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Unread 03-06-2013, 04:41 PM   #30
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Default Updated side effects information at NAABT

We recently updated the sides effects page at NAABT and today expanded the section concerning teeth. Methadone and now buprenorphine have been the subject of rumors that basically say that both medications "rot your teeth" or something along those lines. Although the rumor isn't literally true, a side effect of all opioids, dry mouth, can lead to tooth loss. The new section explains how and how to prevent it. Dental care is less often covered by insurance and can be expensive. For example to pull and replace a single tooth (modern implants) can cost over $3000, and that is for a healthy person without complications. Paying extra close attention to dental care now that you are in treatment might be the single best way to save money on treatment. Below is the added new text:

link to page:

Dry mouth (xerostomia):

This may seem like an innocuous symptom, but it can be very serious and very costly.

Saliva is the mouth’s primary defense against tooth decay, gun disease, and maintains the health of the soft and hard tissues in the mouth. Saliva washes away food and other debris, neutralizes acids produced by bacteria in the mouth and provides disease-fighting substances throughout the mouth.

With dry mouth (which is a side effect from all opioids) these benefits are diminished which allows bacteria to multiply and often leads to gingivitis, periodontitis disease, and eventually bone and tooth loss.
Gingivitis: This is the earliest stage of gum disease, some bleeding with brushing and inflammation of your gums caused by plaque buildup at the gumline. At this early stage in gum disease, damage can be reversed, since the bone and connective tissue that hold the teeth in place are not yet affected.

Periodontitis: At this stage, the supporting bone and fibers that hold your teeth in place are irreversibly damaged. Your gums may begin to form a pocket below the gumline, which traps food and plaque. Proper dental treatment and improved home care can usually help prevent further damage.

Advanced Periodontitis: In this final stage of gum disease, the fibers and bone supporting your teeth are destroyed, which can cause your teeth to shift or loosen. This can affect your bite and, teeth may need to be removed.
Bacteria in plaque are the main cause of gingivitis and periodontitis. Plaque is a sticky film of microorganisms (biofilm) that continuously forms on the teeth and under the gumline. These bacteria may release toxins, especially below the gumline, that irritate the gum tissue and cause inflammation. Toxins or poisons -- produced by the bacteria in plaque as well as the body's “good” enzymes involved in fighting infections -- start to break down the bone and connective tissue that hold teeth in place. The gums may eventually break down and separate from the teeth causing a deep space called periodontal pockets. These pockets are very difficult to clean, allowing the bacteria to grow and multiply. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in place, they become loose, and tooth loss occurs. Gum disease is the leading cause of tooth loss in adults, not tooth decay.

Other contributors to the risk and severity of periodontal gum disease and oral health problems are smoking and diabetes.

According to the CDC, researchers have uncovered potential links between gum disease and other serious health conditions. In people with healthy immune systems, the bacteria in the mouth that makes its way into the bloodstream is usually harmless. But under certain circumstances, these microorganisms are associated with health problems such as stroke and heart disease.

Avoid the pain and cost from the consequences of opioid-induced dry mouth by keeping well hydrated, use OTC treatment for dry-mouth such as Biotene, and pay especially close attention to good oral hygiene with routine dentist visits. Preventative oral care might be the single best way to save money associated with your addiction treatment. Do not overlook the importance of it.

Important disclaimer: Any information in this post is not and does not constitute medical advice under any circumstances. Addiction Survivors, Inc. does not warranty or guarantee the accurateness, completeness, adequacy or currency of the information contained in or linked to the Site. Your use of information on the Site or materials linked to the Site is entirely at your own risk. Voluntary Disclosure: Timothy L. is the President of The National Alliance of Advocates for Buprenorphine treatment. ( The views and opinions of Timothy L., or any poster, are not necessarily the views of NEVER take any online advice over that of a qualified healthcare provider Any information you read here should only serve to inspire you to investigate further with credible, verifiable referenced sources or your doctor.
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