Suboxone Tooth Decay Lawsuit Update: Indivior Reports MDL Plaintiffs Down to 22,098

The latest Suboxone tooth decay lawsuit update comes from the defendant itself: in its quarterly report released on October 29, 2026, Indivior Pharmaceuticals said about 1,925 cases naming about 22,098 plaintiffs were consolidated in the federal Suboxone film MDL as of October 23, 2026, down from roughly 26,307 plaintiffs in July. The company still gives no estimate of possible loss, still says no bellwether trial will start before the end of the first quarter of 2028, and is days from closing a merger that will make the defendant Supernus, Inc.

That combination is unusual for a mass tort that has spent most of its life growing. Between the July and October filings the claimant roster in In re: Suboxone (Buprenorphine/Naloxone) Film Products Liability Litigation, MDL No. 3092, shrank by about 4,209 people, or roughly 16%, even as the federal docket tallied by the Judicial Panel on Multidistrict Litigation (JPML) kept adding actions. This article sets out what the 10-Q says, reconciles the competing case counts that circulate online, explains what the decline does and does not show, and walks through the bellwether timeline, the absence of any settlement, the Supernus merger, and what each development means for claimants' counsel, defendants and funders.

What the Indivior 10-Q says about the Suboxone MDL

Indivior files its quarterly reports with the Securities and Exchange Commission, and its legal-proceedings note is the only regularly updated, company-verified source on the size of the dental litigation. The Form 10-Q for the quarter ended September 30, 2026 makes five points about what the company calls the "Dental MDL."

First, the count. As of October 23, 2026, the filing states that approximately 1,925 cases naming approximately 22,098 plaintiffs have been consolidated in multidistrict litigation in the Northern District of Ohio. The prior quarterly report, covering the period through June 30, 2026, gave approximately 1,967 cases and 26,307 plaintiffs as of July 24, 2026.

Second, Schedule A. The 10-Q again describes a complaint filed in the MDL on June 14, 2024 that attached a schedule of nearly 10,000 plaintiffs, referred to as the "Schedule A Plaintiffs," together with a tolling agreement giving plaintiffs' counsel more time to investigate product use before filing individual complaints. As of October 23, 2026, the plaintiffs had reduced the number of Schedule A claimants to approximately 4,813, compared with about 4,854 in July.

Third, timing. The company repeats language that has appeared in every 2026 quarterly filing: "The MDL cases are in their preliminary stages. Any bellwether trials in the MDL would not occur until the end of the first quarter of 2028 at the earliest."

Fourth, exposure. Indivior says it believes it has meritorious defenses, intends to defend itself vigorously, and that no estimate of possible loss can be made at this time. The filing describes no accrual for the dental claims.

Fifth, scope. The filing notes proposed class actions on similar allegations, which also reach Suboxone tablets, filed in Quebec and British Columbia in April 2024. Those Canadian proceedings sit outside this article's focus; they matter here only as a reminder that the dental theory is not confined to the federal MDL.

The same October 29 release reported total net revenue of $356 million for the quarter, up from $314 million a year earlier, with Sublocade sales of $267 million, up 22%, and net income of $137 million. Those numbers matter to the litigation only indirectly: they show a defendant whose current revenue depends on a long-acting injectable that is not part of the dental claims, rather than on the film product at issue.

Suboxone tooth decay lawsuit update: the numbers over time

The 10-Q figures make more sense in sequence. The table below collects the counts Indivior has disclosed in its SEC filings since late 2025, alongside the JPML's monthly tally of pending federal actions.

