Ozempic teeth: what you need to know

If you thought you might be dealing with queasiness and other digestive issues when starting a medication like Ozempic, there’s a whole other world of possible problems. Enter: Ozempic teeth.

Although this isn’t a medical term, Ozempic teeth refers to anecdotally-reported dental effects of going on GLP-1 medications like semaglutide (Ozempic, Wegovy) for diabetes or weight management. The side effects of these medications may directly or indirectly affect your dental and oral health. Learn more about what causes Ozempic teeth, how to protect your dental health, and when to reach out to your dentist.

‘Ozempic teeth’ is an unofficial term that refers to the many ways semaglutide may affect your teeth, gums, or overall oral health. “While ‘Ozempic teeth’ isn’t a medically defined condition, the term reflects a growing number of anecdotal reports from both patients and dental professionals,” says Daniela Eversgerd, DMD, cosmetic dentist and founder of Allure Dental. “We’re seeing more patients present with increased tooth sensitivity, enamel erosion, and dry mouth, symptoms that seem to correlate with the use of GLP-1 medications,” she explains.

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Ozempic and similar medications are part of a class of drugs called glucagon-like peptide-1 receptor agonists (aka GLP-1s). According to Dr. Eversgerd, these medications can impact your dental health in both direct and indirect ways. “While research is still catching up, we’re beginning to connect the dots between these systemic changes and the symptoms we’re seeing in patients' mouths,” Dr. Eversgerd says.

So what’s going on? According to Dr. Eversgerd, these drugs may contribute to a reduction in saliva and alter gut-brain signaling to impact fluid regulation in the body, leading to dry mouth. “At the same time,” she says, “the indirect effects, such as vomiting, poor appetite, dehydration, and rapid weight loss can weaken the body’s natural defenses, including the oral microbiome.” Taken altogether, you may be more vulnerable to tooth decay, infection, and inflammation.

Not everyone experiences tooth or oral health problems after starting on Ozempic (or a similar GLP-1), and there isn't a good indication of how many do. What we do know is that Ozempic may affect your saliva, tooth enamel, and more. Here are four potential reasons why:

Gastrointestinal side effects

Ozempic can cause gastrointestinal (GI) upset, including nausea and vomiting. As reported in clinical trials, about 20% of people taking the 1 mg dose of Ozempic experienced nausea and 9% had vomiting, compared to 6% and 2% in the placebo group, respectively. 

Although there isn’t specific research on the oral health impacts of vomiting from semaglutide, we do know that there’s a strong connection between vomiting and tooth erosion. Research on bulimia nervosa, an eating disorder which often involves vomiting, shows 10 times higher odds of tooth erosion compared to the general population. 

Dr. Eversgerd says this happens because enamel can erode due to repeated acid exposure from vomiting. But it’s not only vomiting that can result in repeated acid exposure. For example, GERD (gastroesophageal reflux disease), another possible adverse reaction of semaglutide, sends acid bubbling back up into your mouth, which is also linked to dental erosion. 

Dry mouth 

If your mouth is feeling more parched these days, there’s a chance it could be related to your GLP-1. There isn’t strong evidence of dry mouth being a side effect of semaglutide — and it’s not listed in the prescribing information as a potential adverse effect. However, in a small case review, three female patients on semaglutide saw a provider with the complaint of dry mouth (xerostomia). After other medical problems were ruled out, it was surmised that their dry mouth could potentially be associated with semaglutide. 

Unfortunately, if allowed to persist, dry mouth has numerous unwanted effects, including halitosis (bad breath), cavities, and periodontal disease. “Saliva plays a vital role in neutralizing acids, protecting enamel, and controlling the oral microbiome, so its absence can quickly lead to decay and gum issues,” Dr. Eversgerd says. 

Nutrient deficiencies

When you take a GLP-1 — whether for diabetes or weight control — you’ll likely lose weight through a few mechanisms. One of those is simply that the medication reduces your appetite, helping you eat less. While that’s great if you need to lose weight, it may have unintentional consequences on your health if left unchecked. “Changes in diet or decreased food intake may lead to poor nutrition, which can compromise gum and bone health over time,” Dr. Eversgerd says.

