Suboxone Tooth Decay Lawsuit Update

This page explains the Suboxone tooth decay lawsuits, the dental injuries linked to Suboxone film, and where the federal MDL stands in 2026.

The core claim in the Suboxone litigation is straightforward: plaintiffs allege that Indivior and related defendants knew, or should have known, that Suboxone film could cause severe dental damage, including tooth decay, enamel erosion, broken teeth, tooth loss, and expensive dental reconstruction. Plaintiffs contend the companies failed to warn patients and prescribing doctors until the FDA forced a dental warning in 2022.

Suboxone Tooth Decay Lawsuit Updates for 2026

The Suboxone tooth decay litigation is moving from filing claims into proving claims. That means Judge J. Philip Calabrese is focused on census compliance, pharmacy records, dental records, medical records, corporate depositions, and bellwether case selection. The size of the MDL still matters, but the bigger question in 2026 is how many claims are documented well enough to survive discovery and create real settlement pressure.

Suboxone MDL Nears 18,000 Lawsuits

July 10, 2026

The Suboxone tooth decay MDL now includes 17,911 served federal lawsuits against Indivior.

That number is large, but it still does not capture the full size of the litigation because some complaints include up to 100 plaintiffs. So the docket count is not the same thing as the total number of people pursuing Suboxone dental injury claims.

The next big event is bellwether selection. The parties must select 15 cases by July 13, 2026, for the next stage of trial preparation. Those cases will later be narrowed to four final bellwether picks by June 11, 2027. The first Suboxone bellwether trial is not expected until March 2028. That timeline is frustrating for victims, but it is not unusual for an MDL of this size.

The court is also making progress with the Schedule A claims. These abbreviated filings were allowed before the two-year anniversary of the FDA’s June 2022 label change, which may have been a statute of limitations deadline in many states. At one point, more than 9,600 Suboxone claims were on the Schedule A list. The latest report says 4,854 remain.

Those cases need to be cleared one way or another because the MDL cannot move efficiently with thousands of bare bones claims sitting in procedural limbo. Judge Calabrese has made clear that the time has come for those plaintiffs to file proper cases or face dismissal. That is a necessary slog, but it should strengthen the litigation by separating documented claims from unsupported cases.

For settlement purposes, the bellwether process is now the main event. If plaintiffs win early trials, Indivior will face greater pressure to resolve the broader docket. If the defense wins, settlement values could be pushed lower. For now, the litigation is still growing, the trial pool is narrowing, and the court is slowly moving the MDL toward the first real jury tests.

New Suboxone Lawsuit

June 13, 2026

In a new lawsuit filed yesterday, several plaintiffs from Missouri, Maine, and Minnesota joined the Suboxone products liability MDL against Indivior, alleging that Suboxone film caused severe and permanent dental injuries. The plaintiffs claim they were prescribed and used Suboxone film in cities including Festus and St. Louis, Missouri; Bangor, Maine; Stillwater, St. Paul, Warroad, Minneapolis, and St. Louis Park, Minnesota, and later suffered tooth damage requiring substantial dental treatment.

New filings like this show that the MDL is still drawing claims even as the court pushes older claims into formal discovery. The court is trying to move the litigation forward without letting undocumented cases clog the system. That creates a sharper divide between claims supported by records and claims that were preserved but still need to be proven.

Plaintiffs’ Lawyers Note 14 Depositions

May 16, 2026

Plaintiffs’ Suboxone lawyers noted 14 depositions last week. These depositions are important because plaintiffs need corporate testimony on product design, labeling, regulatory decisions, medical safety information, document custody, and the film technology used in Suboxone.

The witness list shows plaintiffs are digging into the heart of the case: who knew what, when they knew it, what Indivior did with safety information, and whether the company could have warned earlier. The Thaxter deposition is especially important because former senior leadership testimony can frame the company’s decisions for jurors and settlement negotiators.

Schedule A Plaintiffs Must File Suit

April 28, 2026

At last week’s case management conference, Judge Calabrese stated that the “time for doing has passed” and that Schedule A plaintiffs must either file individual cases or be dismissed.

Schedule A was created to allow thousands of plaintiffs to file abbreviated complaints without full injury details or medical records, preserving their claims before state statute of limitations deadlines expired. That list originally held almost 10,000 claims. About 5,000 remain. The court’s position, and it is easy to see where the judge is coming from, is that two years is enough time to gather the documentation needed to file a proper individual case.

