Ozempic: The “miracle” weight loss drug and its possible dental effects

If you’re like me, you’ve had several patients come into the dental office and tell you they’re taking a new medication for weight loss: Ozempic (or Wegovy, Semaglutide, or Rybelsus). You may have also seen the drug on social media platforms such as TikTok, with Elon Musk and Andy Cohen attesting to the drug’s effectiveness for shedding pounds.

What is this new miracle drug?

Ozempic was approved in 2017 for treatment of diabetes, and in 2021 for treatment of chronic weight management.¹ It quickly grew in popularity, ranking 90th in 2021 as the most prescribed drug in the US. More than three times as many people in the US were taking the medication in 2021 compared to 2019—almost two million people.² Prescriptions increased again, with US health-care providers writing more than nine million prescriptions by the end of 2022.³

The medication is an injectable taken once a week. The class of drug is glucagon-like peptide 1 (GLP-1) agonists. These drugs stimulate the body to produce more insulin, which helps lower blood sugar levels. They also slow the movement of food from the stomach into the small intestine, which is believed to make someone eat less because they feel fuller faster and longer.⁴

Like most medications, it has side effects, including nausea, vomiting, diarrhea, pancreatitis, changes in vision, hypoglycemia, kidney problems, gallbladder problems, and serious allergic reactions.^4,5

Coverage from RDH's sister publication, DentistryIQ

Dental considerations for people taking Ozempic

Ozempic and dentistry: Implications for today’s clinicians

Oral health implications of Ozempic

While there is currently no research showing the connection between Ozempic and similar weight loss drugs to oral side effects, there are reports of halitosis, gum inflammation, dry mouth, and what’s being called “Ozempic breath” or “Ozempic burp.” It’s believed that the increase in bad breath, or in foul-smelling burps, is due to the mechanism of action of the medication. Food remains in the stomach for a longer period of time, causing an unpleasant or rotting smell.^6,7

More research is needed to determine a connection between these popular weight loss drugs and oral side effects such as halitosis. As dental professionals, we want to stay informed as oral side effects evolve while these drugs continue to grow in popularity.

There are some important considerations when our patients report taking these medications. We should ask what they’re taking the medication for. We need to determine if the patient has diabetes or if they’re taking it for weight management only. If the patient has diabetes, we need to ask follow-up questions about the control of their diabetes, and then be on the lookout for signs of gingival inflammation.

If a patient is taking the medication for weight management, could they be more prone to hypoglycemia if they’re not diabetic and taking a medication that increases insulin? Is the patient experiencing dry mouth, which can increase the risk for developing dental caries? We need to educate our patients on caries prevention, especially those experiencing dry mouth.

Could the patient benefit from a professional fluoride application or prescription fluoride products? While we wait for more research about these medications and their oral side effects, we can advise our patients to drink plenty of water, continue with regular brushing and flossing habits, visit the dentist regularly, and consult their medical provider if they experience side effects that could be related to the medication.7,8

Want another angle on Ozempic? Check out this episode from A Tale of Two Hygienists.

References

1. Kahn J. FDA approves new drug treatment for Chronic Weight Management, first since 2014. U.S. Food and Drug Administration. June 4, 2021. Accessed May 6, 2024. https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014

2. DeSilver D. As obesity rates rise in the US and worldwide, new weight-loss drugs surge in popularity. Pew Research Center. March 21, 2024. Accessed May 6, 2024. https://www.pewresearch.org/short-reads/2024/03/21/as-obesity-rates-rise-in-the-us-and-worldwide-new-weight-loss-drugs-surge-in-popularity

3. Constantino AK. Ozempic, Wegovy drug prescriptions hit 9 million, surge 300% in under three years. CNBC. September 27, 2023. Accessed May 6, 2024. https://www.cnbc.com/2023/09/27/ozempic-wegovy-drug-prescriptions-hit-9-million.html

4. Castro MR. Do any diabetes drugs help you lose weight? Mayo Clinic. June 29, 2022. Accessed May 6, 2024. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/expert-answers/byetta/faq-20057955

5. What is Ozempic?: Ozempic (semaglutide) injection. September 1, 2023. Accessed May 6, 2024. https://www.ozempic.com/why-ozempic/what-is-ozempic.html

6. Maurer B. Ozempic and your oral health: Bad breath, dry mouth, and other side effects. Bristle. December 8, 2023. Accessed May 6, 2024. https://www.bristlehealth.com/blogs/news/ozempic-and-your-oral-health-side-effects-you-should-know

7. Mayer BA. Ozempic breath: Can weight loss drugs cause halitosis? Healthline. May 2, 2024. Accessed May 6, 2024. https://www.healthline.com/health-news/ozempic-breath

8. Cheeseman V, ed. Ozempic and dentistry: Implications for today’s clinicians. DentistryIQ. February 16, 2024. Accessed May 6, 2024. https://www.dentistryiq.com/dentistry/pharmacology/article/14305225/ozempic-and-dentistry-implications-for-todays-clinicians