Legally Reviewed and Edited by: Terry Cochran

Published on: June 25, 2024

Suboxone, a medication combining buprenorphine and naloxone, has been instrumental in treating opioid use disorder (OUD). It has helped countless individuals break free from the grip of opioid addiction and helped reduce fatal overdoses by 50%.

However, despite its efficacy in addressing OUD, complications of Suboxone have been reported, including several dental injuries like cavities and loose teeth. These have raised concerns among patients and healthcare professionals.

If you’ve suffered Suboxone side effects on your teeth, contact our product liability attorneys at Cochran, Kroll, & Associates, P.C. We’ll help protect your rights and win compensation to restore your smile, confidence, and quality of life.

What is Suboxone?

Suboxone is a medication primarily prescribed to treat opioid use disorder (OUD). It has become a mainstay in the fight against opioid addiction, offering a lifeline to many individuals struggling with dependence on opioids. Understanding what the medication is, how it works, and its administration can help explain the complications of Suboxone and its potential benefits.

Components of Suboxone

Suboxone is a combination medication that includes two active ingredients: buprenorphine and naloxone. Here’s what each one does:

• Buprenorphine. Buprenorphine functions as a partial opioid agonist, which means it stimulates opioid receptors in the brain but much less than full agonists such as heroin or prescription painkillers. This mechanism helps diminish withdrawal symptoms and cravings without causing the intense euphoria associated with other opioids, supporting individuals in tapering off opioids and managing their addiction.
• Naloxone. Naloxone is an opioid antagonist. It works by blocking opioid receptors, which can prevent the misuse of Suboxone. If someone attempts to inject Suboxone to get high, naloxone will precipitate withdrawal symptoms, deterring abuse. This safeguard ensures that Suboxone is used as intended – as a therapeutic aid in the treatment of opioid addiction.

Administration of Suboxone

Suboxone is typically administered as a sublingual film or tablet. It’s placed under the tongue (sublingually), where it dissolves and is absorbed into the bloodstream. This method of administration is convenient for several reasons:

• Ease of use. Patients can easily take the medication without needing water or additional tools, making it a discreet and straightforward method.
• Rapid absorption. The sublingual route allows for rapid absorption of the medication into the bloodstream, providing quicker relief from withdrawal symptoms and cravings.
• Reduced risk of misuse. The sublingual film or tablet is designed to discourage misuse. The presence of naloxone further ensures that any attempt to misuse the medication through injection is met with immediate withdrawal symptoms.

The Benefits of Suboxone in Treating Opioid Use Disorder

Suboxone has transformed the landscape of opioid addiction treatment. Its unique formulation and administration method offer several benefits:

• Reduction in cravings and withdrawal symptoms. By partially activating opioid receptors, buprenorphine helps stabilize patients and reduce the intense cravings and withdrawal symptoms that often lead to relapse.
• Improved compliance. Sublingual administration’s convenience encourages adherence to the treatment regimen, which is critical for successful long-term recovery.
• Lower risk of overdose. Because buprenorphine is a partial agonist, it has a ceiling effect. Taking higher doses does not produce the same euphoric effects as other opioids, reducing the risk of overdose.
• Support for long-term recovery. Suboxone can be used as part of a comprehensive treatment plan that includes counseling and behavioral therapies, providing a holistic approach to addiction recovery.

Dental Injuries and Complications Linked to Suboxone Use

While Suboxone is a valuable tool in the fight against opioid addiction, its use has been linked to several dental injuries and complications. These complications of Suboxone, which include tooth decay, oral infections, and tooth loss, can impact patients’ quality of life.

The sublingual administration of Suboxone, which involves placing the medication under the tongue where it dissolves, is a major reason why there is a link between Suboxone and tooth decay. Prolonged exposure to the medication in the oral cavity can create an acidic environment that is detrimental to dental health.

Tooth Decay and Cavities

Tooth decay is one of the most common dental complications linked to Suboxone use. The medication’s sublingual administration means it stays in contact with the teeth and gums for extended periods, increasing the risk of decay.

The acidic environment produced by Suboxone can wear down tooth enamel, leaving teeth more susceptible to cavities. A side effect of Suboxone is dry mouth, which decreases saliva production. Saliva is crucial for neutralizing mouth acids and clearing away food particles, so its reduction can speed up tooth decay.

Oral Infections

Oral infections are another concern for patients using Suboxone. The disruption of the natural bacterial balance in the mouth can lead to infections such as gingivitis and periodontitis. These infections can cause inflammation and pain and, if left untreated, result in more severe dental issues, including tooth loss.

Gum Disease

The sublingual administration of Suboxone can alter the oral bacterial balance and reduce saliva production, fostering an environment conducive to bacterial growth and gum inflammation. Gingivitis, characterized by red, swollen, and bleeding gums, can progress to periodontitis, destroying bone and connective tissue supporting the teeth, potentially resulting in tooth loss.