This cleanup is necessary. A mass tort cannot move toward settlement with thousands of unresolved placeholder claims. Plaintiffs with strong records should benefit from a cleaner docket because the defense will have less room to argue that the inventory is filled with unsupported claims.

Suboxone Lawsuit Schedule Becomes Clear

April 1, 2026

Judge Calabrese entered a new case management order laying out the bellwether schedule for the Suboxone tooth decay MDL.

The good news is that the MDL now has a concrete path to trial. The bad news is that the first trials are projected for 2028.

The order calls for 20 cases to be randomly selected from the remaining 100 case pool for core discovery by June 10, 2026, after which the parties will identify 15 preferred representative cases by July 13, 2026.

Depositions in those tooth decay cases will run through January 15, 2027. Dispositive motions are due by March 12, 2027, and the court expects to narrow the group to four final bellwether cases by June 11, 2027. The first trial is currently projected to begin in March 2028.

This gives the parties a real roadmap. The defense now knows which cases may become trial candidates. Plaintiffs now know what proof the court expects. Settlement pressure usually builds when both sides can see the jury path, even if that path is slow.

Learn more about the Suboxone bellwether trial schedule and MDL discovery process.

Older Suboxone Lawsuit Updates

New Suboxone Lawsuit

March 1, 2026

In a new lawsuit, a family from Darrow, Louisiana, filed suit in MDL No. 3092, alleging that long-term use of Suboxone sublingual film left them with permanent and extensive dental damage after they were prescribed the medication to treat opioid dependence.

The plaintiff is a resident of Ascension Parish, Louisiana, who was prescribed Suboxone film in Hammond, Louisiana, and used the product as directed while living in Darrow. The plaintiff initially became dependent on opioids after being prescribed pain medication by a physician for pain management. Seeking treatment for opioid use disorder, the plaintiff was placed on Suboxone film as part of medication-assisted therapy.

The lawsuit emphasizes that the plaintiff used Suboxone film exactly as prescribed, dissolving the acidic film in the mouth daily, often multiple times per day, for an extended period. During treatment, neither the plaintiff nor the prescribing physicians were warned that the product’s acidic formulation could erode enamel, accelerate decay, or cause permanent dental deterioration.

The claim is a useful example of the recurring plaintiff story in this MDL: a person used the film as directed to treat opioid dependence, later developed serious dental damage, and alleges that a timely warning would have changed monitoring, prevention, treatment decisions, or product choice.

100 Plaintiffs Make Core Discovery Pool

February 25, 2026

Judge Calabrese has randomly selected 100 plaintiffs in the Suboxone Film MDL for potential inclusion in the Core Discovery Pool under Case Management Order No. 15. These cases were chosen from files where defendants say records collection is substantially complete.

Selection does not mean a case is headed to trial, but it does move the case into a smaller group for more intensive case-specific discovery.

This is an important structural step in the path to settlement. Trial dates create pressure, and this Core Discovery Pool is how the court begins testing cases in detail and building toward eventual bellwether trials and serious settlement discussions.

Suboxone Lawsuit Meeting

January 18, 2026

There will be a court conference on January 21, 2026, where Judge Calabrese and the lawyers will address how the Suboxone MDL is moving forward. This type of hearing is a case management conference, which means the court checks progress, resolves disputes, and sets the next steps.

The conference is expected to focus on outside records, plaintiff census compliance, medical and pharmacy records, defendant document production, and the schedule for future conferences.

Third party records remain a recurring problem in this litigation. Some pharmacies, medical providers, and treatment centers have been slow to produce records needed to prove Suboxone use and dental injury. The court may also address whether noncompliant entities should face contempt proceedings or other penalties.

On the defense side, Judge Calabrese is expected to address missing documents, confidentiality disputes, production problems, and scanning or formatting issues that may have affected whether documents and attachments were properly captured and searchable.

Suboxone Settlement Update

January 14, 2026

Many individuals dealing with dental injuries linked to Suboxone are understandably eager for clarity on when settlement payouts might begin. The desire for resolution is real, but so is the litigation timeline.

Some are floating the idea that a settlement could come early. It is not impossible. It is just unlikely. These cases tend to move when trials loom and the risk of a public jury verdict becomes immediate. With key bellwether steps now set, real pressure is more likely to build as the parties move deeper into discovery and trial selection.

In our view, current chatter about an early Suboxone settlement is just that: chatter. A settlement could happen before the first bellwether trial, but Indivior has little incentive to pay full value until the strongest cases are better developed.

