Does Suboxone Help With Tooth Pain?

Yes, Suboxone can potentially help with tooth pain.

Suboxone is a medication that is FDA-approved for opioid use disorder, but it is also used off-label as a pain medication. It has analgesic or pain-relieving properties. Therefore, it can be helpful with tooth pain. 

Anti-inflammatory medications have been shown to be equally effective to opioids for tooth pain and are considered much safer. Therefore, they are usually the first line treatment for patients with tooth pain or after a dental procedure. 

However, if you and your dentist decide that anti-inflammatory medications are insufficient or unsafe for you for some other reason, it may also be a good option short-term for someone that has a history of opioid use disorder and is weary of using opioids after a dental procedure to try Suboxone instead. 

If you are having tooth pain, anti-inflammatory medication such as ibuprofen or naproxen might provide adequate pain relief. If you have tooth pain or are anticipating a dental procedure that is not responsive to anti-inflammatory (NSAID) medications, Suboxone might be a good option.

Suboxone patients can certainly continue the medication during and after a dental procedure, and may even find that it provides additional pain relief. 

Talk to your doctor before any planned dental procedure. 

Can Dentists Prescribe Suboxone?

Dentists can't usually legally prescribe Suboxone. To prescribe products containing buprenorphine (like Suboxone), doctors must obtain a special license, called an X-waiver, in most states. When done, a doctor can use FDA-approved products like Suboxone to help patients with opioid use disorders, or prescribe it off-label to treat chronic pain. 

Dentists often use pure opioids like hydrocodone and codeine to help their patients feel comfortable after a dental procedure.[2] However, as knowledge about the opioid crisis continues to grow, fewer dentists prescribe these medications.[3]

While it's theoretically possible to find a dentist who prescribes Suboxone, it's highly unlikely that they will have gone through the waiver process. Thus, if you would like to try using Suboxone instead of an opioid after a dental procedure, you may need to talk to your regular Suboxone prescriber or find a primary care doctor or addiction specialist that prescribes Suboxone. 

Why It's Important to Talk to Your Doctor Before a Dental Procedure 

If you're using Suboxone, it's important to talk with your dentist about your medication. Untreated pain raises your relapse risks. If you're overcoming an opioid use disorder and using Suboxone, you may require additional opioids after a dental procedure, or you may opt NOT to use opioids given that you are in recovery. Being open with your dentist about your wishes for pain control is essential in finding the balance between getting the pain control you need while still protecting your recovery. [4]. 

Some Forms of Suboxone Impair Dental Health

Some Suboxone products dissolve in your mouth. They start as pills or patches, combine with your saliva, and melt away. The residue left behind could be hard on your teeth. 

The Food and Drug Administration (FDA) recommends that all people using these melt-away products talk with their dentists as soon as their prescriptions start.[5] Talk about how to care for your teeth, and schedule regular checkups to catch problems before they progress.

Sources

1. FAQs About the New Buprenorphine Practice Guidelines. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/become-buprenorphine-waivered-practitioner/new-practice-guidelines-faqs. April 2021. Accessed July 2022.
2. Comparison of Opioid Prescribing by Dentists in the United States and England. JAMA. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2734067. May 2019. Accessed July 2022. 
3. Trends in National Opioid Prescribing for Dental Procedures Among Patients Enrolled in Medicaid. The Journal of the American Dental Association. https://www.sciencedirect.com/science/article/pii/S0002817721002440. August 2021. Accessed July 2022. 
4. What Every Dentist Should Know for Patients Taking Suboxone (Buprenorphine/Naloxone). Massachusetts Dental Society. https://mydigimag.rrd.com/publication/?i=383269&article_id=2708907&view=articleBrowser&ver=html5. Accessed July 2022. 
5. FDA Warns About Dental Problems with Buprenorphine Medicines Dissolved in the Mouth to Treat Opioid Use Disorder and Pain. U.S. Food and Drug Administration. https://www.fda.gov/media/155352/download. January 2022. Accessed July 2022.