GLP-1s Are Changing the Dental Visit

Glucagon-like peptide-1 (GLP-1) receptor agonists have become a household name, often portrayed as a magic weight-loss drug. Originally developed for the management of type 2 diabetes, GLP-1 receptor agonists have gained widespread attention for their weight-loss effects.¹ The synthesized drug mimics the naturally occurring hormone GLP-1 in regulating blood sugar levels, slowing gastric emptying, and promoting satiety.² The increasing use of these medications highlights the need for oral health professionals to understand how they affect oral and systemic health and influence patient management. 

One of the primary effects of these medications is to regulate appetite by modulating insulin and glucagon secretion. After food enters the body, a peptide hormone, GLP-1, is produced through the breakdown of proglucagon within the intestines. These peptide hormones act as a key for specific receptors, known as GLP-1 receptors, triggering physiological responses throughout the body. Once activated, these receptors help regulate blood glucose levels by promoting insulin secretion and inhibiting glucagon release from the pancreas. GLP-1 receptor agonists are intended to mimic the action of these peptide hormones, which are naturally released upon food intake, thereby enhancing their physiological effects throughout the body.³

Oral Considerations

GLP-1 receptor agonists do have negative oral consequences. Gastrointestinal issues, such as nausea, vomiting, and gastric reflux, are common side effects. Repeated exposure to stomach acid can erode enamel and increase the risk of dentinal hypersensitivity and dental caries. Oral mucosal changes have also been reported in association with hyposalivation and xerostomia.⁴

However, GLP-1 receptor agonists have also been linked to potential oral health benefits. In a cell culture study using human periodontal ligament stem cells, GLP-1 receptor agonists showed promise in supporting bone metabolism by inhibiting advanced glycation end products (AGE)-mediated effects. AGEs are harmful compounds formed in food or in the body under high-glucose conditions and are thought to impair bone formation. In the presence of AGEs, these stem cells were unable to differentiate into bone-forming cells. However, when the GLP-1 receptor agonists were introduced, they partially reversed these effects.⁵

GLP-1 receptor agonists may also play a role in the management of obstructive sleep apnea (OSA). Current treatment with continuous positive airway pressure therapy has certain disadvantages, such as low compliance and the potential for weight gain. Alternatively, GLP-1s have been shown to reduce breathing interruptions during sleep and alleviate OSA through weight loss.⁸ 

Clinical Management and Recommendations

When treating patients taking GLP-1 medications, oral health professionals should first obtain a complete and specific medical history. As with any medication, clinicians should ask three questions: What are you taking? Why are you taking it? Did you take it today? Without the answers, even seasoned clinicians may make assumptions. They see GLP-1 receptor agonists listed and may assume the patient has diabetes.

Patients experiencing gastrointestinal side effects may also exhibit clinical signs in the mouth that clinicians could mistakenly attribute to conditions such as gastroesophageal reflux disease or an eating disorder. When clinicians know which medications patients are taking and why, they can open the conversation and help educate patients about the possible causes of the oral and systemic effects they may be experiencing.⁴

When treating these patients in the dental setting, clinicians should also be prepared for potential medical complications. Although GLP-1 receptor agonists alone carry a low risk of hypoglycemia, the likelihood increases when taken in combination with other glucose-lowering medications. In addition, retained gastric contents pose a risk for aspiration when sedating patients for dental procedures. While there is currently insufficient evidence to support the routine withholding of GLP-1 receptor agonists before dental treatment, caution is warranted.⁷

Dental hygienists are often among the healthcare providers patients see most regularly. Oral health professionals are uniquely positioned to build high-quality, long-lasting relationships with patients. As a result of GLP-1 receptor agonist use, patients may experience changes in emotional well-being. Emerging evidence reveals that GLP-1 receptor agonists may influence mental health as well as physical health. A recent systematic review and meta-analysis found that treatment with GLP-1 receptor agonists did not worsen symptoms of depression and was linked to improvements in mental health-related quality of life and emotional eating behaviors. Although the connection to mental well-being is multifactorial, improvements in metabolic health and weight loss may contribute to these positive changes. These findings highlight the multifaceted effects and reinforce that, as clinicians, it is important to view the patient through a whole-person lens.⁸

Much remains to be learned about the long-term oral, systemic, and psychological effects of GLP-1 receptor agonists. Oral health professionals are increasingly encountering patients taking these medications. By understanding the benefits and potential side effects, clinicians can provide an informed, patient-centered care and contribute to the management of patients using GLP-1 therapy.

References

1. Wong HJ, Sim B, Teo YH, et al. Efficacy of GLP-1 receptor agonists on weight loss, BMI, and waist circumference for patients with obesity or overweight: a systematic review, meta-analysis, and meta-regression of 47 randomized controlled trials. Diabetes Care. 2025;48:292-300.
2. Collins L, Costello RA. Glucagon-like peptide-1 receptor agonists.
3. Zheng Z, Zong Y, Ma Y, et al. Glucagon-like peptide-1 receptor: mechanisms and advances in therapy. Signal Transduct Target Ther. 2024;9:234.
4. Mawardi HH, Almazrooa SA, Dakhil SA, et al. Semaglutide-associated hyposalivation: A report of case series. Medicine (Baltimore). 2023;102:e36730.
5. Wang Z, Wang X, Zhang L, Wang B, Xu B, Zhang J. GLP-1 inhibits PKCβ2 phosphorylation to improve the osteogenic differentiation potential of hPDLSCs in the AGE microenvironment. J Diabetes Complications. 2020;34:107495.
6. Yang R, Zhang L, Guo J, et al. Glucagon-like peptide-1 receptor agonists for obstructive sleep apnea in patients with obesity and type 2 diabetes mellitus: A systematic review and meta-analysis. J Transl Med. 2025;23:389.
7. Gu GH, Pauplis C, Seacor T, Devuni D, Krishnarao A. Association of semaglutide with retained gastric contents on endoscopy: Retrospective analysis. Endosc Int Open. 2025;13:e25501468.
8. Pierret ACS, Nefs G, de Wit M, et al. Glucagon-like peptide 1 receptor agonists and mental health: a systematic review and meta-analysis. JAMA Psychiatry. 2025;82:643-653.