Cleaning House

January 7, 2026

Judge Calabrese held a 45 minute Zoom status conference to address several document related issues in the Suboxone MDL. The discussion focused on missing records, document quality problems, and whether evidence collection is moving fast enough to support the next phase of bellwether preparation.

The court ordered the parties to prepare a list of any remaining missing portions of the Suboxone tablet non-disclosure agreement and submit it by January 12, 2026. Judge Calabrese also required a representative from the document storage company to appear at the January 21 hearing to explain what happened to any materials that remain missing.

The court directed the parties to submit written explanations about document scanning errors. These errors may have affected whether certain attachments were properly captured and searchable. That sounds technical, but in a document heavy pharmaceutical case, missing attachments can affect what plaintiffs can prove about company knowledge, labeling decisions, and internal safety discussions.

Judge Calabrese also instructed both sides to keep working together to identify which plaintiffs have substantially completed medical and pharmacy record collection. This is how the court determines which cases are ready to move forward and which claims remain stuck in procedural mud.

Judge Calabrese also required Plaintiffs’ leadership to promptly respond to the defendants’ request to limit public access to parts of a prior hearing transcript.

Finally, the court requested an update on depositions, including sworn testimony from company employees who maintained documents or have relevant knowledge about Suboxone film, warnings, safety information, and corporate decision-making.

Show Cause Orders

September 28, 2025

Over the past two weeks, plaintiffs in the Suboxone Film MDL have filed 132 responses to show cause orders. These orders require plaintiffs to explain why their claims should not be dismissed for missing census forms or other procedural gaps. The recent wave of filings reflects a coordinated effort to address those issues and keep viable claims active on the docket.

Cases with no response may be dismissed. That is appropriate. Plaintiffs who follow the rules should not have their cases slowed by claims that cannot be documented or prosecuted.

New Order

September 18, 2025

A new order from Judge Calabrese marks a shift toward stricter enforcement in the Suboxone tooth decay litigation. During a September 9, 2025, in person status conference, the court addressed procedural issues involving noncompliance with prior court directives.

The judge said he would order the three remaining third-party providers to turn over medical or related records for specific plaintiffs. If providers do not comply, the party requesting the records can file a motion for contempt under Rule 45.

The court also dismissed with prejudice the claims of several plaintiffs who failed to comply with Case Management Order No. 15. That means the claims are permanently dismissed and cannot be refiled.

This kind of enforcement is not necessarily bad for plaintiffs. In a large MDL, unsupported claims need to be removed. A cleaner docket helps plaintiffs with documented cases and gives the parties a more honest picture of settlement exposure.

Status Conference Today

September 9, 2025

Today’s Suboxone hearing is about keeping the cases moving. The judge will check on subpoenas to treatment centers and a pharmacy that have not turned over records. The court will also look at plaintiff census compliance. If a plaintiff has not submitted the census or medical record forms, the judge may dismiss that case.

On the defense side, the court will push for clearer rules and deadlines for document production and corporate witness testimony. There is also a dispute about old company emails and a recent privilege clawback that the judge may address.

The takeaway for existing plaintiffs is straightforward: get the paperwork in to protect your claim.

Suboxone Lawsuit Count

September 5, 2025

As of Tuesday, there are 1,882 filings in the Suboxone tooth decay MDL pending in the Northern District of Ohio. That figure does not reflect the true scale of the litigation.

Under Case Management Order No. 14, the court has permitted batch filings of up to 100 plaintiffs per complaint. As a result, the number of docketed cases significantly understates the number of individuals pursuing claims.

The big question is how many compensable claims exist within the larger claimant inventory. Our guess is less than half. That is why record collection and census compliance are now so central.

Batch Filing of Suboxone Lawsuits

August 18, 2025

We are seeing fewer Suboxone lawsuit filings but larger batches of plaintiffs. In one recently filed lawsuit, 54 plaintiffs from across the United States filed a joint complaint in the Suboxone MDL alleging serious dental injuries from prescribed use of Suboxone film.

The plaintiffs claim that the manufacturers knowingly designed Suboxone film with an acidic formulation that causes irreversible dental damage, including tooth decay, erosion, and loss, without adequately warning physicians or patients.

Batch filings make administrative sense in a large MDL, but they also create a need for careful case screening. Each plaintiff still needs individual proof of product use, injury, timing, and damages.

More on Getting Pharmacy Records to Prove Your Case

August 10, 2025

One persistent choke point in moving Suboxone tooth decay cases toward trial has been the sheer slog of collecting medical and pharmacy records.