Date of count	Source	Cases	Plaintiffs	Schedule A claimants
June 14, 2024	Schedule A complaint (as described in 10-Qs)	1 complaint	nearly 10,000 listed	nearly 10,000
Early 2025	Q1 2025 10-Q	not stated here	not stated here	8,575 (amended)
October 29, 2025	Q3 2025 10-Q	over 1,900	over 22,500	8,035
Early 2026	FY2025 10-K	about 2,000	more than 25,000	about 5,400 (as of Feb. 24, 2026)
April 28, 2026	Q1 2026 10-Q	about 1,900	about 25,000	not restated here
June 1, 2026	JPML pending-dockets report	1,833 pending (1,908 ever filed)	not reported	not reported
July 24, 2026	Q2 2026 10-Q	about 1,967	about 26,307	about 4,854
October 1, 2026	JPML pending-dockets report	2,022 pending (2,112 ever filed)	not reported	not reported
October 23, 2026	Q3 2026 10-Q	about 1,925	about 22,098	about 4,813

Three trends stand out. The plaintiff count rose from about 22,500 in October 2025 to a peak of about 26,307 in July 2026 and then fell back to about 22,098, slightly below where it was a year earlier. The Schedule A group, by contrast, has fallen steadily, from nearly 10,000 at filing to about 4,813, a reduction of more than half. And the JPML's action count rose by 189 between June and October, from 1,833 to 2,022, while Indivior's own case count fell by 42 between July and October.

The divergence between the JPML figure and the company figure is not a contradiction. The two sources count different things on different dates, as the next section explains.

How many Suboxone tooth decay lawsuits are there?

As of October 23, 2026, Indivior counts about 1,925 cases naming about 22,098 plaintiffs in the federal MDL, while the JPML's October 1, 2026 report lists 2,022 pending actions in MDL 3092. Both numbers can be accurate at once.

The JPML counts actions, meaning docketed civil cases on the MDL court's ledger. A complaint naming one plaintiff and a complaint naming 46 count the same: once. The JPML report also counts every pending action regardless of whether the defendant considers it duplicative, served, or properly part of the dental litigation. Its report for October 1, 2026 showed 2,022 pending of 2,112 ever filed, which means about 90 actions have already left the docket through dismissal, remand or resolution.

Indivior counts cases naming plaintiffs, which captures the multi-plaintiff complaints that dominate this docket. Twenty-two thousand plaintiffs spread across fewer than 2,000 cases works out to more than 11 plaintiffs per case on average, and the Schedule A complaint alone accounts for a large share of the total. The company's count is also taken three weeks later than the JPML's, on October 23.

That distinction explains why law-firm pages give such different answers to the question. Pages that cite "about 2,000 lawsuits" are quoting the JPML action count. Pages that cite "more than 11,000" or "over 20,000" claims are using plaintiff counts, sometimes from older Indivior filings, sometimes from plaintiffs' leadership census figures that are not public court records. None of these is wrong on its own terms; they answer different questions. For practitioners, the plaintiff count in the 10-Q is the better proxy for the size of any eventual settlement program, and the JPML action count is the better proxy for the court's docket-management burden.

A third figure sits outside both: claimants preserved by tolling agreement who have not filed at all. The Schedule A mechanism is the visible part of that inventory, but neither the JPML nor Indivior's headline count captures every unfiled claim that plaintiffs' firms hold. Our analysis of the October 2026 JPML statistics flagged Suboxone as the clearest example of an MDL where the federal action count understates the claimant population.

Why did the number of Suboxone plaintiffs drop?

Indivior's filing reports the decline without explaining it, so any account of the cause is inference. The roughly 4,209-plaintiff drop between July 24 and October 23, 2026 is consistent with plaintiffs being dismissed or withdrawn after records review, rather than with any settlement, because no settlement has been announced and the company still reports no loss estimate.

Several mechanisms common to large pharmaceutical MDLs can shrink a plaintiff roster without a single trial or settlement:

• Product identification. The claims concern the film formulation. Plaintiffs who, on review of pharmacy records, used only tablets, generic buprenorphine-naloxone, or another transmucosal product may fall outside the master complaint's theory against Indivior. Product Identification problems tend to surface once pharmacy records arrive, and the MDL court has spent much of 2025 pressing pharmacies and providers to produce those records.
• Records-driven vetting. The bellwether protocol required a records collection stage for a 500-plaintiff pool and a 100-plaintiff Core Discovery Pool, according to case trackers. Records work in a sample often prompts firms to re-examine their whole inventory, not just the sampled cases.
• Fact-sheet compliance. Plaintiff Fact Sheet (PFS) and census obligations, backed by show-cause orders, typically produce a wave of dismissals of claimants who cannot be located or do not respond.
• Pleading clean-up. Multi-plaintiff complaints are sometimes severed, refiled or consolidated; the count of "plaintiffs named" can fall when duplicates are removed or claimants are moved between complaints.

