More and more of our patients are taking medications like semaglutide or tirzepatide — known by names such as Ozempic, Wegovy, or Mounjaro. This is noticeable in the dental practice because these medications change something that is crucial for dental health: the conditions in the mouth.

First and foremost, because there is a lot of nonsense about it on the internet: There is currently no indication that these active ingredients directly attack the tooth structure. A 2026 in Canadian Journal of Diabetes published review by Dr. Aviv Ouanounou (University of Toronto) explicitly states that no direct pharmacological effect on hard tooth substance has been proven. What actually happens is indirect—and precisely for that reason, easily manageable.

What changes in the mouth

Dry mouth

This is the most important point. Saliva is not a byproduct, but a defense system: it buffers acids, washes away bacteria, and returns minerals to the tooth enamel. If saliva flow decreases, the risk of tooth decay—especially root caries—and gum inflammation increases. In evaluations of the US reporting database for adverse drug reactions, semaglutide shows a clear signal for Dry mouth.

Acid from reflux and vomiting

Nausea and vomiting are among the most common side effects, especially during the initial dosing phase. Stomach acid is aggressive to tooth enamel; repeated contact leads to Erosion. The enamel is getting thinner, the teeth are becoming more sensitive and translucent at the edges.

Changes in taste and bad breath

Both are described and mostly temporary, but can change eating habits — which in turn has an effect on the teeth.

The second context: Inflammation

Regardless of the medications, there is a long-known connection between obesity and periodontitis. Both conditions share a mechanism: Inflammation. Adipose tissue is hormonally active and secretes so-called adipokines, which have a pro-inflammatory effect. Systematic reviews show more inflammation of the periodontium in obese patients, a higher risk of tooth loss, and a slower healing after periodontal treatment.

This is the truly relevant point for treatment planning — and it applies in both directions: whoever loses weight also improves the starting conditions for oral health.

What this means for implants

A closer look is worthwhile here, because the findings of the study are often presented in an overly simplified way.

A study of 325 implant patients over more than five years found in obesity a A 56 % increase in the risk of peri-implantitis — 34 cases of % compared to 23 cases of % among those with a BMI below 30 — even after adjusting for smoking, diabetes, and age. Peri-implantitis is an inflammation that can lead to bone loss around the implant.

At the same time: find meta-analyses no statistically significant difference in actual implant loss between obese and non-obese patients. The inflammatory markers around the implant—plaque, probing depth, bleeding, bone loss—are measurably worse, though not necessarily the final outcome. The authors also point out an overall low explanatory power of the available studies hin.

Honestly summarized: Being overweight is a reason for closer follow-up care, not for advising against one. Implant treatment.

What you can do specifically

Tell us

This is the most important point. If we know that you are taking a GLP-1 medication, we plan prophylaxis intervals, fluoridation, and follow-up care differently — and we know what to look out for during the check-up.

Do not brush your teeth immediately after vomiting

The enamel is softened directly afterwards by the acid; brushing then wears it away. Better: rinse with water or a fluoride mouthwash and wait about 30 minutes.

Working against the dryness

Drink water regularly, sugar-free chewing gum or lozenges to stimulate saliva, and saliva substitutes if needed. Avoid acidic and sugary drinks as much as possible — they hit unprotected enamel.

Consistently use fluoride

And schedule professional dental cleanings more frequently than usual during this phase.

Do not stop taking the medication on your own authority

The cardiometabolic benefits of these therapies are well documented. Dental side effects are a reason for better care, not for discontinuing therapy — that decision belongs in the hands of your treating physician anyway.

How we deal with it

In our practice, we have been working completely digitally for years, with metal-free restorations made of Zircon and E-Max from our own laboratory. In patients undergoing GLP-1 therapy, we pay special attention to two things: early signs of enamel erosion, which can be detected early, and the condition of the gums, as the tendency for inflammation may be increased here.