Dry Mouth

Dry mouth, a common side effect of Suboxone, can have consequences for oral health. Saliva neutralizes acids in the mouth, washing away food particles and providing disease-fighting substances. A reduction in saliva production can lead to an acidic oral environment, increasing the risk of tooth decay and cavities.

Additionally, dry mouth can contribute to the development of gum disease, as the lack of saliva allows harmful bacteria to thrive. Patients may experience difficulty swallowing, speaking, and tasting and a persistent sore or dry throat.

Tooth Loss

The combination of tooth decay, cavities, and oral infections can culminate in tooth loss. Patients on long-term Suboxone therapy have reported needing tooth extractions due to severe dental damage. The loss of teeth can impact an individual’s ability to eat, speak, and maintain a normal appearance, affecting both physical health and self-esteem.

Jaw and Bone Loss

Jaw and bone loss are severe side effects associated with long-term Suboxone use, often from untreated dental issues like gum disease and tooth loss. The acidic environment created by Suboxone can erode tooth enamel and damage the gums, leading to periodontitis, which can destroy the bone and connective tissues that support the teeth.

This bone loss weakens the jaw structure, potentially causing teeth to become loose and even fall out. Over time, bone loss can alter the shape of the jaw and face, affecting appearance and function.

Studies and Findings on Suboxone and Dental Health

Many studies and findings have demonstrated the impact of Suboxone on dental health, showing a strong correlation between Suboxone and dental work needed after use. Here are a few highlights:

• 2022 JAMA article. This study analyzed the effect of sublingual buprenorphine/naloxone use on dental health compared to transdermal buprenorphine and oral naltrexone. It found that per 1,000 person-years, the sublingual medication resulted in 21.6 adverse dental effects, while the others had 12.2 and 10.9, respectively. For dental cavities, the results were 8.2 versus 3.5 and 3.8.
• 2013 study. As far back as 2013, research showed dental issues associated with buprenorphine use. This study showed that patients on buprenorphine treatment reported an average of 5.2 dental caries and 2.4 cracked teeth, with over half (54.5%) having low salivary buffering capacity, which can contribute to increased dental decay.
• 2023 analysis. A 2023 analysis performed on the World Health Organization database found that among 30,769 reports on all forms of buprenorphine, 20 cases of dental problems were specifically linked to sublingual/buccal buprenorphine. The medication was associated with a 15 times higher reporting of dental issues than other buprenorphine formulations and 6 times more than methadone, indicating a potential risk factor for dental complications.

Legal Considerations: Product Liability and Failure to Warn

Patients who have suffered severe dental injuries as a result of using Suboxone may have grounds to file a product liability lawsuit against the medication’s manufacturers. Our attorneys at Cochran, Kroll, & Associates, P.C. can review your case and help you understand the grounds for filing a Suboxone lawsuit on your behalf:

Product Liability Lawsuits

Product liability lawsuits are legal claims brought against manufacturers, distributors, or sellers of defective products that cause harm to consumers. In the context of Suboxone, a product liability lawsuit asserts that the manufacturers failed to provide adequate warnings about the potential dental risks associated with the medication.

These lawsuits can be based on several legal theories, including:

• Negligence. The manufacturer may be accused of negligence if they failed to conduct sufficient testing or failed to identify and disclose the potential risks of dental complications associated with Suboxone use.
• Strict liability. Under strict liability, a manufacturer can be held liable for harm caused by their product, regardless of whether they were negligent. If they marketed and sold Suboxone without warning and knew it was dangerous, the manufacturer could be held strictly liable.
• Breach of warranty. This theory asserts that the manufacturer breached an implied or express warranty that the product was safe for use. If Suboxone caused unexpected dental harm, it could be considered a breach of the implied warranty of merchantability.

Failure to Warn

The failure to warn doctrine is a key element in many pharmaceutical product liability cases. It requires manufacturers to provide adequate warnings about any potential risks associated with their products. If the manufacturers of Suboxone did not adequately inform patients and healthcare providers about the risk of dental complications, they can be held liable for any resulting injuries.

Several factors are considered in a failure to warn case:

• Knowledge of risk. Whether the manufacturer knew or should have known about the potential dental risks associated with Suboxone.
• Adequacy of warnings. Whether the warnings provided were clear, comprehensive, and effectively communicated the risks to patients and healthcare providers.
• Causation. Whether the lack of adequate warnings directly caused the patient’s injuries. Plaintiffs must demonstrate that if they had been properly warned, they would have taken different actions, such as seeking alternative treatments or taking extra precautions to protect their dental health.

In the case of Suboxone, the FDA found reasonable cause of harm in 2022 and issued a warning. This warning required the manufacturer, Indivior, to warn consumers of the potential for serious dental problems when using the medication. This lack of warning means consumers who used Suboxone before 2022 were likely unaware of these side effects and may have a claim based on failure to warn.

