Dental complications from sublingual buprenorphine treatment: A prospective cohort study

The aims of this R21 grant are to conduct a prospective cohort study of individuals receiving sublingual buprenorphine or methadone to evaluate the prevalence and incidence of oral complications, and to conduct a qualitative study to understand the barriers and facilitators to preventing and receiving oral health care.

Methadone and buprenorphine are very popular medication used to help treat OUD, they are taken daily for extended periods of time, usually several years or more. Additionally, many patients take buprenorphine as a twice-a-day to as often as four-times-a-day dosing, either due to personal preference, or because divided dosing provides better relief for craving, or to provide better analgesia for the chronic pain that OUD patients commonly experience.

The difference between methadone and buprenorphine is that methadone is taken a liquid and swallowed, and buprenorphine is given in a sublingual way, the medication is placed under the tongue for several minutes or more until the medication dissolves.

Buprenorphine is estimated to be acidic (pH>4) when dissolved in water, which means individuals that take buprenorphine are exposing their oral cavity to the acidic content of this medication several times a day for a long period of time, this exposure to the tooth enamel can cause dental caries.

We are doing this study to determine the patterns of dental decay among patients with opioid use disorder (OUD) receiving buprenorphine and methadone.