The Effects Of Opioid Use And Addiction On Oral Health

Effect Of Opioids On Oral Health

Due to the rising number of opioid related deaths, oral health issues related to opioid use and addiction are often overlooked. Opioid use can lead to poor oral health and disease because of certain side effects, neglect, and cravings for sugary foods.

If you are struggling with an addiction to opioids it is important to get the help you need. This may come in the form of inpatient treatment or a medication-assisted treatment program. If your oral health has suffered from substance abuse, scheduling an appointment with a dentist is generally the first step to fixing your smile.

The Effects Of Opioid Addiction On Oral Health

Dentists prescribe over 10% of all opioid prescriptions each year. While opioids are effective for treating pain, they’re extremely addictive because limited use can lead to physical and psychological dependence. Ironically for dentists, opioid misuse can also cause problems for dental hygiene and overall oral health.

Opioids And Oral Health

Dry mouth, a common side effect of opioid use, can lead to serious oral health conditions. Dry mouth is a lack of saliva production, which jeopardizes oral health. Saliva helps prevent bad breath, tooth decay, and gum disease, while also lubricating the mouth and making it easier to swallow, speak, eat, and taste food.


People suffering from opioid addiction also tend to neglect oral health. Because opioids relieve pain, an addicted person may not realize they have oral health problems until the issue becomes more severe. Also, people addicted to opioids may crave sugary foods. Sugar stimulates the reward centers in the brain, which can lead to a high risk of tooth decay.

Dental disease is also typical among populations struggling with opioid misuse, and they may develop large amounts of plaque and tartar. Because of the euphoric effects of opioids, people may grind their teeth or clench their jaws periodically, further contributing to poor oral health.

What Are The Effects Of Opioids On Oral Health?

Opioid addiction can lead to serious effects regarding oral health and dental hygiene, including:

  • bad breath
  • dry mouth
  • gum infections
  • oral cancer
  • pain in muscle joints/jaw
  • plaque build-up
  • precancerous oral conditions
  • tartar build-up
  • tooth decay

Opioid addiction damages oral cavities and can cause severe behavioral and emotional problems that may lead to malnutrition, which can harm oral health and lead to disease.

Periodontal Disease And Opioid Addiction

Periodontal disease refers to the severe infection of the gums. People suffering from opioid addiction, and other substance use disorders (SUDs), are more likely to have periodontal disease than the general population. Most people addicted to opioids and other substances don’t visit the dentist every year, and many don’t brush their teeth as recommended.

Tartar and plaque build-up, as well as overall neglect to oral health, make those addicted to opioids likely victims of periodontal disease. Other reasons for developing the disease include:

  • ignoring signs of tooth decay
  • injecting drugs like heroin
  • limited access to dental care
  • smoking tobacco
  • suppressed pain responses

Long-term addiction to heroin can directly worsen oral health. Poor personal hygiene, consistent malnutrition (lack of proper nutrition), and the physical effects of the drug all increase the likelihood a person develops periodontal disease. In severe cases, heroin use can lead to oral cancer or precancerous conditions. Extreme levels of decay, and dental trauma, are common when those using heroin enter methadone treatment.

Methadone Treatment May Worsen Oral Health

Methadone is an opioid used during treatment to reduce drug cravings and symptoms of withdrawal. However, if dental care isn’t considered, using methadone can further worsen oral health. Methadone is usually dispensed in a syrup containing sugar. This can complicate an already bad situation in the mouth, make dry mouth worse, and lead to more plaque build-up. While there is sugar-free methadone available, it’s typically more expensive.

Many patients who are treated with methadone also exhibit symptoms similar to “meth mouth,” which includes large lesions on the gums and cracked teeth caused by excessive grinding and clenching.

Opioids And The Dentist Office

Dentist offices contribute to the number of prescription opioids administered and prescribed each year. Many prescription opioids, including oxycodone, morphine, and codeine, are routinely prescribed to treat dental pain. Dentists are becoming more concerned about prescribing opioids as the opioid crisis worsens. However, they do provide some tips to help avoid dry mouth, including:

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  • Avoid alcohol – alcohol can actually cause dry mouth, and abusing opioids with alcohol makes it worse, not to mention other serious health risks, like breathing problems and extreme sedation.
  • Avoid sugary, acidic, or spicy foods – A lack of saliva, caused by dry mouth, can make spicy and acidic foods irritable to eat. Sugary foods need saliva to break them down, so without it, dry mouth increases dental problems like tooth decay.
  • Use a dry mouth rinse – these rinses can help increase the flow of what little saliva is produced by moisturizing the mouth.

Treatment For Opioid Abuse And Addiction

Opioid addiction treatment is likely to begin with a medically supervised detox program. These programs usually take place in a hospital or inpatient treatment center, and ensure a person is safe and comfortable during withdrawal. Staff may administer medications to help reduce drug cravings and uncomfortable symptoms.

Further treatment should follow a detox program, and can include a combination of medication and behavioral therapy. Currently, there are three government approved medications used for treating opioid addiction: buprenorphine, methadone, and naltrexone.

Medication-Assisted Treatment, or MAT, is best used alongside behavioral therapy. Behavioral therapy aims to change a person’s thinking and attitudes towards drugs, and MAT increases the chances a person will engage in and finish treatment. Inpatient, or residential, rehab may be a good option for those suffering from opioid addiction and poor oral health, because staff can likely treat both conditions at the same time.

California Dental Association - Resources for dentists as opioid crisis declared public emergency

Dental Products Report - How the opioid crisis affects oral health

Dimensions of Dental Hygiene - The Opioid Crisis

National Institute on Drug Abuse - Effective Treatments for Opioid Addiction

U.S National Library of Medicine - Drug addiction and periodontal diseases


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