Suboxone Dental Crisis: Exclusive State-by-State Breakdown

Drugwatch gathered data on Suboxone dental problems from people seeking help with filing a Suboxone lawsuit beginning in October 2023. As of December 2025, Drugwatch has received more than 13,300 reports of dental issues from people in all 50 U.S. states and the District of Columbia.

We’ve used this data to analyze Suboxone-related dental trends unique to U.S. states and regions for 2024.

Many people who reported dental issues revealed that they were never warned about serious dental problems that significantly impacted their quality of life.

Dentist Dr. Joseph Hasso explained to Drugwatch that sublingual forms of Suboxone or buprenorphine could cause dental problems because they change the pH balance in the mouth.

“[This] can increase the risk for cavities and under-the-surface decay, gum (periodontal) irritation and even gum disease (periodontitis),” Hasso said.

The top five states reporting dental problems per capita in 2024 were Maine, New Hampshire, New Mexico, Vermont and Washington.

With a rate of roughly 10.04 reports per 100,000 people, Maine had the highest percentage of people reporting Suboxone dental problems compared to their population.

The five states with the lowest dental report rates based on population are Georgia, Hawaii, Kansas, Texas and Iowa.

With a dental report rate of just 0.43, Texas and Iowa saw the lowest rate of Suboxone dental problems reported in 2024.

Suboxone Dental Problem Rates in All 50 States

Many of the states with high Suboxone dental problem rates are in the eastern half of the U.S. This could be because many of these states have had higher buprenorphine prescription rates in recent years.

Data from the CDC shows the states with the highest buprenorphine dispensing rates in 2023 were West Virginia, Vermont, Kentucky and Maine. Buprenorphine dispensing rate data often includes Suboxone, as it is a main ingredient of the medication. The Drug Enforcement Administration lists Suboxone as a brand-name formulation of buprenorphine.

We received the highest number of Suboxone dental problem reports from New York (701), followed by Florida (518), Washington (504), Massachusetts (399) and California (375).

It’s worth noting that these states also have higher populations overall, so they may naturally have more individual reports.

When adjusted for population and per-capita calculations, Washington and Massachusetts were also in the top 10 for the highest rates of dental problem reporting.

In addition to ranking dental problem rates by state, we ranked each region of the U.S. and found the highest rate of dental issue reports came from the Northeast, at 3.44 per 100,000 people.

Suboxone Dental Problem Rate Highest in the Northeast

The Northeast has some of the states with the highest individual Suboxone dental problem rates, such as Maine, which led the country in dental problem rates in our study.

The Northeast has historically been hard hit by the opioid crisis, which could account for high levels of dental problem reports related to Suboxone. The overall rate for dental problem reports in this region is 3.44 per 100,000 people.

The Midwest Has the Lowest Rate of Suboxone Dental Problems

The region with the lowest rate of Suboxone dental problems is the Midwest, with a rate of 1.84 per 100,000 people.

The Midwest has had barriers to access for opioid use disorder treatment because of a lack of providers in rural areas, which could account for low rates of dental problem reports related to Suboxone.

The South Is the Second-Highest Region for Suboxone Dental Problem Reports

The South has the second-highest rate of Suboxone dental problem reports, with 2.12 reports per 100,000.

Notably, this region includes West Virginia, which had the highest rate of buprenorphine prescriptions in 2023.

The West Ranks Third for Suboxone Dental Problem Reports

The West ranks third for Suboxone dental problem reports, with a rate of 1.85 out of 100,000. New Mexico has the highest report rate at 6.95 out of 100,000.

Buprenorphine prescriptions have been steadily rising in the West, with some locations spiking in prescription rates. From 2017 to 2018, the West had the largest increase in prescriptions at 18.2%.

In a 2024 study, researchers found Oregon’s buprenorphine prescription rate rose from 8.9% in 2016 to 37.5% in 2021.

A comparison of submissions made to Drugwatch and the data in the FDA Adverse Event Reporting System (FAERS) shows that Suboxone dental problems appear to be underreported.

FAERS collects reports of adverse events voluntarily submitted to the FDA. It’s important to note that reports in FAERS don’t necessarily mean the drug caused the reaction.

