GLP-1s and Oral Health: What You Should Know

GLP-1 receptor agonists are prescribed for type 2 diabetes and sometimes for weight management. It can affect the entire body — including the oral cavity.

If you are taking GLP-1s, you may be experiencing the common side effects such as gastrointestinal (GI) issues and muscle-loss. However, GLP-1 receptors can affect the entire body including the oral cavity.  GLP-1s can cause changes in hydration, nutrition and GI functions that directly affect the mouth.  These effects may increase the risk for dry mouth, gum inflammation and plaque accumulation, tooth decay and sensitivity, erosion in the enamel and bad breath.

GLP-1s reduces salivary flow due to dehydration and suppresses appetite, altering saliva’s pH. This increases plaque and raises the risk for decay and gum disease. An altered oral bacteria can lead to gingivitis and periodontal risk. Acid exposure from vomiting and reduced buffering capacity can also weaken enamel and increase dentinal sensitivity.  Vomiting, GI upset and delayed gastric emptying can also affect enamel.  Dry mouth and microbial imbalance may cause halitosis.

Is Altered Taste a Side Effect?

There are known GLP-1 receptors in the taste buds in the mouth, so this may be the cause. However, the true cause of why taste changes happen is still unknown.  There have been reports of metallic tastes and reduced sensitivity to some tastes. Some users of GLP-1 drugs may experience Ozempic tongue— a persistent bitter, sour or metallic taste in the mouth. While there isn’t yet a definitive reason for this, dry mouth may be a possibility.

There are ways to help with dry mouth. Using sugar-free gum to increase saliva flow,  oral rinses or artificial saliva to add moisture. Also drinking plenty of water and brushing twice daily with a fluoride toothpaste is necessary.

What Can You Do to Manage Symptoms?

Good overall oral hygiene is key!

• For dry mouth and bad breath, over-the-counter topical products like mouth rinses, lozenges, sprays, or gels geared toward alleviating dry mouth can be helpful.
• Overall hydration should be maintained.
• Balanced nutrition is also important in overall dental and oral health. To mitigate acid erosion of your teeth, you can rinse the mouth with water (or another acid-neutralizing liquid like milk or sodium bicarbonate rinse) or a fluoridated mouth rinse after meals.

What Types of Products are Recommended?

The American Dental Association recommends using a soft-bristled brush twice a day with a toothpaste containing fluoride for two minutes and using an interdental cleaner (like floss) daily.

For more complicated issues, you should seek an oral & maxillofacial surgery specialist who can identify major problems before they escalate.  We recommend you see your dentist for biannually checkups if you are using GLP-1 medications.

Dr. Pamela Alberto earned her DMD from the University of Pennsylvania School of Dental Medicine and her certificate in oral and maxillofacial surgery from the University of Medicine and Dentistry of New Jersey’s University Hospital. Dr. Alberto is the former assistant dean of predoctoral education at New Jersey Dental School. She is currently a clinical associate professor at Rutgers School of Dental Medicine. www.drpalberto.com