In theory, this should be a straightforward paper chase where plaintiffs sign HIPAA releases, pharmacies produce prescription histories, and the litigation moves forward. In practice, many record holders have been slow, inconsistent, or difficult to reach.

Without pharmacy records, plaintiffs cannot make the critical evidentiary showing that they were prescribed brand name Suboxone film before the onset of dental injuries. That leaves cases stalled in procedural limbo.

A clear path to a Suboxone settlement depends on resolving this bottleneck. The bellwether process depends on narrowing the plaintiff pool to documented claims. A global settlement also depends on knowing which claims can actually be proven.

Is Indivior Misjudging What a Suboxone Settlement Will Look Like?

July 17, 2025

Indivior may be betting that juries will not connect with people in recovery. If that is the calculation, it could be wrong and expensive.

For years now, plaintiffs’ lawyers have been talking to the people behind these cases. They are parents, workers, spouses, and friends. People who fought their way back from addiction and followed the treatment plan. They took Suboxone, stayed the course, and did the work. They were not reckless. They trusted the system. What they did not expect was permanent dental damage hidden behind that trust.

Jurors may understand that story. They may see people who used a prescribed medication to rebuild their lives and were not given the dental warnings they needed. If Indivior assumes stigma will do the defense work, it may be underestimating the fairness and common sense of everyday jurors.

Suboxone Lawsuit Profile Is Changing

July 11, 2025

Unlike some mass torts, Suboxone has flown under the radar. That may change as discovery develops and the bellwether process brings real plaintiffs into focus.

The plaintiffs in these cases can be compelling: people in recovery, often with no serious prior dental issues, now facing tens of thousands of dollars in dental reconstruction. Once those stories start appearing in trial exhibits and witness testimony, Indivior’s risk calculation could shift quickly.

Deposition Process

July 8, 2025

The MDL judge issued a new order outlining how depositions will proceed. The order applies to general witnesses and those involved in the bellwether process unless earlier orders already cover those details.

Depositions will usually happen in person unless both sides agree to proceed remotely. The order also addresses confidentiality, exhibits, remote deposition procedures, scheduling, and the number of lawyers permitted to question witnesses.

This kind of deposition order may sound routine, but it sets the rules for testimony that could shape the entire case. In a pharmaceutical MDL, corporate witness testimony is often where plaintiffs test what the company knew, how it responded, and whether earlier warnings were feasible.

Indivior’s Blind Spot

July 3, 2025

There is a dangerous assumption built into Indivior’s defense strategy if the company believes juries will discount plaintiffs because of a history of opioid addiction. That would be a misreading of the human story in these cases.

Many plaintiffs did what the medical system asked them to do. They sought treatment. They stayed on medication. They used Suboxone as prescribed. Then they suffered serious dental injuries they say they were never warned about.

Broken teeth, extractions, dentures, implants, and out of pocket dental bills can change a person’s life. A jury may respond strongly to that evidence, especially if plaintiffs can show the company had earlier information about the risk and failed to act.

Getting Suboxone Pharmacy Records

June 27, 2025

One challenging part of the Suboxone litigation is getting pharmacy records. Pharmacies do not always make this easy.

Walgreens, Safeway, and Porch Light Health | Front Range Clinic were previously ordered to show cause for allegedly failing to comply with Case Management Order No. 13, which requires production of pharmacy records within 30 days after receiving valid medical authorizations.

The judge later withdrew the show cause order as to two providers identified by Plaintiffs’ Leadership Counsel as having complied with the record requests, but left the hearing in place for Walgreens Pharmacy.

Pharmacy records are critical because they can establish whether a plaintiff used brand name Suboxone film, when it was used, and for how long.

Path to Trial

May 24, 2025

The MDL judge issued Amended Case Management Order No. 15, outlining the bellwether trial protocol in the federal Suboxone litigation.

The order establishes a phased process beginning with a 500 member Records Collection Pool. Plaintiffs in this pool must provide signed medical authorizations for records related to Suboxone treatment and claimed injuries. Plaintiffs who do not comply may have their cases dismissed.

From the initial 500 cases, 100 are randomly chosen for the Core Discovery Pool. Those plaintiffs and the defendants must exchange detailed fact sheets and medical records through Rubris Crosslink. After depositions and document exchanges, 15 trial pool cases will be selected. Ultimately, four bellwether trial candidates will be finalized.

This protocol is the roadmap for the first real trial tests in the litigation, unless a global Suboxone settlement comes first.

Drop in Schedule A Claims

March 13, 2025

Not long after the Suboxone MDL was formed, the potential statute of limitations in states with a two year deadline created a rush to file claims by June 2024.