What the data does not show is a collapse of the litigation. The plaintiff count is back to roughly its level of October 2025, the JPML's action count is at a high, and the case count fell by only 42 in the quarter. The more likely reading is that the July figure was inflated by claimants who had not yet been vetted, and the October figure reflects a roster that has been through more of that process. Whether the decline continues will be visible in the next 10-Q, which Supernus, Inc. would file for the period after the merger.

Schedule A and the tolling agreement

The Schedule A complaint is a docket-management device that has become central to the litigation's arithmetic. Rather than file thousands of individual complaints, plaintiffs' counsel filed one complaint on June 14, 2024 listing nearly 10,000 people, paired with a Tolling Agreement that preserves the claims while counsel investigate whether each person used Suboxone film and suffered a qualifying dental injury. Each Schedule A claimant must eventually either file an individual complaint or drop out.

The Schedule A list has shrunk from nearly 10,000 to 8,575, then 8,035, then about 5,400, then about 4,854, and now about 4,813. Some of that decline reflects claimants who converted to individual or multi-plaintiff short-form complaints, which would move them from the Schedule A count into the case and plaintiff counts; some reflects claimants dropped. The 10-Qs do not break out the two. The small change in the latest quarter, a reduction of about 41, suggests the Schedule A list is close to its working floor, and that the July-to-October decline in total plaintiffs came mostly from filed cases rather than from Schedule A.

For Statute of Limitations purposes, the arrangement matters most to the roughly 4,800 claimants still on the list: their claims are preserved only on the agreement's terms, which have not been published.

What the plaintiffs allege and which claims survived

The litigation rests on a straightforward theory. Suboxone film, a buprenorphine-naloxone strip dissolved under the tongue to treat opioid use disorder, is acidic, and plaintiffs allege that prolonged contact with teeth caused decay, erosion, fractures and tooth loss. They allege that Indivior knew or should have known of the risk, that a safer formulation was feasible, and that the label did not warn of dental injury until 2022.

The regulatory history anchors the timeline. On January 12, 2022, the Food and Drug Administration issued a Drug Safety Communication warning about dental problems with buprenorphine medicines dissolved in the mouth, covering both tablets and films placed under the tongue or against the inside of the cheek. The agency said it had identified 305 cases of dental problems, 131 of them classified as serious, including tooth decay, cavities, dental abscesses and infection, tooth erosion and tooth loss. It required a new warning in the prescribing information and medication guides, and those labels were updated by June 2022. The FDA did not identify a dental concern with buprenorphine skin patches or injections, which is why the litigation targets the film and not Indivior's injectable Sublocade.

Cases began to accumulate after the warning, and the JPML centralized them in the Northern District of Ohio before Judge J. Philip Calabrese in February 2024 under master docket No. 1:24-md-3092. Two defendants matter most: Indivior, which holds the approval for Suboxone film and controls its label, and Aquestive Therapeutics, which developed and manufactures the film.

Which claims survived in the Suboxone MDL?

The core Failure to Warn and pre-approval Design Defect claims survived Indivior's motion to dismiss, while post-approval design-defect claims were dismissed, according to case trackers summarizing Judge Calabrese's December 31, 2024 ruling. The distinction tracks federal Preemption (Products) doctrine: once the FDA approved the formulation, a manufacturer generally cannot unilaterally change it, so a claim that the company should have redesigned the approved product after approval runs into impossibility preemption. A claim that a safer design should have been adopted before approval does not face the same bar.

Failure-to-warn claims proceed against Indivior as the label holder, which can strengthen a label through the FDA's changes-being-effected process. The fight on those claims will turn on what Indivior knew before 2022 and when, and on the Learned Intermediary Doctrine, since the warning runs to the prescribing physician.

