AS the demand for weight loss drugs continues to rocket, so do reports of potential side effects.
The most common include nausea, vomiting, bloating, constipation and diarrhoea, but some users also experience dramatic facial changes and thinning hair.
Now, to add to the list of possible risks, experts are warning of a worsening phenomenon dubbed ‘Ozempic teeth’.
It’s the term coined to describe the worrying rise in dental issues – including dry mouth, bad breath, gum disease, fungal infections and tooth decay – affecting some of the estimated 1.5million people in the UK using GLP-1 medications such as Mounjaro, Ozempic and Wegovy.
Dr James Goolnik, dentist and founder of Optimal Dental Health, London, tells Sun Health: “I’m seeing a marked increase in dental issues among patients who are on weight loss drugs.
“The biggest problem is dry mouth (xerostomia), which affects 100 per cent of my patients who are on GLP-1 medications.
“Dry mouth occurs when the salivary glands don’t produce enough saliva. This is a huge concern.
“Saliva is our natural defence mechanism against tooth decay.
“It plays a vital role in neutralising acids, washing away food particles, and protecting tooth enamel.
“If there’s not enough saliva, this raises the risk of tooth decay, gum disease, mouth sores, and bad breath.”
A recent study published in the journal Medicine found a strong link between the use of semaglutide (sold under the brand names Mounjaro, Ozempic, Rybelsus, and Wegovy) and decreased saliva (hyposalivation).
Scientists say dry mouth may occur as part of the fluid loss linked to weight loss, as a result of dehydration caused by vomiting and diarrhoea, or due to inflammation of the nasal passages (nasopharyngitis, another possible side effect), which leads to mouth breathing.
Research suggests that decreased saliva can lead to tooth decay, oral fungal infections and bad breath (halitosis).
It’s early days, though.
GLP-1 injections have only been approved for weight loss in the UK (through the NHS and registered healthcare professionals) for just over a year-and-a-half.
While some people are already reporting mouth-related issues, it will take time before we see the results of further studies.
That said, already the warning signs are not good – and this is something many dentists are picking up on.
Dr Sulaman Anwar, specialist periodontist and founder of Serio Dental, London, says: “At least 10 per cent of my patients, if not more, are on weight loss medication.
“A typical scenario is where I see a patient has lost an incredible amount of weight in a short period of time.
“It turns out they’re on weight loss medication and also presenting with new symptoms which have developed relatively quickly, such as fungal infection, mouth ulcers or early signs of tooth decay.
“The other day, for example, I saw one patient, a man in his 40s, who had lost a lot of weight on semaglutide medication.
“He was showing signs of early tooth decay – softening of the tooth enamel, discolouration and cavities (which showed up on an X-ray).
“These changes surprised me as he is someone who comes in for regular check-ups.”
He adds: “Another patient, a woman in her late 50s, also on semaglutide medication, had developed a fungal infection in her mouth, caused by low saliva and an extremely dry mouth.
“She had redness and crusting on the corners of the lips (angular cheilitis), a creamy, curd-like coating on her gums and a white froth on her tongue.
“She also had an unpleasant taste in her mouth.
“This can be caused by fungal infection, but GLP-1 drugs can also affect the sense of taste.”
Researchers at the University of Pennsylvania found that GLP-1s can significantly impair all five basic tastes (sweet, sour, bitter, salty and savoury).
One theory is that these medications affect the way the brain and taste pathways process taste signals.
If you’re using GLP-1 medications, you need to be extra vigilant when it comes to your dental health
Dr Sulaman Anwar
“Dysgeusia is when your sense of taste changes,” says Dr Goolnik. “Foods may taste metallic, bitter, or just ‘off’.
“This is another common side effect of weight loss medication.
“I’d say about a third of my patients who are on weight loss drugs have experienced changes in taste.
“This can discourage proper eating, as food tastes less appealing. It can also affect oral hygiene habits, and in some cases, people may avoid brushing their teeth or using certain products because of the altered taste sensations.
“Or, they eat more sugary foods to try to counteract the weird, bitter taste in their mouth.
“Too much sugar also affects oral health. A dry mouth, tooth decay and gum disease can also cause bad breath.”
How do weight loss jabs work?
WEIGHT loss jabs are all the rage as studies and patient stories reveal they help people shed flab at almost unbelievable rates, as well as appearing to reduce the risk of serious diseases.
The injections work by suppressing your appetite, making you eat less so your body burns fat for energy instead and you lose weight.
They do this by mimicking a hormone called GLP-1, which signals to the brain when the stomach is full, so the drugs are officially called GLP-1 receptor agonists.
They slow down digestion and increase insulin production, lowering blood sugar, which is why they were first developed to treat type 2 diabetes in which patients’ sugar levels are too high.
In the UK, there are several licensed GLP-1 medicines, including semaglutide (sold under the brand names Wegovy, Ozempic and Rybelsus), tirzepatide (Mounjaro) and liraglutide (sold under various brand names).
Side effects are common but most are relatively mild.
Around half of people taking the drugs experience gut issues, including sickness, bloating, acid reflux, constipation and diarrhoea.
Dr Sarah Jarvis, GP and clinical consultant at patient.info, adds: “One of the more uncommon side effects is severe acute pancreatitis, which is extremely painful and happens to one in 500 people.”
Other uncommon side effects include altered taste, kidney problems, allergic reactions, gallbladder problems and hypoglycemia.
Evidence has so far been inconclusive about whether the injections are damaging to patients’ mental health.
Dr Anwar adds: “Everyone should be mindful of looking after their dental health.
“But if you’re using GLP-1 medications, you need to be extra vigilant, especially if you notice any unusual changes.
“You should also always tell your dentist if you’re taking weight loss drugs.
“While dentists do check medical history and medication, some people can be reticent in admitting they’re using these injections.
“Dentists are recognising that weight loss medications can have an impact on people’s teeth.
“As a result, many dentists are now adapting how they practice.
“This includes monitoring patients more closely and offering preventative care, support and advice, so that any issues are dealt with effectively before they progress.”
So what should you be doing to prevent any issues?
Dr Goolnik, who also specialises in nutrition, offers the following tips:
1. Eat lots of crunchy and green leafy vegetables
Crunchy vegetables, like raw carrots and broccoli, will help to remove plaque from the surface of your teeth.
Leafy veg, like spinach and kale, contain iron, which helps to strengthen enamel and guard against gum disease.
2. Sip water throughout the day
It’s vital to stay hydrated.
This will also help to stop your mouth from getting dry.
Teeth issues reported among jab users
THE internet is full of people complaining of weight loss jab side effects, and many of these include problems in their mouths.
One reddit user said: “I’ve been on Ozempic for three months and I have a cracked tooth and inflamed gums.”
Another wrote: “I wake up in the night frequently with a dry mouth.”
While a third commented: “At the dentist today I found out that several of my teeth need to be pulled out because they’ve corroded.”
Others have raised that their teeth feel “so sensitive”, and one person even said their gums “feel hot and are darkening purple”.
Another jab user said: “My teeth have hurt so badly since starting Ozempic. It’s awful.”
While an anonymous poster taking Mounjaro wrote: “I’ve always had cavities every so often, but I can count at least six right now since starting my journey.”
3. Brush and floss teeth regularly
This will ensure your mouth is free of any lingering food debris between your teeth.
Flossing also helps to remove plaque.
4. Top up on dairy or (sugar-free) dairy alternatives
Yoghurt and cheese are great for strengthening tooth enamel and fighting against cavities as they are high in calcium and protein.
Almost all calcium in the body is stored in bones and teeth, and calcium deficiency has been shown to increase the risk of tooth loss.
5. Snack on nuts
Raw, unsalted nuts are great for teeth; they are low in carbohydrates (which can activate the acid-producing bacteria that can lead to tooth decay).
Their high fibre content also means you have to chew them, which naturally stimulates the production of saliva, helping to reduce the risk of tooth decay.
6. Choose low acid fruits such as strawberries and apples
Both contain malic acid, which can help to naturally whiten teeth.