To prevent the court from being inundated with individual filings, Judge Calabrese permitted a consolidated lawsuit referred to as the Schedule A cases, encompassing approximately 9,600 individuals. Most of those cases were still gathering documentation to support their claims.

In recent weeks, the number of Schedule A complaints has been reduced to 8,611 because some claims that were initially preserved did not prove viable.

That is not surprising. In every mass tort, the preserved inventory shrinks once lawyers begin collecting pharmacy records, medical records, dental records, and product identification.

Multiple Lawyers

November 23, 2024

Many Suboxone victims have hired more than one lawyer for their claim. One key takeaway from Thursday’s status conference was the need for attorneys to use the Rubris Crosslink platform to begin addressing duplicate representation.

Duplicate representation can create conflicts and inefficiencies that slow down case progress and complicate settlement negotiations. This is not a Suboxone specific problem. It happens in every mass tort.

The Rubris platform helps identify overlapping legal representation so conflicts can be resolved earlier and cases can move more efficiently.

Suboxone Settlement Rumors

July 2, 2024

There is scattered talk of early settlement discussions in the Suboxone MDL. We do not expect Indivior to get serious about settlement until there is more trial pressure.

Settlement rumors are worth watching, but they should not be mistaken for a real settlement process. In most pharmaceutical MDLs, defendants do not pay meaningful settlement value until bellwether cases are developed and trial risk becomes concrete.

Plaintiff Attorneys’ Request for Tolling Period Goes On

May 17, 2024

Plaintiffs have pushed for a tolling agreement that would allow claims to be preserved while lawyers investigate product use, pharmacy records, medical records, and dental injuries.

No one can say with certainty what the statute of limitations deadline is in every case because state law varies and individual facts matter. But lawyers on both sides recognize that a potential June 2024 deadline exists for many plaintiffs in states with a two year statute of limitations.

The judge adopted a procedural approach that allowed plaintiffs’ leadership to file a master complaint with individual plaintiffs listed on Schedule A. This gave plaintiffs a way to preserve claims without immediately overwhelming the court with thousands of separate lawsuits.

The procedure added hoops, but it also helped protect claims while the parties sorted out documentation and filing mechanics.

JPML Creates Suboxone MDL

February 4, 2024

The Judicial Panel on Multidistrict Litigation created the Suboxone MDL, consolidating federal lawsuits alleging that the manufacturers of Suboxone film failed to adequately warn consumers that the medication could cause dental decay.

The Panel transferred the cases to the U.S. District Court for the Northern District of Ohio before Judge J. Philip Calabrese.

The MDL is In re: Suboxone (Buprenorphine/Naloxone) Film Products Liability Litigation, case number 1:24-md-03092.

New Suboxone Case Highlights Statute of Limitations Issue

January 22, 2024

A new Suboxone case filed this week highlights the challenge of bringing claims after a statute of limitations deadline may have passed.

The plaintiff, a Kentucky resident, alleges he used prescription Suboxone film and later suffered tooth damage. He also alleges he only discovered in late 2023 that Suboxone film had caused his dental injuries.

That allegation is central because Kentucky has a one year statute of limitations. The plaintiff is relying on the discovery rule, arguing that he filed within one year of learning that Suboxone may have caused his injuries.

Statute of limitations fights will continue to shape the MDL. Even strong injury claims can face serious problems if they were filed too late under the law of the plaintiff’s state.

Frequently Asked Questions About the Suboxone Litigation

What is the real reason people are suing over Suboxone?

The lawsuits allege that Indivior failed to warn patients and doctors that Suboxone film could cause serious dental injuries, including tooth decay, enamel erosion, tooth loss, extractions, and expensive restorative dental work. Plaintiffs argue that the company knew, or should have known, about the risk much earlier and failed to provide adequate warnings.

Who qualifies for the Suboxone tooth decay lawsuit?

Potentially qualifying claims usually involve people who used Suboxone film and later developed significant dental injuries. Stronger claims often include proof of brand name Suboxone film use, dental records showing injury progression, and treatment records showing extractions, implants, dentures, bridges, crowns, root canals, or other major dental work.

Can I still apply for the Suboxone lawsuit?

You may still have a case depending on your state, timing, product use, and dental injury history. But our firm is not taking new Suboxone claims in 2026.

When is the first Suboxone trial?

The first Suboxone bellwether trial in the MDL is currently projected for March 2028.

How bad does my tooth damage have to be to have a case?