Aquestive's position is narrower. Its own Form 10-Q for the quarter ended June 30, 2026 says the motion to dismiss was granted as to all claims against Aquestive except the design-defect claims and claims for Punitive Damages. Aquestive also discloses that Indivior has agreed to defend it in these matters and that Indivior's contractual indemnification obligation remains in effect. In practice, that makes Indivior, and soon Supernus, Inc., the economic defendant for both companies.

The 10-Qs also flag one parallel case on similar allegations in New Jersey state court. Most claims, however, are concentrated in the federal MDL.

When is the first Suboxone bellwether trial?

No bellwether trial will begin before the end of the first quarter of 2028 at the earliest, according to Indivior's October 2026 10-Q, and case trackers report a first single-plaintiff Bellwether Trial setting in March 2028. That is roughly four years after centralization.

The pre-trial pipeline, as summarized by trackers and reflected in the court's case management orders posted on the MDL page, has three stages:

1. Records collection. The court identified a pool of 500 plaintiffs for records collection under the bellwether protocol.
2. Core discovery. Judge Calabrese randomly selected 100 plaintiffs for a Core Discovery Pool, in which depositions and case-specific expert work proceed.
3. Trial selection. The parties narrow the core pool to a small set of trial candidates; one tracker reports the final bellwether selections are expected by June 2027, a date not confirmed in the company's filings.

Before any trial, the court will also have to resolve expert challenges. General Causation (whether Suboxone film can cause the dental injuries alleged) and Specific Causation (whether it did for a given plaintiff, as opposed to the dental effects of opioid use, diet, dry mouth or pre-existing dental disease) will be tested through Rule 702 motions, the federal equivalent of a Daubert Challenge. Recent pharmaceutical MDLs show how decisive that stage can be. In the Depo-Provera MDL, a settlement reached most claimants before Rule 702 rulings, leaving a minority of cases dependent on those undecided rulings, as our Depo-Provera coverage explained. In the Suboxone MDL, the expert phase is still ahead.

Is there a Suboxone tooth decay settlement?

No. As of the October 29, 2026 filing, no settlement of the dental claims has been announced, and Indivior states that no estimate of possible loss can be made. A company that had agreed, or was close to agreeing, a global resolution would ordinarily have to consider accruing a probable and estimable loss, so the absence of any accrual is itself informative.

Readers searching for "Suboxone settlement" will find older, unrelated payments. Indivior has paid to resolve antitrust claims over its switch from tablets to film, including a $385 million settlement with direct purchasers in 2023, and it has finalized opioid settlements with cities, counties and other subdivisions in 49 states, completed in January 2026. None of those resolves a dental injury claim.

Law-firm pages also publish "expected payout" ranges for Suboxone dental claims, typically tens of thousands of dollars per claimant scaled to the severity of dental work. Those figures are marketing estimates with no basis in any court order, settlement matrix or verdict, and this article does not repeat them as if they were. The only data points that will move claim values are bellwether results, Rule 702 rulings, and any Global Settlement terms, none of which yet exist.

Insurance adds a further wrinkle. Indivior's earlier 2026 filings disclose that its primary insurance carrier and secondary carriers have issued a reservation of rights against payment of any liability costs. A reservation of rights is common in product cases, but it signals that any eventual resolution may be funded at least partly from the balance sheet rather than from coverage.

What happens to the Suboxone lawsuits after the Supernus merger?

The Suboxone lawsuits continue against the same corporate defendants after the merger; only the parent's name changes. Under the August 2026 merger agreement, a merger subsidiary of Indivior merges into Supernus Pharmaceuticals, Supernus survives as a wholly owned subsidiary of Indivior, and Indivior is renamed Supernus, Inc.

The structure matters for the litigation. Because Indivior is the surviving parent, not a target being absorbed, the Indivior entities named in the MDL remain in place, their liabilities stay with them, and Supernus's legacy business becomes part of the same consolidated group. There is no transfer of assets out of the defendant that would raise a successor-liability or fraudulent-transfer question of the kind seen in Texas Two-Step restructurings. Claimants keep suing the same entities; those entities simply sit inside a larger, renamed company.

