That Pill You’re Taking Might Be Hurting Your Teeth

January 12, 2026

How Common Medications Like Suboxone, Can Affect Your Oral Health.

Here’s something most people don’t think about: that medication you take every morning, whether it’s for blood pressure, allergies, depression, or recovery, might be quietly causing problems in your mouth. We see it all the time at Potomac Dental Centre. Patients come in with sudden cavities, gum issues, or unexplained tooth decay, and they’re genuinely puzzled. “I brush twice a day,” they’ll say. “I floss. What’s going on?”

Often, the culprit is sitting right there in their medicine cabinet.

The Dry Mouth Problem (It’s Bigger Than You Think)

Let’s talk about saliva for a second. Yes, really. Saliva does a lot more than help you swallow food. It’s actually your mouth’s natural defense system. It washes away food particles, neutralizes acids produced by bacteria, and delivers minerals that help strengthen tooth enamel. When your mouth dries out, all of that protection disappears.

And here’s the kicker: over 500 medications list dry mouth as a side effect. According to the American Dental Association, these include antihistamines like Benadryl, antidepressants like Zoloft and Prozac, blood pressure medications, pain relievers, and decongestants. Even some over-the-counter cold medicines can dry you out.

You might not notice it right away. Maybe your mouth feels a little sticky when you wake up. Maybe you’re reaching for water more often. But over time, that reduced saliva flow creates the perfect environment for cavities to form and bacteria to thrive.

Suboxone and Your Teeth: What the FDA Wants You to Know

Now, let’s get into something that doesn’t get talked about enough: Suboxone and similar buprenorphine medications used in addiction recovery. These medications have genuinely helped millions of people reclaim their lives from opioid dependency. That’s not up for debate. But in January 2022, the FDA issued a drug safety communication that caught a lot of people off guard.

The warning? Buprenorphine medicines that dissolve in the mouth have been linked to serious dental problems, including tooth decay, cavities, oral infections, and even tooth loss. The FDA reviewed 305 cases of dental issues in patients taking these sublingual medications, with 131 classified as serious. In 26 of those cases, patients had no prior history of dental problems at all.

Why does this happen? When buprenorphine dissolves under your tongue, it creates an acidic environment. That acid can wear down enamel over time. Combine that with the medication’s tendency to cause dry mouth, and you’ve got a one-two punch your teeth really can’t handle.

We want to be clear about something: if you’re taking Suboxone or a similar medication, do not stop taking it without talking to your doctor. The benefits of these medications in treating opioid use disorder far outweigh the dental risks. But you should know what’s happening so you can take extra precautions, and so we can help you protect your teeth while you’re on this treatment.

Blood Pressure Meds and Gum Troubles

If you take calcium channel blockers for high blood pressure (medications like Norvasc, Procardia, or Cardizem) you might notice something strange happening with your gums. They can start to swell and grow over your teeth, a condition called gingival hyperplasia or gum overgrowth. It’s not dangerous exactly, but it makes cleaning your teeth properly almost impossible. And that leads to more plaque buildup, more bacteria, and (you guessed it) more problems.

Studies suggest anywhere from 6% to 15% of patients on these medications experience some degree of gum enlargement. It’s worth mentioning to your dentist if you’re on these drugs, especially if your gums seem puffy or tender.

The Bisphosphonate Situation

This one’s important for our patients who take medications for osteoporosis or certain cancers. Bisphosphonates (drugs like Fosamax, Boniva, and Reclast) strengthen bones throughout your body. But they can also affect the jawbone in rare cases, leading to a condition called osteonecrosis of the jaw, or ONJ. Essentially, bone tissue in the jaw doesn’t heal properly after dental procedures like extractions or implant surgery.

The risk is relatively low for people taking oral bisphosphonates for osteoporosis. Studies suggest the prevalence ranges from about 0.07% to 0.1% in the United States for patients taking these medications long-term. But it’s significantly higher for cancer patients receiving IV bisphosphonates, where rates can reach several percent. This is exactly why we ask about your medications before any procedure. If you’re on these drugs, we might recommend completing any needed dental work before you start treatment, or we may take a more cautious approach to extractions and implants.

Antidepressants, Anxiety Meds, and the Grinding Connection

SSRIs (medications like Lexapro, Celexa, and Paxil) are incredibly effective for depression and anxiety. But they come with an unexpected side effect for some people: bruxism, or teeth grinding. You might be clenching your jaw during the day without realizing it, or grinding in your sleep. Over time, this wears down your enamel, causes sensitivity, and can even crack teeth.

A 2015 multicenter study published in Clinical Neuropharmacology found that approximately 14% of patients taking antidepressants experienced bruxism. And a 2020 study in BMC Psychiatry found that people taking antidepressants were 10 times more likely to report bruxism compared to those taking other medications. So if you’ve started on an antidepressant and wake up with jaw pain or headaches, it’s worth bringing up. A night guard can make a world of difference.

What Can You Actually Do About All This?

Okay, so maybe this all sounds a bit doom and gloom. But honestly? Once you know what you’re dealing with, you can take steps to minimize the damage. Here’s what we recommend:

Stay hydrated. This sounds basic, but sipping water throughout the day helps counteract dry mouth. Some patients find that sugar-free gum or lozenges with xylitol also help stimulate saliva production.

Rinse after dissolving medications. If you take sublingual medications like Suboxone, wait until the medication fully dissolves, then gently rinse your mouth with plain water. Don’t brush right away. Your enamel is vulnerable when exposed to acid, and brushing immediately can actually cause more harm. The FDA recommends waiting at least one hour before brushing.

Use fluoride. A prescription-strength fluoride toothpaste or rinse can help strengthen weakened enamel. We can recommend specific products based on your situation.

Come see us more often. If you’re on medications that affect your oral health, twice-yearly cleanings might not be enough. Some patients benefit from cleanings every three or four months, at least while they’re on certain medications.

Tell us everything. We mean it. Bring a list of your medications: prescription, over-the-counter, supplements, everything. Don’t assume something isn’t relevant. You’d be surprised how often a medication we wouldn’t have guessed plays a role in what we’re seeing in your mouth.

The Bottom Line

Your medications are there for a reason. They’re managing conditions that matter. The last thing we want is for you to feel like you have to choose between your overall health and your dental health, because you don’t. With the right information and a proactive approach, you can protect your teeth while still taking the medications you need.

At Potomac Dental Centre here in Hagerstown, we see patients dealing with medication-related dental issues regularly. Whether it’s rebuilding teeth damaged by dry mouth, addressing gum problems caused by blood pressure meds, or carefully planning implant work for patients on bisphosphonates, we’ve got the experience to help you navigate these challenges.

So bring us your questions. Bring us your medication list. Let’s figure this out together.

Sources: