By Dr. Dominique Carson, LMP, H.C.
As GLP-1 weight-loss medications like Ozempic become more popular, the term "Ozempic teeth" has emerged, raising concerns among patients and dental professionals. Although not a formal diagnosis, this term refers to a group of oral health issues that may be linked to the medication’s side effects, such as enamel erosion, chronic dry mouth, tooth decay, and increased sensitivity.
Conversations about "Ozempic teeth" have increased as more patients report oral health concerns requiring timely attention. GLP-1 medications do not directly harm dental structures but may cause acid reflux and chronic dry mouth, which can contribute to tooth decay and gum inflammation. 16%–20% of Ozempic users report nausea, a side effect that can expose teeth to stomach acid and contribute to enamel erosion. It is also reported that approximately 24% of GLP-1 medication users report acid reflux, another factor associated with enamel wear and dental damage.
The term describes these secondary changes. Patients should watch for symptoms like persistent dryness, difficulty swallowing, or increased tooth sensitivity, and seek prompt professional evaluation if they occur. Dental professionals stress the importance of preventive care and thorough patient education.
In a recent interview, Preferred Health Magazine discussed "Ozempic teeth" with Dr. Aaron Bulleigh, DDS, of Desert Springs Dental Care. The conversation highlighted key patient education and prevention strategies, such as maintaining hydration, using saliva substitutes like Biotene, and scheduling biannual dental checkups to ensure the utmost care for his patients.
Preferred Health Magazine: In relation to the "Ozempic teeth" trend, have you observed an increase in patients requesting treatment for dental issues, and what are the most common complications you see?
Dr. Aaron Bulleigh: While I haven't encountered many patients specifically citing "Ozempic teeth," it is important to acknowledge that while GLP-1 medications are vital and effective, they do carry certain dental implications. Based on my clinical observations and available research, Ozempic is associated with Xerostomia, or chronic dry mouth.
This condition presents a significant challenge because saliva plays a critical role alongside brushing in maintaining oral hygiene; it naturally rinses away bacteria and plaque. When the medication reduces salivary flow, plaque accumulates, leading to the erosion of tooth enamel. This secondary effect is the core of the problem, as the loss of enamel width results in a thinner appearance and structural destruction of the teeth. Ultimately, the medication's impact on saliva creates a cause-and-effect cycle where bacteria can more easily damage the teeth.
PHM: Is it the ongoing impact on dental health that has led dentists to name the phrase “Ozempic Teeth”?
Dr. Bulleigh: I believe that is the case. I can't confirm the origin, but it makes sense. Patients using these medications are observing these specific outcomes—byproducts of the treatment—and associating them with their dental health. Rather than focusing solely on the medication itself, I believe the medical and dental communities must collaborate to educate patients. If a patient is prescribed a GLP-1, such as Ozempic, we must be prepared to manage potential reductions in salivary flow.
Various interventions are available, including prescription medications and over-the-counter salivary substitutes. However, I often advise my patients to take a simpler approach: carry a bottle of water and take a sip every 15 to 20 minutes. Instead of just swallowing, swish the water around the mouth to rinse the tooth surfaces. This helps protect the enamel structure, which can otherwise begin to appear thinner due to these side effects.
PHM: Is the rapid weight loss responsible for the visible changes in facial structure, particularly around the mouth and teeth?
Dr. Bulleigh: Exactly. It stems from the significant fat deposits we have in our faces, especially right beneath the cheekbones. While this can occur naturally during any period of rapid weight loss, the specific facial appearance we are seeing now is a direct side effect of how quickly these patients are dropping weight.
PHM: Is there an increased risk of enamel erosion due to the nausea and vomiting linked with Ozempic use?
Dr. Bulleigh: One hundred percent, nausea, and reflux are really a severe problem! Someone has acid reflux via Ozempic, or some people just have it naturally. I have actually performed full-mouth reconstructions on patients. They’ve had such bad acid reflux that acid dissolves their teeth, and so I've got to put on manufactured enamel in front of crowns, because crowns are not as affected by the acid reflux. So, yes, 100% authentic to the degree that it increases from the acid reflux, which is 100% correlated with destroying the enamel.