The strongest cases usually involve serious, documented dental injury. Important factors include:

• Multiple extractions, usually three or more
• Significant tooth decay, enamel erosion, or tooth loss
• Root canals, crowns, bridges, implants, dentures, or other major restorative dental work
• Clear proof of Suboxone film use, especially brand name Suboxone film
• Use before the 2022 FDA dental warning
• Dental records showing damage developed or worsened after Suboxone use began
• No long history of severe dental problems before taking Suboxone
• Out of pocket dental bills, future treatment estimates, or records showing ongoing dental needs

How do I know if I have a strong case for the Suboxone lawsuit?

A stronger case usually has three things: proof of Suboxone film use, serious dental injury, and records connecting the timeline of use to the dental damage. Dental records, pharmacy records, treatment notes, and proof of extractions or major restorative work are especially important.

Suboxone Lawsuit Timeline

The Suboxone MDL is moving from filing claims to proving claims. The court is narrowing the case pool, forcing plaintiffs to document product use and dental injury, and building toward the first bellwether trials. The process is slow, but it is now organized around real trial preparation.

Step 1: The Warning Finally Came

January 2022: The FDA required dental warnings for buprenorphine medicines dissolved in the mouth. Before that warning, many Suboxone film users had no reason to know the medication could damage their teeth.

What this means for plaintiffs: Cases involving Suboxone film use before the dental warning may be stronger because the failure to warn argument is cleaner.  Still, the current warning is inadequate.

Step 2: The Cases Were Centralized

February 2024: The JPML centralized federal Suboxone tooth decay lawsuits in the Northern District of Ohio before Judge J. Philip Calabrese.

What this means for plaintiffs: Each plaintiff still has an individual claim, but the MDL allows one judge to manage discovery, scheduling, expert issues, and bellwether trial preparation.

Step 3: Documentation Became the Gatekeeper

2025 to 2026: The court has pushed plaintiffs to provide census forms, pharmacy records, dental records, medical records, and proof of Suboxone film use.

What this means for plaintiffs: Strong cases are not just about serious dental injuries. Plaintiffs need records showing Suboxone film use, timing, dental deterioration, treatment, and damages.

Step 4: Bellwether Cases Start Taking Shape

2026 to 2027: The court is narrowing the pool toward a small group of representative cases for trial preparation.

What this means for plaintiffs: This is where settlement value starts to become more concrete. The defense gets a closer look at real plaintiffs, real dental injuries, and real damages.

Step 5: Trial Pressure Is Real, But Slow

Projected March 2028: The first bellwether trial is expected in 2028.

What this means for plaintiffs: A settlement could happen before trial, but the current schedule suggests this will not be a quick payout litigation unless Indivior decides it wants to avoid bellwether risk.

Suboxone

Approved by the FDA in 2002, Suboxone was promoted as a safer and easier way to treat opioid addiction. By combining buprenorphine, a drug that eases withdrawal and blocks the high from stronger opioids, with naloxone to deter abuse, it quickly became a common medication in recovery programs nationwide.

Suboxone’s roots go back decades, when researchers discovered buprenorphine could manage opioid dependence with a lower overdose risk than methadone. Taken as a dissolvable strip under the tongue, it seemed effective and convenient. What patients were not told, plaintiffs allege, is that the same acidic formulation that made Suboxone easy to take could damage teeth over time. That risk did not appear on the label for nearly 20 years.

Failure to Warn About Suboxone Tooth Decay

No one is arguing that Suboxone should disappear from addiction treatment. Plaintiffs’ lawyers in the Suboxone tooth decay litigation are not calling for a Suboxone recall. The claim is narrower: Indivior and the other defendants should have warned doctors and patients much earlier that Suboxone film could cause serious dental injuries.

The original labels for Suboxone tablets and film carried no meaningful dental warning. Plaintiffs allege that the defendants had enough information to know that prolonged exposure to an acidic sublingual film could damage teeth, erode enamel, accelerate decay, and lead to tooth loss. The lawsuits allege wrongful conduct in the design, testing, labeling, packaging, promotion, marketing, distribution, and sale of Suboxone film.

This warning failure is especially serious because Suboxone is prescribed to people working to recover from opioid addiction. Many patients are trying to rebuild their lives and may already face financial barriers to dental care. If they had been properly warned, they could have taken preventive steps, such as rinsing after use, using fluoride, seeing a dentist more frequently, or discussing alternative treatment options with their doctors.