The deal is an all-stock transaction in which each Supernus share converts into the right to receive 1.5401 Indivior shares. Both companies' stockholders approved the merger-related proposals on October 15, 2026, and Indivior's third-quarter release assumes the merger is completed on November 2, 2026. Supernus stockholders have filed demand letters and two complaints in the Supreme Court of the State of New York, County of New York, alleging disclosure defects in the joint proxy statement; those suits concern the merger disclosures, not the dental claims.

For the MDL, the practical consequences are modest but real:

• Disclosure continuity. The legal-proceedings note will move into Supernus, Inc.'s filings. The next count will appear in the combined company's reports, and any change in how it describes the Dental MDL will be worth reading closely.
• Ability to pay. A larger, more diversified company is, if anything, a more creditworthy defendant, which reduces the collection risk that sometimes shadows pharmaceutical mass torts.
• Settlement incentives. Merged companies sometimes prefer to resolve legacy litigation to clear the balance sheet, but nothing in the filings indicates such a plan.

Suboxone MDL timeline: from FDA warning to 2028 trial

The litigation's key dates, drawn from the FDA, the JPML, the MDL court and Indivior's and Aquestive's SEC filings, run as follows:

• January 12, 2022. The FDA warns that buprenorphine medicines dissolved in the mouth can cause dental problems, citing 305 reported cases, 131 of them serious.
• June 2022. Prescribing information and medication guides for transmucosal buprenorphine products carry the new dental warning. Plaintiffs treat this as the date after which the label disclosed the risk.
• February 2024. The JPML centralizes the federal dental cases in the Northern District of Ohio as MDL No. 3092 before Judge J. Philip Calabrese.
• June 14, 2024. Plaintiffs file the Schedule A complaint listing nearly 10,000 claimants, backed by a tolling agreement.
• December 31, 2024. Judge Calabrese rules on the motions to dismiss, leaving failure-to-warn and pre-approval design-defect claims in the case and dismissing post-approval design claims, according to case trackers; Aquestive is left facing only design-defect and punitive damages claims.
• 2025. Bellwether records collection begins for a 500-plaintiff pool; the court issues show-cause orders to pharmacies and providers slow to produce records; the Schedule A list falls to 8,575 and then 8,035.
• 2026. The court randomly selects 100 plaintiffs for the Core Discovery Pool. Indivior's plaintiff count peaks at about 26,307 in July, then falls to about 22,098 by October 23.
• August to October 2026. Indivior and Supernus sign an all-stock merger agreement; stockholders approve it on October 15; Indivior's October 29 release assumes a November 2 closing.
• End of Q1 2028, at the earliest. First bellwether trial, per Indivior; trackers cite a March 2028 setting.

Seen as a whole, the timeline shows an MDL that has moved at an ordinary pace for a pharmaceutical docket of its size. More than four years will separate the FDA warning from the first trial, and the case has not yet reached the expert phase that typically decides whether a pharmaceutical mass tort settles, shrinks or collapses.

How the Suboxone MDL compares with other drug MDLs

By federal action count, the Suboxone docket is mid-sized. The JPML's October 1, 2026 report, which we analyzed in our JPML case-count coverage, listed 2,022 pending Suboxone actions, against about 6,412 in the Depo-Provera MDL, 4,025 in the GLP-1 receptor agonist MDL and 12,381 in the hair relaxer MDL.

By plaintiff count, the picture changes. Because the Suboxone docket is built on multi-plaintiff complaints and the Schedule A list, its roughly 22,098 plaintiffs exceed what its action count would suggest. That makes it an outlier: most product MDLs proceed largely on single-plaintiff short-form complaints, so the action count and the plaintiff count roughly converge. In Suboxone, the ratio is more than 11 to 1.

The comparison also shows where the case sits in its life cycle. Depo-Provera reached a Master Settlement Agreement in July 2026 while expert rulings were still pending. The GLP-1 MDL has been through extended Rule 702 proceedings. The Suboxone MDL has not reached either point. Its distinctive features are a single dominant economic defendant, a narrow product theory tied to one formulation, and a regulatory warning date that divides claims into pre-warning and post-warning periods. Each of those features will shape how a Settlement Matrix, if one is ever negotiated, values individual claims: by product, by injury severity, and by when the claimant used the film relative to the 2022 label change.