PHM: How often does a patient visit the dentist if they’re taking Ozempic or any GLP-1 medication?
Dr. Bulleigh: I think these meds are important because, in the grand scheme of things, if somebody is obese to the point that their health is fragile, and there's a possible serious disease or loss of life if they don't lose weight, then certainly that outweighs whatever risk there might be with enamel destruction or decay. So it's this balance that we, as a medical community, have to be willing to address. For now, since there is no long-term study, seeing a dentist every six months is sufficient. Enamel destruction, even with severe acid reflux, takes a long time before you really start to see the problem. The good news is that, if, in fact, let's say I saw somebody today and everything looked fine, and then six months from now they come back, and I can tell that the backs of their anterior front teeth are starting to look like acid destruction, I can send them to a gastroenterologist. They can give them some meds that reduce acid reflux. We have to come up with ways to treat the symptoms of GLP-1 treatment, such as acid reflux.
PHM: Does rapid weight loss lead to any nutritional deficiencies that could specifically affect dental health or impact the teeth?
Dr. Bulleigh: There is this constant attack, either acidic foods trying to take away and tear down, or dry mouth, where bacteria can start to attack. So, there aren't really any signs that are going to change, because the teeth have already developed. Now, one thing that I think would be interesting, of course. So far, I don't have any adolescent patients who are taking Ozempic. However, I would be very concerned about prescribing someone whose teeth are still developing, meaning they still have some baby teeth, because the roots of teeth are inside our bones. It's still developing, and you know, if it turns out that a GLP-1 medication somehow hinders or causes a defect in the development, then we definitely never want to put an adolescent or younger on a GLP-1.
PHM: Is there a better way to educate people about oral health while taking, you know, these GLP-1 medications? Do you recommend that oral health screenings be part of the routine for someone participating in any obesity treatment program?
Dr. Bulleigh: I certainly do. While I believe the medical community is improving, there is still significant progress to be made. In the current landscape, my medical colleagues rarely consult me on dental matters, even though I make it a point to consult with their doctors when a patient is on significant medications such as blood thinners or heart medicine. These are major health considerations that require collaboration.
The scale of the issue is notable. While only a small fraction of patients might require surgery like wisdom tooth extraction under general anesthesia, there is a much larger population—potentially tens of thousands—using GLP-1 medications who may be struggling with dry mouth and acid reflux. These are not minor inconveniences; they are significant problems for oral health.
In my view, when a physician prescribes a GLP-1 medication, they should proactively inform the patient about the risks of dry mouth and acid reflux. They should recommend that the patient see their dentist to ensure the dental provider is aware of and prepared for the situation. If physicians include this in their notes, dentists can then monitor these specific issues during biannual checkups to ensure the patient's oral health remains stable and healthy.
PHM: What future research do you think is needed to understand better the long-term effects of Ozempic, or any medications that are similar?
Dr. Bulleigh: I believe the primary focus should be on investigating the underlying causes of acid reflux in these patients. While it is known that the medication slows stomach motility, I suspect—and this is currently conjecture—that the powerful muscles at the top and bottom of the stomach, specifically the pyloric and labial sphincters, are being affected. If the pyloric sphincter is not contracting as tightly as it should, it allows stomach acid to flow back up, leading to reflux during the night or throughout the day.
Research into why this occurs is essential, especially as these medications evolve through new generations. Ideally, future versions of these drugs will address and eliminate these physiologic side effects. I would like to see research into supplemental treatments that could stimulate salivary glands to counteract the dryness caused by the primary medication.
Dr. Aaron Bulleigh, DDS
Dentist Las Vegas |
Desert Springs Dental Care
5693 S Jones Blvd #113, Las Vegas, NV 89118
https://www.dentistlasvegasnevada.com/