title: Rampant caries from oral transmucosal fentanyl citrate lozenge abuse.
abstract: BACKGROUND
  Oral transmucosal fentanyl citrate lozenges (lollipops) are indicated for the oral management of breakthrough cancer pain. When abused, these sucrose-containing lozenges can cause rampant dental caries.
  
  
  METHODS
  The authors examined a 19-year-old man whose dentist referred him because of total dental coronal destruction. After the authors questioned the patient, they concluded that his frequent oral use of sucrose-containing opioid fentanyl citrate lozenges across a three-year period caused the dental condition.
  
  
  CONCLUSIONS
  Dentists should be aware that oral transmucosal fentanyl citrate lozenges are being prescribed off-label for the control of pain from nonmalignant sources. Fentanyl citrate's effective analgesic potency can lead to misuse and potential abuse. Early recognition of its misuse could prevent severe dental caries and the need for extensive dental restoration.
authors: Salivary Gland Center, Columbia University College of Dental Medicine, 630 West 168th St., New York, NY, USA.
authors: Louis
authors: L
authors: Mandel
authors: Michele J
authors: MJ
authors: Carunchio
mesh_terms: D000278:Administration, Buccal; D000701:Analgesics, Opioid / Q000009:adverse effects*; D002326:Cariogenic Agents / Q000009:adverse effects; D003731:Dental Caries / Q000209:etiology*; D005283:Fentanyl / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000150:complications*; D014677:Pharmaceutical Vehicles / Q000009:adverse effects; D013395:Sucrose / Q000009:adverse effects; D013607:Tablets; D014277:Trigeminal Neuralgia / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D002326:Cariogenic Agents; D014677:Pharmaceutical Vehicles; D013607:Tablets; D013395:Sucrose; D005283:Fentanyl