Research suggests that adults taking these medications have a heightened risk of nutrient deficiencies, and about one in four people develop a deficiency within a year of starting a GLP-1. One deficiency you might want to pay special attention to for your teeth? Vitamin D, the most commonly found vitamin deficiency. Vitamin D promotes calcium absorption; together, vitamin D and calcium promote tooth mineralization, and a deficiency leaves you more vulnerable to cavities and gum disease.

Gut bacteria imbalance

Researchers are still learning more about how the gut microbiome (the collection of trillions of microbes like bacteria and yeast that live in the intestines) affects our health, including oral health. Some research suggests that certain bacteria in the gut microbiome is linked to the development of cavities. 

The research on how semaglutide affects the gut microbiome is early — and what we know is only found in animal studies. There is some indication that semaglutide might decrease the diversity of the gut microbiome, a key indicator of its health, but we need more human-based studies to know for sure what’s going on. 

There are many things you can do to prevent Ozempic teeth. If you suspect semaglutide or another GLP-1 is affecting your oral health, here are four ways to help safeguard your smile (and breath):

Maintain your saliva

Hydrating is one of the best things you can do to keep your mouth moisturized. “Sipping water throughout the day and using xylitol-based sugar-free lozenges or xylitol gum can help stimulate saliva flow,” Dr. Eversgerd recommends. If these symptoms are severe, there are prescription products that boost saliva flow. Ask your dentist if these are right for you.

Wait to brush

If you have an episode of vomiting, don’t brush your teeth right after — no matter how tempting that may be. Doing so has been shown to weaken enamel. It’s best to rinse that icky taste out with plain water, then “wait 20 minutes before brushing,” Dr. Eversgerd says. 

If nausea and vomiting are severe, talk to your prescriber about adjusting your dose or possibly changing medications.

See your dentist

Dr. Eversgerd recommends scheduling a dental check-up after starting a GLP-1 medication, to establish a baseline of your dental health. 

Another reason to see a dentist regularly while on Ozempic is if you’re taking it for managing type 2 diabetes. People with diabetes are at a higher risk of dental problems, such as gum disease, loose teeth, and dental bone loss, so it’s in your best interest to maintain a close connection with your dentist to prevent these complications.

Consider an Rx toothpaste

Prescription toothpaste containing fluoride or nano-hydroxyapatite helps strengthen and remineralize enamel, Dr. Eversgerd says. This is something your dentist may recommend for you if you develop issues with erosion or sensitivity. 

Dr. Eversgerd recommends talking to your dentist if you are noticing bothersome oral symptoms, including:

• Persistent dry mouth

• Increased tooth sensitivity

• Gum irritation

• Metallic taste in your mouth

Your dental provider can help you determine a plan to stop Ozempic teeth from worsening, restore saliva flow, prevent cavities, and more. Depending on the severity of oral health changes, they may recommend coming in for routine cleanings more often. 

In some instances, people have reported stopping the medication because of the oral health side effects — but you should never stop taking medication without first consulting your healthcare provider and developing a plan that works for you. 

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Although not part of the official list of side effects of taking Ozempic, it’s possible to develop tooth and oral health problems after starting on a GLP-1. The colloquial term for this is “Ozempic teeth.” These issues aren’t direct results of the medication, but may be related to other side effects of Ozempic. 

• “Ozempic teeth” isn’t an official diagnosis, but is a colloquial term that can include dry mouth, enamel erosion and cavities, and even gum disease.

• Ozempic may contribute to dental problems by directly reducing saliva (the substance that keeps your mouth clean), triggering side effects like acid reflux or vomiting (which can erode enamel and cause decay), possibly affecting the gut microbiome, and leading to deficiencies in nutrients such as vitamin D  that are critical for tooth health..

• Several prevention strategies can help keep your mouth clean and improve the health of your gums and teeth while you take Ozempic or another GLP-1. These include sipping water throughout the day, not brushing your teeth right away if you experience vomiting, and using prescription toothpaste.

• If you experience symptoms of Ozempic teeth, such as dry mouth, bad breath, side effects like acid reflux or vomiting, or other changes in your teeth and gums, talk to your dentist or another healthcare provider.