In January 2022, the FDA issued a warning about dental problems associated with buprenorphine medicines dissolved in the mouth, including Suboxone film. The warning identified risks such as tooth decay, cavities, oral infections, and tooth loss. Plaintiffs argue that the 2022 warning confirms what should have been disclosed years earlier.

At the center of every Suboxone lawsuit is a failure to warn claim. Plaintiffs allege that patients used the product as prescribed, trusted the label, and were not told that the film could contribute to severe tooth decay, broken teeth, oral infections, extractions, implants, dentures, and expensive dental reconstruction. Had the warnings been timely and adequate, many users could have taken steps to reduce the risk or chosen a different treatment option.

Studies Linking Suboxone to Dental Damage

In 2012, Harvard Medical School professors published a case report on a patient whose oral health declined after 18 months on Suboxone tablets. The patient reportedly had no prior history of serious dental problems and later required extensive treatment for decay across multiple teeth. The authors suggested that sublingual delivery of buprenorphine and naloxone kept the medication in prolonged contact with the teeth, accelerating damage.

The following year, the same lead author and colleagues reported a series of 11 patients at Brigham and Women’s Hospital who saw rapid dental deterioration after starting buprenorphine treatment. Problems included cavities, cracked teeth, crowns, root canals, and extractions. Researchers noted that the low pH of Suboxone created an acidic environment where enamel erosion and decay can thrive.

Other research has echoed these findings, reinforcing what the early studies suggested years ago: Suboxone’s formulation and delivery method can pose serious risks to dental health.

The pH of Suboxone

Suboxone has a low pH when dissolved in water, meaning it is acidic. The pH scale ranges from 0 to 14. A pH of 7 is neutral. Values below 7 are acidic. Tooth enamel begins to demineralize when the oral environment drops below about 5.5.

When enamel loses minerals such as calcium and phosphate, the tooth structure weakens. That makes teeth more vulnerable to cavities, decay, and fracture. When an acidic medication dissolves under the tongue and remains in the mouth, it can create repeated periods of acid exposure.

This is why plaintiffs argue the risk should have been obvious. The problem was not some obscure scientific mystery. A low pH film placed in the mouth every day, sometimes more than once a day, creates a foreseeable risk of enamel damage. The plaintiffs contend Indivior should have warned patients and doctors much earlier.

Dry Mouth

Xerostomia, commonly called dry mouth, is a condition involving reduced saliva production. Saliva helps protect teeth by rinsing away food particles and bacteria, neutralizing acids, stabilizing pH, and keeping the mouth moist.

When saliva production drops, the mouth becomes more acidic and less able to defend against decay. That can contribute to cavities, oral infections, enamel erosion, and tooth loss.

Suboxone may contribute to dry mouth. Plaintiffs allege that this risk, combined with the acidic nature of the film and its prolonged contact with teeth, created a predictable dental danger that should have been disclosed much sooner.

Why Suboxone Lawyers Focus on Brand Name Film Use Before June 2018

The strongest Suboxone dental injury claims generally involve brand name Suboxone film use before June 2018. Before that time, Indivior controlled most of the market for Suboxone film and was responsible for the product’s design, labeling, testing, and warnings.

After June 2018, generic versions of Suboxone became more widely available and took over a larger share of the market. Generic claims are more complicated because generic manufacturers generally must use the same FDA approved labeling as the brand name manufacturer. That creates legal barriers in failure to warn cases.

This does not mean every post 2018 claim is worthless. It means the product history and pharmacy records become even more important. A plaintiff needs to know whether the prescription was brand name Suboxone film, generic buprenorphine naloxone film, or another product entirely.

That is why pharmacy records are so central in this MDL. They identify the product, prescription dates, dosage, and sometimes the manufacturer. Without those records, a plaintiff may have serious dental injuries but still struggle to prove the product link needed for a successful case.

Who Are the Defendants in the Suboxone Lawsuits?

The primary defendant in the Suboxone lawsuits is Indivior, Inc., the pharmaceutical company that makes and sells Suboxone. Indivior focuses on drugs used to treat opioid dependence.

Indivior was formerly a division of the British pharmaceutical company Reckitt Benckiser. In 2014, Reckitt spun off Indivior and its opioid addiction treatment business into a new publicly traded company.

The Suboxone tooth decay lawsuits generally name Indivior, Reckitt, and various U.S. operating entities as defendants. Plaintiffs also name Aquestive Therapeutics Inc., a New Jersey pharmaceutical company connected to the film technology used with Suboxone.

Indivior’s past conduct may also affect how jurors view the company. In 2019, the Department of Justice indicted the company for false marketing claims and a scheme involving Suboxone film. Prior criminal and civil settlements do not prove the dental injury claims by themselves, but they reinforce plaintiffs’ broader argument that Indivior put sales and market control ahead of patient safety.

Is There a Suboxone Class Action Lawsuit?

Many people refer to the Suboxone litigation as a class action lawsuit. Technically, it is not a class action. It is a multidistrict litigation, or MDL.

The Suboxone MDL, MDL No. 3092, is pending in federal court in the Northern District of Ohio before Judge J. Philip Calabrese. The MDL was created to streamline pretrial proceedings for plaintiffs who allege that Suboxone film caused severe dental injuries, including tooth decay, tooth loss, and enamel erosion.

What an MDL Means for Suboxone Plaintiffs

An MDL works differently from a class action. Each plaintiff keeps an individual lawsuit. Settlement value, if there is a settlement, is based on that person’s product use, dental injuries, records, timing, damages, and state law.

The MDL process allows one judge to oversee common pretrial issues, including discovery, motions, expert testimony, and bellwether trial preparation. This helps avoid inconsistent rulings and allows the parties to test recurring evidence more efficiently.

How an MDL Can Lead to a Settlement

A major feature of an MDL is the bellwether trial process. A few representative cases are selected for early jury trials. These cases help both sides evaluate how juries may respond to the evidence.

Bellwether verdicts can shape settlement negotiations. If juries return strong verdicts for plaintiffs, defendants usually face greater pressure to negotiate a broader settlement. If defendants win early trials, they gain leverage and may offer less.

That is why the March 2028 trial window is important even though it is far away. It gives the litigation a destination. Settlement talks may occur before then, but meaningful settlement pressure usually grows when trial risk becomes concrete.

Potential Suboxone Lawsuit Settlement Amounts

Our lawyers previously estimated that settlement payouts for many Suboxone tooth decay lawsuits could fall between $50,000 and $150,000. Smaller cases could be worth less, and stronger cases could be worth more.

This estimate is speculative. The litigation is still developing, the first bellwether trial is not projected until 2028, and there is no global settlement. It is impossible to predict average settlement amounts with certainty at this stage.

If Suboxone cases go to trial and plaintiffs win, individual verdicts could be higher than settlement values, especially in cases involving severe dental destruction, multiple extractions, implants, dentures, large out of pocket dental bills, and strong proof that earlier warnings would have changed patient or doctor behavior.

The cases with the strongest settlement value are likely to involve documented brand name Suboxone film use, use before the 2022 FDA dental warning, serious dental injuries, clear dental records, and limited preexisting dental problems. Cases with weak product proof, long treatment gaps, preexisting severe dental disease, or unclear causation may have lower value.

It would be easy to throw out a high settlement number to attract attention. That would not be responsible. The honest answer is that settlement values will depend on the quality of the evidence, the bellwether trial results, the strength of expert testimony, and how many claims survive the documentation process.

Suboxone Settlement and Criminal Charges

In 2016, 41 states and the District of Columbia filed an antitrust lawsuit against defendants for alleged monopolistic practices in the opioid addiction treatment market involving Suboxone.

That case, filed in the Eastern District of Pennsylvania, settled in 2023, with Indivior agreeing to pay $102.5 million.

Further legal challenges followed. In 2019, a federal grand jury in Virginia indicted Indivior, accusing the company of operating an illegal nationwide scheme to increase prescriptions of Suboxone film. The indictment claimed that Indivior’s “Here to Help” program was used to connect patients with doctors known for prescribing Suboxone and other opioids beyond legal limits.

Indivior was also accused of stopping production of its tablet form of Suboxone to impede FDA approval of generic versions.

To resolve related claims, Reckitt forfeited $647 million in proceeds from Indivior, paid $700 million in civil settlements to the federal government and six states, and paid an additional $50 million to the Federal Trade Commission. Reckitt’s total resolution was reported at $1.4 billion.

There were also personal consequences for Indivior executives. Shaun Thaxter, the former CEO, was sentenced to six months in federal prison, fined $100,000, and ordered to forfeit $500,000 after pleading guilty to misdemeanor misbranding of Suboxone film. Timothy Baxter, Indivior’s former medical director, also pleaded guilty to the same charge and received six months of home detention, 100 hours of community service, and a $100,000 criminal fine.

Those prior proceedings are not the same as the dental injury lawsuits. But they give context to plaintiffs’ argument that Indivior has a history of aggressive Suboxone related conduct and cannot simply ask jurors to assume it always put patient safety first.