Use of glucagon-like peptide-1 receptor agonists (GLP-1s) such as Wegovy®, Ozempic®, Zepbound®, Mounjaro® and generic semaglutide has increased substantially in recent years. Most patients have heard of GLP-1s, and many are taking them. Although GLP-1s, such as Ozempic, have been used to manage Type II Diabetes for some time, their application has expanded, and research into short and long-term side effects remains ongoing. As usage continues to surge, staying ahead of the side effects is essential.

Recently, the terms 'Ozempic face' and 'Ozempic mouth' have been used to describe some of the visible side effects of taking GLP-s, but it is important to note that there is currently no verified direct link to GLP-1s negatively impacting teeth. However, while a direct impact has not been shown, confirmed associated side effects -- such as dry mouth and vomiting-- can result in an acidic oral pH, which causes enamel erosion, and creates a favorable environment for dental decay and mechanical wear.

A May 9, 2025, article published in THE INDEPENDENT stated:

"Research has shown that the most common adverse effects with GLP-1s are all gastrointestinal (nausea, vomiting, and diarrhoea) and up to 19 per cent of people experienced vomiting as a result of taking the drugs in some trials. A study of 2.4 million Americans with type 2 diabetes published in January identified that, while those on GLP-1s had a lower risk of developing 42 different diseases, they had a higher risk of 19 side effects or diseases. One of these was nausea and vomiting: patients were 30 per cent more likely to develop these symptoms."

Anything that alters the pH and microbiome of the mouth has the potential to impact dental health, especially direct exposure to acids. The longer this persists unmitigated and impacted by concurrent factors-- such as diet and brushing-- the more extensive the damage is likely to be. Read more on how to manage below:

WHAT TO DO:

SCHEDULE REGULAR DENTAL CHECKUPS & TALK TO YOUR PROVIDERS

As always, be sure to inform your dental care provider(s) of any updates in your health, medications, or any issues you may be experiencing. Don’t assume a symptom you are experiencing, or a new medication, cannot impact your oral health.

Often, the clinically visible signs present themselves long after you may feel a change. In the case of acid erosion, we can take measures to minimize damage and place restorations when indicated, but we cannot reverse it; prevention is key! Keeping regular checkup intervals gives patients and providers alike the opportunity to raise and address concerns earlier on. Your provider may recommend more frequent dental visits, applications of topical fluoride, special rinses, pastes, or more. The specific course of action will vary based on your needs and concerns.

AVOID ACIDIC FOODS AND DRINKS

Chemical erosion of tooth enamel can occur from any acidic source. While GLP-1s may cause nausea and vomiting that brings stomach acid into the oral cavity, the acid from foods and beverages can cause the same damage. The longer the pH in your mouth remains acidic, the more damage can be caused.

Exposure to acid can also impact the oral mucosa, causing irritation and contributing to dry mouth. The presence of saliva is an integral part of maintaining a healthy mouth, so this can further compound any issues you may be experiencing.

DRINK WATER

Staying hydrated by drinking water is essential. Generally, water has a neutral pH, and can act as a buffer. It can temporarily soothe sore tissues and can flush out debris without the risks of acidic and/or sugar-filled beverages. To note: Sparkling water is acidic

RINSE YOUR MOUTH

Whether or not you are on GLP-1s, if you vomit, try to rinse your mouth out with water or a baking soda mix. This will help neutralize the acid. Even if you rinse your mouth out, it is still recommended to wait 30-60 minutes before brushing your teeth. 

CONSIDER SALIVA SUBSTITUTES OR STIMULANTS

Saliva naturally cleanses your mouth, and is a pH neutralizer. If you are experiencing dry mouth (xerostomia) with or without vomiting, compensating for the lack of saliva is essential for maintaining oral health. There are several products on the market that can stimulate production of your own natural saliva and/or act as a replacement to prevent the uncomfortable and damaging side effects of xerostomia. Talk to your providers about the best option for you!

WEAR PRESCRIBED DENTAL APPLIANCES

When compromised by acid erosion, your teeth are more susceptible to the mechanical wear of grinding. If a nightguard has been recommended, it is imperative that you continue (or start) to wear it if you are experiencing these symptoms.

AVOID BRUSHING FOR 30-60 MINUTES AFTER EATING

Whenever tooth enamel is exposed to acid, the acid itself chemically erodes the enamel, which makes it susceptible to mechanical wear for some time after. While enamel is the hardest substance in the body, when it is compromised by acid, it can be physically eroded by brushing. As such, it is advisable to abstain from brushing for at least thirty minutes, but preferably 60, after eating, drinking anything but water, or vomiting. This can help to avoid eroding the enamel & any root surfaces that may be exposed due to gum recession. And, don't forget to always use a soft-bristle toothbrush!

PRIORITIZE NUTRITION

Proper nutrition is a large component of dental health. According to the ADA, “Calcium is a mineral found in many foods, and is essential for forming and maintaining healthy bones and teeth, including hydroxyapatite, the primary calcium phosphate mineral in bone and enamel.” Other side effects of GLP-1s include decreased nutrient absorption and changes in taste. Continuing to eat a well-balanced diet and supplementing as indicated can help mitigate these side effects.

FOLLOW UP WITH YOUR PRESCRIBING PROVIDER

Be sure to report any side effects to the doctor who prescribed the medication, in addition to any other healthcare providers you may see.

REQUEST & FACILITATE COLLABORATIVE CARE

Collaborative care is when multiple providers caring for an individual patient work together to achieve the best outcomes for that individual. Sharing your accurate medical history - including all medical procedures, medications, over-the-counter supplements, concerns, and symptoms with all of your providers is imperative. Many providers will request that you share the names and contact information of other providers you may be seeing to collaborate on your plan of care.

WHAT NOT  TO DO:

NEVER STOP TAKING A MEDICATION WITHOUT CONSULTING THE APPROPRIATE PROVIDER(S)

DON'T IGNORE SYMPTOMS

**DISCLAIMER: INFORMATIONAL PURPOSES ONLY. NOTHING HEREIN SHOULD BE CONSTRUED AS MEDICAL OR DENTAL ADVICE. SPEAK WITH YOUR PROVIDER(S) ABOUT THE BEST PLAN OF CARE FOR YOU.

Sources:

1. Becker C. Growth, Volume, Price: The Skinny on GLP-1 Medications. National Conference of State Legislatures. Published December 16, 2024. https://www.ncsl.org/state-legislatures-news-details/growth-volume-price-the-skinny-on-glp-1-medications 

2. Coffey H. Forget Ozempic face – should we be worried about Ozempic teeth? The Independent. Published May 9, 2025. Accessed May 15, 2025. https://www.the-independent.com/health-and-wellbeing/ozempic-face-teeth-mouth-wegovy-mounjaro-b2748008.html 

3. Kulthanan K, Nuchkull P, Varothai S. The pH of water from various sources: an overview for recommendation for patients with atopic dermatitis. Asia Pacific Allergy. 2013;3(3):155. doi:https://doi.org/10.5415/apallergy.2013.3.3.155

4. Logan P. On the Increase in Use of GLP-1s. blogs. Published June 12, 2024. https://medicine.iu.edu/blogs/bioethics/on-the-increase-in-use-of-glp-1s 

5. Watanabe JH, Kwon J, Nan B, Reikes A. Trends in glucagon-like peptide 1 receptor agonist use, 2014 to 2022. Journal of the American Pharmacists Association. 2023;64(1). doi:https://doi.org/10.1016/j.japh.2023.10.002