Sublingual Buprenorphine/Naloxone Tied to More Adverse Dental Outcomes

FRIDAY, Dec. 16, 2022 (HealthDay News) — There is a higher risk for adverse dental outcomes associated with sublingual buprenorphine/naloxone compared with transdermal buprenorphine or oral naltrexone, according to a research letter published in the Dec. 13 issue of the Journal of the American Medical Association.

Mahyar Etminan, Pharm.D., from the University of British Columbia in Vancouver, Canada, and colleagues used the PharMetrics database to examine the association between sublingual buprenorphine/naloxone and dental adverse events. The analysis included 21,404 new users of sublingual buprenorphine/naloxone, 5,385 users of transdermal buprenorphine, and 6,616 users of oral naltrexone.

The researchers found that the incidence of any dental adverse event was 21.6 per 1,000 person-years with sublingual buprenorphine/naloxone, 12.2 per 1,000 person-years with transdermal buprenorphine, and 10.9 per 1,000 person-years with oral naltrexone. The risk for dental adverse events was higher for sublingual buprenorphine/naloxone versus both transdermal buprenorphine (adjusted hazard ratio [aHR], 1.42) and oral naltrexone (aHR, 1.67). Similarly, the incidence of dental caries or tooth loss was 8.2 per 1,000 person-years with sublingual buprenorphine/naloxone, 3.5 per 1,000 person-years with transdermal buprenorphine, and 3.8 per 1,000 person-years with oral naltrexone. A higher risk for dental caries or tooth loss was seen for sublingual buprenorphine/naloxone versus both transdermal buprenorphine (aHR, 1.57) and oral naltrexone (aHR, 1.71).

“Clinicians might consider drugs other than sublingual buprenorphine/naloxone in patients with previous dental problems,” the authors write. “These patients might also benefit from regular oral health examinations by their dentist.”

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