save a full dose for the aforementioned occurrences. Instead, I take 2 mg every 2 hours in the a.m. until I reach 6 mg. Because of Buprs variable half-life of 20-70 hours I can last until around 0400-0500 the next morning before I feel symptoms coming on. They usually wake me, which is my reminder to take the medicine soon.