Observational research to assess the prolonged effects of medication for opioid use disorder (oral-moud) on oral health: a mixed methods study

The National Institute of Dental and Craniofacial Research awarded Chestnut Health Systems Inc. $606,406 on September 1, 2026, under the Oral Diseases and Disorders Research program (CFDA 93.121) to conduct observational research assessing the prolonged effects of medications for opioid use disorder on oral health.

The research follows a sequential explanatory mixed methods study design guided by an oral health disparities framework adapted to include opioid use disorder treatment and recovery constructs such as treatment adherence, recovery capital, and stigma. The study seeks to identify potential factors underlying the onset and progression of oral disease associated with dissolvable buprenorphine and methadone; understand the contribution of environmental and behavioral factors to oral disease among patients receiving these medications; and determine how potential oral disease might be mitigated during medication-assisted treatment. The research will examine the relationships between patients' access to dental care and opioid use disorder treatment and recovery. The study is set at a federally qualified health center with integrated medication-assisted treatment, dental, and subordinate services in Chicago, Illinois.

The project runs from September 1, 2026, through May 31, 2031. This award is assistance type Project Grant through NIDCR's extramural research program supporting basic, translational, and clinical research in dental, oral, and craniofacial health and disease.

Abstract

Increased treatment access, uptake, and retention are essential for addressing the overdose epidemic that has claimed over 1 million american lives over the past two decades. Among the few FDA-approved medications for opioid use disorder (moud), dissolvable formulations of buprenorphine (d-BUP) and orally administered methadone are the most utilized. Past research has demonstrated an association between these medications and oral diseases that can negatively impact patients' overall health and quality of life. However, these claims are limited to evidence from retrospective and cross-sectional studies with no or limited comparison groups. Moreover, non-oral moud alternatives are often less appealing and accessible to people with OUD. Competing oral health and addiction medicine priorities and limitations of prior studies in this area highlight the need for research to determine (a) if causal links exist between one or both of these medications (e.g., d-BUP and methadone) and oral health problems, (b) whether one medication might be more detrimental to oral health, and (c) how potential oral disease might be mitigated during moud treatment. This project will identify the potential factors underlying the onset and progression of oral disease associated with d-BUP and methadone. We also seek to understand the contribution of environmental and other behavioral factors to oral disease among patients receiving moud as well as patients' relationships with dental care access and OUD treatment and recovery. The study follows a sequential explanatory mixed method study guided by an oral health disparities framework adapted to include OUD treatment and recovery constructs (e.g., treatment adherence, recovery capital, stigma). Our study has a unique setting: a federally qualified health center with integrated moud, dental, and primary care that offers both d-BUP and methadone. This study has the following aims: (aim 1) examine the association between moud and dental caries (tooth decay) through a cross-sectional comparison of prevalence and severity among a sample (n=381) of people with OUD who are moud-naïve and moud patients; (aim 2) document and compare differences in dental caries increment among a cohort of d-BUP and methadone patients (n=376) over 12 months; (aim 3) identify actionable oral heath intervention points: (a) qualitatively understanding how moderating and mediating factors influence oral health outcomes among patients (n=30-80) receiving moud and (b) collaborating with an expert advisory board to identify points of intervention to inform clinical recommendations for patients receiving moud.