Methadone is a prescription drug used to help individuals overcome withdraws from highly addictive illicit substances, such as heroin, but it has detrimental oral health effects. This manuscript reviews the oral health manifestations of methadone maintenance therapy, and considers its implications to oral care. It hopes to raise awareness among health care professionals, regulating bodies and the population at large about the oral side effects of methadone, the implications for dental treatment and considerations to better enhance the oral health of methadone users. The role of professional teams, particularly dentists and dental hygienists, is illustrated.