Semaglutide and tirzepatide, two common injectable medications that are increasingly used for obesity and diabetes, were analyzed in a preprint impact study by health-care research company, nference, on the oral effects caused by GLP-1s. These medications activate GIP and GLP-1 hormone receptors that can significantly impact appetite, dietary intake, body weight, glycemic control, and gastrointestinal physiology.¹ 

They can also affect oral health. As diabetes is linked to periodontal disease—and GLP-1s are primarily taken to manage this condition—they may alleviate gum inflammation. However, they can also cause xerostomia, enamel erosion, gastric reflux—as well as other oral health conditions that may be exacerbated by nutrient deficiencies caused by GLP-1s.^1,2 

Relevance of this research 

Ozempic and other similar medications have spiked in popularity over the last few years as people increasingly turn to these drugs to lose weight. They were initially intended as blood sugar regulators—not as an elective weight loss solution—and their recent spike in popularity means their long-term effects on oral health have yet to be studied extensively. CareQuest data estimates 25 million people will be taking a GLP-1 by 2030.² 

In fact, “Ozempic teeth” is a catchall phrase that describes the decline of dental health due to GLP-1s; reports of xerostomia, tooth decay, and other dental complications that have emerged following GLP-1 misuse; these drugs have been increasingly obtained without medical indication due to social media trends and celebrity endorsement over the past few years.³ Oral health side effects include periodontitis and reduced bone/tissue regeneration caused by appetite suppression and nutrient deficiencies.⁴

However, as the preprint study points out, "population-scale risk of new-onset oral disease remains unclear.” 

Obtaining data and results 

The authors collected data from 184,582 semaglutide or tirzepatide users (excluding patients with substantial or preexisting oral-health burdens) and reported 15 oral and dental conditions over a 12-month follow-up period. 

They defined GLP-1 users as “adults with at least two prescriptions of either medication within twelve months and at least twelve months of available follow-up data after treatment initiation.” 

Here are the results:

Overall oral-health outcomes: 

• 8.69% of GLP-1 users developed at least one newly documented oral health condition. 

• Xerostomia was the most common condition, occurring in 5.29% of users. 

Compared with other anti-diabetic therapies, GLP-1 users had lower risk of: 

• Any oral-health condition: Relative Risk (RR) 0.74 

• Dental caries: RR 0.47 

• Periodontitis: RR 0.501 

Dental calculus was the only condition observed significantly more often among GLP-1 users. RR compares the likelihood of an outcome in an exposed or treatment group to the probability in an unexposed or control group. 

Overall, semaglutide and tirzepatide were not significantly associated with an overall increase in oral health problems. Dry mouth is already the most common side effect of most prescription and OTC medications, but in this instance, xerostomia incidence increased with greater treatment-associated weight loss.⁵ 

The authors noted that “the development of oral health conditions after initiation of a GLP-1 receptor agonist may not be a consequence of the medication but rather could be related to other underlying risk factors. While the data presented here do not provide proof that GLP-1 receptor agonists protect against the development of oral health conditions, it does suggest that these agents at least do not significantly increase the risk for their development.” 

It is also worth mentioning that patients with a higher baseline BMI or higher magnitude weight loss experienced more oral health conditions after taking GLP-1s. According to the authors: “While higher baseline BMI could be associated with higher infection risk, this explanation seems less likely given the lack of correlation with baseline HbA1c.” An HbA1c test measures average blood sugar levels over time to help diagnose and manage diabetes. In this study, the baseline HbA1c “would also be expected to serve as a marker of infection risk.” 

What this means for clinicians 

As this data has yet to be peer reviewed and is only one out of many studies focusing on the correlations between GLP-1s and declining dental health, more research is needed to draw conclusive results. 

“As GLP-1 medications become increasingly common, dental professionals should understand how these therapies and the significant metabolic, dietary, and behavioral changes that accompany their use may influence oral health,” said Dr. Pamela Maragliano, chief editor of Dental Economics.  

“While xerostomia deserves our attention, this early research is also an important reminder not to confuse association with causation or assume that GLP-1 use inherently leads to dental disease. For now, a thorough medication history, attention to changes in salivary flow and nutrition, and individualized preventive strategies remain our best approach while we await stronger, peer-reviewed evidence.” 

Ultimately, it is important for clinicians to be aware of the potential effects drugs like semaglutide and tirzepatide can have on patients’ gum and tooth health. This is especially if they are taking them for weight loss because the negative oral health effects associated with GLP-1s may be exacerbated by malnutrition and the vitamin deficiencies stemming from weight loss. 

References

1. Marwaha A, Murugadoss K, Venkatakrishnan AJ, Soundararajan V. Oral health outcomes with GLP1 receptor agonists compared with other metabolic interventions. nference. Preprint posted online August 24, 2026. https://doi.org/10.20944/preprints202608.1618.v1  

2. GLP-1 medications and oral health. CareQuest Institute for Oral Health. 2025. https://carequest.org/resource/visual-report/glp-1-medications-and-oral-health/  

3. Muhammad HE, Cheema AAA. From prescription to trend: the misuse of Ozempic in the age of social media. Ann Med Surg (Lond). 2025;87(10):6876-6877. doi:10.1097/MS9.0000000000003801 

4. Berg Y, Gabay E, Božić D, Shibli JA, et al. The impact of nutritional components on periodontal health: a literature review. Nutrients. 202415;16(22):3901. doi:10.3390/nu16223901 

5. Mulligan R, Suarez D, Han P. Dry mouth: medications and their effect on saliva. University of Southern Carolina. October 9, 2019. https://ostrowonline.usc.edu/medications-that-cause-dry-mouth/