Ongoing Litigation for Suboxone Cases

For those considering a Suboxone lawsuit, it’s essential to understand the current legal landscape. The first case against Indivior was filed in 2023, leading to a cascade of lawsuits against the company. Many people have since filed claims alleging that Suboxone caused serious dental problems.

Due to the high number of cases, the court consolidated them into a multidistrict litigation (MDL) in the Northern District of Ohio. This means that instead of handling each case separately, they’re all managed together to make the process more efficient and consistent.

As of June 2024, there were 358 Suboxone tooth decay lawsuits pending in this MDL. So far, there haven’t been any public settlements or scheduled trials for these cases. In June 2024, Judge Calabrese, who presides over these cases, issued an order to form a Plaintiffs’ Leadership Development Committee. This committee is designed to help newer attorneys learn from seasoned lawyers on the Plaintiffs’ Leadership Committee.

Lawyers have been busy discussing the discovery process and a tolling agreement, which is important because it pauses the statute of limitations. This pause helps ensure that people have enough time to file their claims, even if there are delays in getting medical records from dentists.

Possible Settlements from a Suboxne Lawsuit

When you file a Suboxone lawsuit with the attorneys at Cochran, Kroll, & Associates, P.C., we’ll use our experience and legal knowledge to get you a fair settlement for your dental damages. Your Suboxone settlement could include the following:

• Compensation for medical expenses. You could be reimbursed for all dental treatments required due to tooth decay and other oral health issues caused by Suboxone, including fillings, root canals, extractions, and dentures.
• Lost wages recovery. If your dental problems led to missed workdays, you might receive compensation for lost income, including past and future lost wages, if ongoing treatment impacts your ability to work.
• Pain and suffering damages. We can help you seek damages for the emotional distress and reduced quality of life caused by your dental issues. This award can include the psychological impact of losing teeth and dealing with chronic pain.
• Exemplary damages. Depending on the results from the bellwether trial in the MDL, the court might award punitive damages to punish Indivior for their negligence and deter similar future conduct. These damages are in addition to compensatory damages and serve as a penalty for the company.

How Cochran, Kroll & Associates, P.C. Can Help Victims of Suboxone-Related Dental Injuries

Victims of Suboxone-related dental injuries can face physical, emotional, and financial challenges. Cochran, Kroll & Associates, P.C. is committed to providing compassionate and effective legal support to individuals who have suffered severe dental complications due to Suboxone use.

With our experience in product liability and personal injury cases, our attorneys have the expertise to help clients navigate these legal claims.

• Comprehensive case evaluation. When you reach out to Cochran, Kroll & Associates, P.C., you can expect a comprehensive evaluation of your case. Our firm’s legal team will review your medical records, dental history, and any documentation related to your use of Suboxone. This detailed assessment helps us build a strong case that clearly illustrates the connection between Suboxone use and your dental injuries.
• Professional guidance and support. Eileen Kroll, a registered nurse and experienced attorney at Cochran, Kroll & Associates, P.C., brings a unique perspective to the firm. Her medical background provides valuable insight into the health-related aspects of your case, ensuring our legal strategies are based on an understanding of medical issues.
  Eileen Kroll’s dual expertise allows her to effectively communicate with healthcare providers and experts, bolstering your case with solid medical evidence.
• Pursuit of maximum compensation. Our attorneys at Cochran, Kroll & Associates, P.C. are dedicated to pursuing the maximum compensation for our clients. This compensation can cover medical expenses, including dental treatments, surgeries, and ongoing care.
  Additionally, we seek to recover damages for pain and suffering, emotional distress, and any loss of income resulting from your dental injuries. We aim to ensure you receive the financial support necessary to address the impact of Suboxone-related dental complications on your life.
• Personalized legal approach. Cochran, Kroll & Associates, P.C. provides personalized legal services tailored to each client’s unique circumstances. We understand that the consequences of Suboxone-related dental injuries extend beyond physical pain, affecting your well-being and quality of life.
  Our firm’s compassionate approach ensures you receive the attention and support you need, from consultation to resolution.

Contact Cochran, Kroll & Associates, P.C.

While Suboxone is a crucial tool in combating opioid addiction, its use can lead to severe dental complications. If you or a loved one has suffered dental injuries due to complications of Suboxone use, contact our law firm for a free consultation.

Our experienced legal team is ready to help you with your case and pursue the compensation you deserve. Reach out today to learn how we can assist you in holding the manufacturers of Suboxone accountable for their failure to warn about the medication’s potential dental risks.

Our contingency fee basis means we only get paid if we win your case, so there is no financial risk to you to get started. Call our law firm today at 1-866-MICH-LAW (1-866-642-4529) and schedule your no-obligation, free case evaluation.

Disclaimer : The information provided is general and not for legal advice. The blogs are not intended to provide legal counsel and no attorney-client relationship is created nor intended.