Millions of Americans are currently taking a GLP-1 medication like Ozempic, Wegovy, Mounjaro or Zepbound for diabetes and weight loss. Although most people know these medications are for weight loss and blood sugar control, dentists are starting to notice an increase in dry mouths, increased sensitivity and early signs of enamel wearing in patients taking GLP-1 medications.
Although ‘Ozempic teeth’ is becoming a popular term online, it is not a medical diagnosis and there is not a great deal of research on the topic. However, the reasons why this can happen are easy to understand and mostly can be managed.
Why GLP-1 medications can affect your teeth
GLP-1 medications mimic a hormone in our gut to slow digestion and make you feel full. This explainer gives a simple overview of how GLP-1 medications work and the differences between semaglutide and tirzepatide. There are several side effects these medications can cause that can affect your teeth:
Nausea and vomiting. These are the most common side effects. In the main trial looking at the effects of semaglutide for weight loss (STEP 1), around 44% of patients experienced nausea and 25% vomiting, compared to 17% and 7% on the placebo. Most cases are mild and happen while the dose is being increased. Stomach acid is strong enough to weaken tooth enamel.
Reflux. Due to the slowing of gastric emptying, some people experience heartburn and regurgitation into the throat. This can cause erosion of the back of the teeth.
Dry mouth. Patients and dentists have reported experiencing dry mouths. This can occur due to people simply not drinking as much. As well as reducing hunger these medications can reduce the feeling of thirst. Saliva helps protect our teeth by clearing food debris and buffering acids. Therefore, having less saliva will increase the risk of cavities and gum issues.
Reduced eating. The whole point of the medication is to reduce eating. However, some people end up snacking on soft, sugary and acidic foods and drinks because other foods don’t sound appealing. Diets low in calories can lack essential nutrients for healthy gums.
While there are no large studies showing that GLP-1 medications damage teeth, what we know comes from their well-documented gastrointestinal side effects and from what dentists are seeing in patients who take them. You can find a summary of semaglutide’s known side effects and how often they occur.
What to look out for
- Increased sensitivity to hot/cold/sweets
- Yellow / glassy-looking edges to your teeth (thin enamel)
- Dry mouth / sticky mouth (especially first thing in the morning)
- Persistent bad breath
- Gum bleeding, redness and recession
- Poor healing
If you notice any of these issues, let your dentist know at your next appointment.
Tips for protecting your teeth while on a GLP-1
- Do not brush your teeth straight after vomiting. The acid makes the enamel weak for a while and brushing can cause it to wear. Rinse with water or water with a little baking soda. Wait about 30 minutes before brushing.
- Try to stay hydrated throughout the day. Drinking regularly will help your mouth.
- Chew sugar-free gum or use sugar-free xylitol mints to stimulate saliva flow.
- Use fluoride toothpaste. Ask your dentist if using a high-fluoride toothpaste or varnish would be suitable for you.
- Be mindful of what you are sipping. Many sodas, sports drinks, fruit juices and low-calorie flavored waters are acidic. Try to sip plain water.
- Manage any reflux. If you have heartburn, speak to your prescriber. Try to avoid eating later in the evening and raise the head of your bed.
- Keep your checkups. A dentist can detect early signs of erosion.
Tell your dentist you are on it, especially before sedation
Many people forget to mention a weight-loss injection as a medication when visiting the dentist. However, it is important to let them know. Not only will it help them understand what changes are happening in your mouth, but it also matters if you are having a procedure that involves sedation.
As GLP-1 medications slow stomach emptying there is a slight risk of food still being in your stomach. In October 2024, five medical societies (including the American Society of Anesthesiologists) stated that most patients can continue taking their GLP-1 medication prior to procedures, but those at higher risk may need to follow a liquid diet for 24 hours before. Your dental team and prescriber will decide what is best for you. Do not stop or skip doses on your own.
Summary
GLP-1 medications can be life-changing for blood sugar and weight control. However, the gastrointestinal side effects and reduced saliva can cause extra stress on your teeth. Simple changes like rinsing after vomiting, staying hydrated, using fluoride products and attending regular checkups can help. Let your dentist know you are on a GLP-1 medication. If nausea, vomiting or reflux won’t settle, let your prescriber know.
References
Wilding JPH et al (2021) Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). New England Journal of Medicine. 384:989–1002.
American Society for Metabolic and Bariatric Surgery, American Society of Anesthesiologists, American Gastroenterological Association, ISPCOP and SAGES (2024) Multi-society clinical practice guidance on GLP-1 receptor agonists before elective surgery and endoscopy. (October 29.)
American Dental Association (MouthHealthy) Dry Mouth and Dental Erosion.
Note: This article is for general information only and should not be taken as medical or dental advice.