Orally dissolving buprenorphine for opioid use disorder linked to caries

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of the American Dental Association Pub Date : 2024-07-01 DOI:10.1016/j.adaj.2024.03.001

Stuart L. Segelnick DDS, MS, Mea A. Weinberg DMD, MSD, RPh

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Abstract

Background

Buprenorphine is under scrutiny because of the development of xerostomia and caries. The purpose of this article was to inform dental care professionals about the oral effects of buprenorphine and to increase knowledge and awareness of medication-assisted treatment in the management of opioid use disorder (OUD).

Case Description

In 2022, the US Food and Drug Administration issued a warning about xerostomia and caries associated with the use of transmucosal (sublingual and buccal formulations) buprenorphine. Dental health care professionals should instruct patients taking buprenorphine on how to prevent these dental issues by means of rinsing with water and swallowing once the drug has been completely dissolved, followed by toothbrushing at least 1 hour after taking the drug. In addition, a fluoride supplement should be prescribed.

Practical Implications

It is imperative for dentists to recognize buprenorphine as medication-assisted treatment and to recognize a patient as having an OUD. While taking buprenorphine, the patient should have more frequent oral health care appointments, including home care instructions and caries risk assessment to monitor for caries and xerostomia so that treatment, if indicated, could be initiated as soon as possible. In addition, the dentist’s role in OUD is to make sure patients follow the treatment recommendations and use the buprenorphine and to not have them discontinue because of potential caries risk.

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治疗阿片类药物使用障碍的口溶丁丙诺啡与龋齿有关。

背景：丁丙诺啡因口腔干燥症和龋齿的发生而备受关注。本文旨在向牙科护理专业人员介绍丁丙诺啡对口腔的影响，并提高他们对药物辅助治疗治疗阿片类药物使用障碍（OUD）的了解和认识：2022 年，美国食品和药物管理局发布了关于使用经黏膜（舌下和口腔制剂）丁丙诺啡会引起口腔干燥症和龋齿的警告。牙科保健专业人员应指导服用丁丙诺啡的患者如何预防这些牙科问题，方法是在药物完全溶解后用水漱口并吞咽，然后在服药后至少 1 小时刷牙。此外，还应处方氟化物补充剂：牙医必须认识到丁丙诺啡是药物辅助治疗，并认识到患者患有 OUD。在服用丁丙诺啡期间，患者应定期预约口腔保健，包括家庭护理指导和龋病风险评估，以监测龋病和口腔干燥症，以便在有指征的情况下尽快开始治疗。此外，牙医在 OUD 中的作用是确保患者遵循治疗建议并使用丁丙诺啡，不要让他们因为潜在的龋齿风险而中断治疗。

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来源期刊

Journal of the American Dental Association 医学-牙科与口腔外科

CiteScore

5.30

自引率

10.30%

发文量

221

审稿时长

34 days

期刊介绍： There is not a single source or solution to help dentists in their quest for lifelong learning, improving dental practice, and dental well-being. JADA+, along with The Journal of the American Dental Association, is striving to do just that, bringing together practical content covering dentistry topics and procedures to help dentists—both general dentists and specialists—provide better patient care and improve oral health and well-being. This is a work in progress; as we add more content, covering more topics of interest, it will continue to expand, becoming an ever-more essential source of oral health knowledge.