What it means for claimants' counsel, defendants and funders

For claimants' counsel. The 22,098 figure is the number Indivior is willing to state publicly, and it is down 16% in a quarter. Any eventual settlement program will be negotiated against a vetted roster, so the firms whose inventories survive records review will be best positioned. The film-only theory makes product identification the first gate; pharmacy records showing dispensing of the branded film, not tablets or a generic, will be essential. The surviving claims are concentrated against Indivior on failure to warn and pre-approval design, which puts the pre-2022 knowledge record at the center of discovery. Firms holding Schedule A claimants also need to track the tolling agreement's terms, since those roughly 4,800 claims depend on it.

For defendants. Indivior's posture is consistent: preliminary stage, meritorious defenses, no estimate. The plaintiff decline supports a narrative that the inventory contains many claims that do not survive scrutiny, and the defense will likely press that point when bellwether selection and Rule 702 motions arrive. The narrowing of claims against Aquestive, combined with Indivior's indemnity, concentrates the defense in one company, which simplifies strategy but also concentrates exposure in the renamed Supernus, Inc.

For litigation funders. Funders underwriting Suboxone portfolios should value them on plaintiff counts adjusted for attrition, not on JPML action counts. The October 10-Q shows attrition of about 16% in one quarter, and the Schedule A list has lost more than half its original names. With no trial before 2028 and no settlement framework, duration risk is high. Courts in other MDLs have begun ordering disclosure of Third-Party Litigation Funding in connection with settlement opt-outs and lien questions, as the paraquat MDL did in October 2026 (paraquat opt-out coverage); funders should expect that scrutiny to travel.

For claimants and their dentists. The case turns on records: prescriptions showing film use, dental records showing the timing and progression of injury, and evidence separating film-related damage from other causes. That is a description of what the litigation tests, not advice about any individual claim.

What to watch next

• The merger closing, assumed for November 2, 2026, and the first Supernus, Inc. filing that carries the Dental MDL disclosure.
• The next JPML report, which will show whether the action count keeps rising while the company's plaintiff count falls.
• Case management conferences before Judge Calabrese, and any order narrowing the Core Discovery Pool toward trial selection.
• Rule 702 scheduling for general and specific causation experts, which will set the real timetable for a March 2028 trial.
• Any accrual or loss estimate in a future filing, which would be the clearest public signal that settlement talks have advanced.

FAQ

What is the latest Suboxone tooth decay lawsuit update?

On October 29, 2026, Indivior reported that about 1,925 cases naming about 22,098 plaintiffs were pending in the federal Suboxone film MDL as of October 23, 2026, down from about 26,307 plaintiffs in July. It reported no settlement, no loss estimate and no bellwether trial before the end of the first quarter of 2028.

Who is the judge in the Suboxone MDL?

U.S. District Judge J. Philip Calabrese of the Northern District of Ohio presides over MDL No. 3092, In re: Suboxone (Buprenorphine/Naloxone) Film Products Liability Litigation, master docket No. 1:24-md-3092. The JPML assigned the litigation to him in February 2024.

How many Suboxone tooth decay lawsuits are there?

About 1,925 cases naming about 22,098 plaintiffs, according to Indivior's October 23, 2026 count; the JPML separately listed 2,022 pending federal actions on October 1, 2026. The difference reflects counting method and date, since many complaints name multiple plaintiffs.

When is the first Suboxone bellwether trial?

Not before the end of the first quarter of 2028, according to Indivior's filings; trackers report a March 2028 setting for the first single-plaintiff bellwether trial.

Is there a Suboxone tooth decay settlement?

No. No dental-injury settlement has been announced, and Indivior says it cannot estimate a possible loss. Earlier Indivior settlements resolved antitrust and opioid claims, not tooth decay claims.

What happens to the Suboxone lawsuits after the Supernus merger?

They continue against the same Indivior entities. Indivior is the surviving parent and will be renamed Supernus, Inc.; the merger, approved by stockholders on October 15, 2026, does not move the dental liabilities out of the defendant.