The explosive popularity of GLP-1 receptor agonists for weight management has created a new patient population with distinct oral health considerations. An estimated 15 million Americans now use medications like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro), and dentists are increasingly encountering associated oral manifestations.

Gastrointestinal Side Effects and Oral Impact

Nausea and vomiting affect 20-40% of GLP-1 users, particularly during dose escalation periods. Frequent vomiting introduces stomach acid to the oral cavity, causing erosive damage to enamel primarily on lingual surfaces of maxillary teeth.

Patients experiencing regular nausea often reduce oral intake and hydration, contributing to xerostomia. Decreased salivary flow compounds erosion risk and increases caries susceptibility. Proactive fluoride therapy and saliva substitutes may be indicated.

Gastroparesis, a delayed gastric emptying effect, has been reported. This may affect conscious sedation protocols, as patients may not achieve adequate fasting states despite following standard NPO instructions.

Rapid Weight Loss Considerations

Patients losing significant weight rapidly may experience changes in denture fit. Facial volume loss affects denture stability and retention, potentially requiring relines or remakes sooner than anticipated.

Nutritional deficiencies can emerge during aggressive caloric restriction, potentially affecting oral wound healing and periodontal health. Vitamin D, B12, and protein insufficiencies are most commonly reported.

Some practitioners report changes in taste perception among GLP-1 users, though this side effect is less documented in the literature. Patient-reported dysgeusia should be noted in records.

Clinical Recommendations

Medical history updates should specifically inquire about GLP-1 medication use, including dose and duration. Document any gastrointestinal side effects the patient reports.

Consider recommending alkaline rinses (baking soda solution) following vomiting episodes to neutralize acid before brushing. Direct brushing immediately after acid exposure accelerates enamel loss.

For surgical procedures requiring sedation, extended fasting periods may be prudent. Some anesthesiologists now recommend 24-48 hour liquid-only diets for GLP-1 patients before sedation.

Insurance and Documentation

When documenting erosion or other conditions potentially related to GLP-1 use, thorough records support medical necessity for treatment. Photograph erosive patterns and note medication history clearly.

As this patient population grows, expect evolving guidance from the ADA and specialty organizations. Staying current with emerging research ensures optimal patient care.