GLP-1 Medications and Your Oral Health: What You Actually Need to Know

If you’re taking Ozempic, Wegovy, Mounjaro, or any of the other GLP-1 medications, I need to talk to you about your mouth. Not because I want to scare you, but because I’ve been seeing a pattern in my practice that’s becoming impossible to ignore. These medications are genuinely life-changing for a lot of people. I get that. But they create specific problems in your mouth that most doctors aren’t talking about, and most patients don’t find out about until there’s already damage. I’ve spent my career taking care of patients going through major metabolic changes. I work with a lot of bariatric surgery patients and people managing complex medical conditions during cancer treatment. So when GLP-1 medications started becoming mainstream, I immediately recognized the oral health risks. They’re almost identical to what I see with my bariatric patients, just from a different mechanism. Here’s what’s actually happening, and what you need to do about it.

The Four Problems We Are Seeing: 

1. Your Mouth Gets Incredibly Dry

This is the big one. GLP-1 medications reduce saliva production significantly. And saliva isn’t just moisture – it’s your mouth’s entire defense system. It neutralizes acids, helps remineralize early decay, washes away bacteria, and contains antimicrobial proteins that actively fight infection. When you don’t have enough saliva, everything falls apart. Cavities develop faster. Gum disease progresses more aggressively. Early decay that your mouth would normally reverse on its own just keeps getting worse. I’ve seen patients who’ve gone their whole lives without a cavity suddenly develop multiple in a year after starting these medications.

1. Acid Reflux Destroys Your Enamel

GLP-1 medications slow down how fast your stomach empties. That’s part of how they work for weight loss – you feel full longer. But it also means stomach acid has more opportunity to come back up. And when stomach acid hits your teeth repeatedly, it dissolves enamel. Not damages it. Dissolves it. That damage is permanent. I see this erosion pattern constantly now. It’s different from regular cavities – the enamel just thins out and wears away, especially on the inner surfaces of your teeth. Once it’s gone, it’s gone. We can’t grow it back. And if you’re one of the people dealing with nausea and vomiting from these medications? That acid exposure is even worse.

1. Your Nutrition Takes a Hit

These medications suppress appetite. That’s the point. But a lot of patients aren’t eating enough protein, calcium, vitamin D, or other nutrients that are critical for keeping your mouth healthy. This is especially problematic if you’re considering dental implants or already have them. Implants need good bone health to integrate properly and stay stable long-term. I ask every patient about their family history and diet because I want to make sure you’re not setting yourself up for the same problems your parents had. If your mom lost her teeth at 50, we need to talk about why and whether you’re headed in the same direction.

1. Everything Tastes Different

Taste changes are common with GLP-1 medications. And when food doesn’t taste right, people compensate by eating more intensely flavored things – which often means more sugar, more acid, or both. It’s not a huge problem on its own, but combined with everything else, it adds up.

The Sedation Risk No One Talks about

This is critical. If you’re taking GLP-1 medications and you need any dental procedure with sedation, you need to tell your dentist. Not as a casual mention – as the first thing you say when discussing the procedure. These medications significantly delay stomach emptying, which means you have a much higher risk of aspirating during sedation. Aspiration is when stomach contents get into your lungs. It’s serious. It can be life-threatening. We modify our protocols when we know you’re on these medications. Extended fasting times. Coordination with your prescribing physician. Different sedation approaches. But we can only do that if you tell us.

What Actually Works to Protect Your teeth

I’m not going to give you a generic list that looks like it came from a dental hygiene pamphlet. Here’s what actually works based on what I’ve seen with my patients: For Dry Mouth: Drink water constantly. Not just “stay hydrated” – I mean keep water with you all day and sip it continuously. Your mouth needs that mechanical washing action. Use alcohol-free rinses with xylitol or fluoride. The alcohol in regular mouthwash makes dry mouth worse. Chew sugar-free gum with xylitol. It stimulates saliva production. Do this after meals especially. Products like Biotene help, but they’re temporary relief. You’re managing a chronic problem, not fixing it. For Acid Damage: This is where most people make a critical mistake. If you vomit or have acid reflux, DO NOT brush your teeth right after. The acid softens your enamel, and brushing at that moment causes significantly more damage than the acid alone. Instead: rinse with water or a baking soda solution (one teaspoon in eight ounces of water). Wait 30 to 60 minutes. Then brush. Use high-fluoride toothpaste. Ask your dentist about prescription-strength options. Regular fluoride isn’t enough when you’re dealing with this much acid exposure. If you have reflux, work with your doctor to get it under control. Protecting your teeth starts with managing the acid at its source. For Nutrition: Even though your appetite is suppressed, you need to prioritize certain things:

• Protein: minimum 0.8 to 1.0 grams per kilogram of body weight. Your gums are tissue. Tissue needs protein.
• Calcium: 1000 to 1200mg daily for bone and tooth structure
• Vitamin D: 2000 to 4000 IU daily (or whatever your doctor recommends) for calcium absorption
• Vitamin C: critical for gum health and collagen synthesis
• B vitamins: support tissue health and healing

Talk to your doctor about supplementation if you’re not getting these from food. Professional Care: Come in more often. If you’re on GLP-1 medications, you should be getting your teeth cleaned every three to four months instead of every six months. This isn’t upselling – it’s risk management. We need to catch problems early, before they become expensive and painful.

If You have Implants or Want Implants

I’ve placed thousands of dental implants and trained over 2,000 dentists in implant surgery at the Misch International Implant Institute. So I pay very close attention to anything that affects how implants heal and how long they last. If you’re taking GLP-1 medications and considering implants, we need to have a more detailed conversation about timing, nutrition optimization, and monitoring. Implants rely on good bone health and good healing. These medications can compromise both if we’re not proactive. If you already have implants, the dry mouth and potential nutritional issues put you at higher risk for peri-implantitis – which is basically gum disease around the implant. Left untreated, it leads to implant failure. We can treat it with laser protocols (I use the PerioLase for this), but catching it early makes a massive difference.

When You Need to Call

Don’t wait until something hurts. Call if you notice:

• Persistent sensitivity to hot, cold, or sweets
• Bleeding gums
• White spots on your teeth (that’s early decay)
• Teeth that look more translucent or yellow than they used to
• Any sore or lesion in your mouth that doesn’t heal in two weeks
• Chronic dry mouth that isn’t improving with the basics

What this really comes down to

GLP-1 medications work. I’m not telling you to stop taking them. But you need to understand that they create a high-risk environment in your mouth, and that risk doesn’t go away on its own. The patients who do well are the ones who are proactive. They adjust their home care. They come in more often. They actually follow through with the fluoride treatments and the dietary recommendations. They tell me when something changes. The patients who struggle are the ones who think they can keep doing what they’ve always done and everything will be fine. It won’t. These medications change the game, and your dental care needs to change with them. I built my practice around taking care of people going through complicated health situations. Whether it’s bariatric surgery, cancer treatment, or complex dental failures that other dentists won’t touch – I specialize in cases where the standard approach doesn’t work anymore. GLP-1 medications fall into that category. You need someone who understands what’s happening systemically and knows how to adjust their care accordingly. If you’re taking these medications and you’re not sure your current dentist is paying attention to these risks, that’s a problem. This isn’t something you can afford to ignore until there’s a crisis.