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November 09, 2023 (Cleveland, OH)

The Center’s Northeast Ohio Hospital Opioid Consortium Hosts Education on Dental Health and Medications for Opioid Use Disorder

The November meeting of the Northeast Ohio Hospital Opioid Consortium featured guest speaker Frank Beck, DDS, FAAHD, MAGD, FICOI, DSCDA, who spoke about the impact on oral health resulting from vital therapy utilizing medications for opioid use disorder (MOUD) and the dangers of improper dental treatment. Dr. Beck is inaugural dean at NEOMED Bitonte College of Dentistry and chief regional opioid officer at Mercy Health.

The virtual meeting — available now on The Center’s YouTube Channel — provided information for mitigation strategies, including dental pre-habilitation, peri-habilitation and post-habilitation protocols and a clear explanation of approved drugs for treatment.

Dr. Beck explained that while MOUD are essential for treatment, medical and dental awareness is severely lacking on their impact on oral health. Advocating for an evidence-based protocol to be established for intervention and prevention of negative dental health, he explains that “individuals induced on suboxone without any dental intervention will lose 20 teeth during the first 300 days of their induction.”

In 2022, the U.S. Food & Drug Administration (FDA) issued an alert about the negative dental impacts of dissolvable MOUD. The issue states: “Dental problems have been reported with medicines containing buprenorphine that are dissolved in the mouth. The problems, including tooth decay, cavities, oral infections and loss of teeth, can be serious and have been reported even in patients with no history of dental issues. Despite these risks, buprenorphine is an important treatment option for opioid use disorder and pain, and the benefits of these medicines clearly outweigh the risks.”

Currently, the FDA approves of three drugs for medically assisted treatment and MOUD. These drugs include methadone, buprenorphine, and Suboxone — a combination of buprenorphine and naloxone. Dr. Beck explains that Suboxone is 10 times more expensive than buprenorphine alone and comes with more devastation as it promotes oral decay.

Even with buprenorphine, Dr. Beck recommends a complete dental rehabilitation initial clearance which includes: a caries risk assessment, full mouth radiographic evaluation, panoramic radiograph, dental evaluation and periodontal evaluation before a patient gets their first induction of a MOUD.

The presentation also discussed the following areas:

  • Connecting patients to treatment.
  • Xylitol and its impact on oral health.
  • The importance of a balanced oral pH.
  • The benefits of monitored dental care to prevent future pain and ongoing health concerns.

More information on the importance of dental care when prescribing MOUD can be found in the full Opioid Consortium presentation on The Center for Health Affairs’ YouTube channel.