Drugwatch received over 13,300 reports of Suboxone tooth decay, cavities and other dental problems from October 2023 to November 2025.

There were only 212 reports of oral and tooth problems from 2000 to Nov. 30, 2025, suggesting underreporting when compared with the number of people who reached out to Drugwatch.

A reason for underreporting might be that the general public doesn’t know they can report problems to the FDA through MedWatch.

The reports Drugwatch received are from people who are directly seeking help for their Suboxone-related dental problems, not simply reporting them.

Suboxone combines the drugs buprenorphine and naloxone to treat opioid use disorder. The strip dissolves under the tongue, connecting with the same receptors as other opioid drugs to prevent cravings and lessen the “high” people experience from opioids.

While Suboxone (buprenorphine/naloxone) sublingual film is effective at preventing opioid deaths, serious dental side effects can have a negative impact on patients. These may include tooth decay, cavities, oral infections and tooth loss.

“Dental problems can result in pain and/or dental sensitivity, embarrassment from the appearance of dental decay, and problems with eating, which can become a vicious cycle contributing [to] social isolation, depression and general discomfort due to loss of confidence and social ease during the recovery period,” Hasso said.

Nevertheless, the FDA has said the benefits outweigh the risks of untreated opioid use disorder (OUD).

“In clinical practice, I see the same pattern: when we get someone onto an adequate dose and keep them there, they are more likely to stay alive, more likely to stay in treatment and less likely to return to street opioids,” Dr. Barbara Sparacino, a triple board-certified physician in adult psychiatry, geriatric psychiatry and addiction medicine, told Drugwatch.

However, people have reached out to Drugwatch to share that dental problems from Suboxone have impacted their lives emotionally and financially.

Allison’s Story

Allison, who is omitting her last name for privacy, shared that she started taking Suboxone to help her with her painkiller addiction. Since then, she has suffered from severe gum disease, tooth decay and broken teeth.

“I have no dental insurance or funds to regularly see a dentist. I brush and floss every day, use mouthwash and nothing is helping. My gum lines are becoming almost black and it’s embarrassing, especially working in the front of the house in the service industry,” Allison told Drugwatch.

Studies in PLoS Medicine and in Health and Human Rights Journal found that people may be reluctant to continue treatment and medication for OUD because they feel stigmatized by being “dependent” on the treatment, even when effective. In fact, the majority of people on buprenorphine treatment express an interest in discontinuing the medication.

“Discontinuation is often due to stigma, lack of access to trained providers, limited insurance coverage and misperceptions about what recovery should look like,” said Dr. Chad Elkin, a board-certified physician in addiction medicine.

Yet dental side effects are a growing concern.

Dana’s Story

Though Suboxone is effective at treating OUD, some patients expressed to Drugwatch that they wouldn’t have used it if they knew they would lose their teeth and suffer dental problems.

“As of today, I have lost seven teeth, and have another that has to be pulled. In addition, I need yet another root canal on a front tooth and two crowns, none of which I can afford at this point. It’s humiliating and has left me in a constant state of anxiety and hopelessness,” said Dana, who is omitting her full name for privacy.

Dana said the medication helped address one part of her life, only to destroy another.

“Had I been informed of these disastrous possible effects, I never would have started the medication. The distress at this point is insurmountable.”

The bottom line is that Suboxone is still life-saving care for people with OUD, and there are ways to reduce the risk of dental problems.

“What I emphasize with patients is that … we don’t want fear about teeth to push them to stop treatment abruptly. Instead, we talk about practical harm reduction,” Sparacino said.

For some people, significant dental problems may occur despite good care. Patients should ask their doctor about other treatment options if they experience severe issues, Sparacino said.

As an example, there are long-acting injectable buprenorphine products that may help treat OUD without contact with the teeth.

We analyzed our own internal data based on Suboxone patients who contacted Drugwatch to inquire about Suboxone dental lawsuits.

To calculate the rate of dental problems, we used the number of dental reports from our 2024 data, as well as 2024 state population data from the Federal Reserve Bank of St. Louis.

To compare our dental reports with FDA data, we searched for key terms in FAERS. We also consulted data and research from medical experts in peer-reviewed medical journals.