Also, when you eat an apple, you spend a little more time chewing which helps to stimulate gums and increase saliva production.
Other low acid fruits include melon, blueberries and pears.
7. Chew sugar-free gum with xylitol after meals
It’s scientifically proven to reduce cavities, neutralise harmful acids, and keep your breath fresh.
Xylitol is a natural sugar alternative that bacteria cannot digest, meaning it actively fights against tooth decay.
It stops bacteria from sticking to your teeth, lowering plaque build-up and reducing the risk of cavities and bad breath.
Chewing also increases saliva flow, which helps wash away acid and protects your enamel.
The 6 ‘Nozempic’ foods that mimic weight loss jabs
By Ella Walker, Freelance Health Writer
WEIGHT loss drugs can sound like a magical quick fix to overeating and constant hunger pangs. But not everyone is eligible for the drugs, and lots wouldn’t opt for them even if they were.
Many of us are still looking to blast some belly fat though, so what if we said you could mimic the meds, with none of the unpleasant side effects? The good news is there are simple ways to mimic fat jabs.
Yep, with just a few diet changes, you could swerve the headaches, nausea, constipation and diarrhoea the drugs can trigger, and still gain the health benefits of losing a few pounds.
First developed to treat type 2 diabetes, the medications – Wegovy and Mounjaro (available on the NHS) – are licensed for weight management for people living with obesity (BMI over 30), or those overweight (BMI of 27) with a weight related comorbidity, “like high blood pressure, high cholesterol or even knee osteoarthritis,” explains Dr Tom Curtis, Clinical Head of Obesity at Voy.
Ozempic is also prescribed to treat type 2 diabetes but is not licensed for weight loss in the UK.
They work by mimicking naturally occurring incretins – hormones, like GLP-1 – that tell your brain you’re full up.
“They reduce your minute-to-minute hunger drive,” says Dr Curtis.
“They also slow stomach emptying, so make you fuller for longer and can stabilise blood sugars.”
But certain foods can put the brakes on hunger like this too…
“Everybody creates GLP-1 after they eat, along with a whole swathe of other hormones that tell us we’re full and don’t necessarily need to carry on eating,” says Emily Lenoir, a registered associate nutritionist and behaviour change coach at Voy.
“There are a few foods that might increase the feeling of fullness, and that often is in relation to a slight peak in GLP-1.”
- Chicken, turkey, salmon, eggs – protein is your friend.
- Fibre – from a variety of fruits and vegetables – makes you feel fuller for longer.
- Go big on homemade granola and porridge for breakfast to curb hunger pangs through the day.
- Nuts like almonds, pistachios, and peanuts might actually increase GLP-1 levels thanks to being packed with protein, fibre and healthy fats.
- Avocado can slash insulin levels and increase GLP-1 levels, alongside peptide YY – another appetite-regulating hormone – when eaten in place of carbs.
- Kefir, sauerkraut, yogurt, pickles and kimchi are all tasty fermented foods that could supercharge your appetite-curbing hopes.
You can read more about Emily’s suggestions here.
As you may have gathered, what you eat has a huge impact on your teeth and oral hygiene.
A balanced diet, healthy snacks and staying hydrated can all help to protect teeth and prevent tooth decay.
But people on GLP-1 jabs can easily become deficient in nutrients.
If you’ve lost your appetite, you won’t feel like eating as much.
If you’re not eating enough, or you’re only eating very small amounts of non-nutritious foods, this can lead to nutrient deficiencies, which will have a knock-on effect on your oral health.
Some key nutrients, such as vitamins C, D, E, and B12, and also, iron, magnesium and omega-3 fatty acids, are crucial for healthy gums and teeth.
Vitamin C
A lack of vitamin C can lead to bleeding gums and tooth decay.
The best food sources are fruit and vegetables like oranges, peppers, strawberries, blackcurrants and broccoli.
Alternatively, you can try a supplement like Altrient C Liposomal Vitamin C (£52.21 for 30 1,000mg sachets).
This formula has a 98 per cent absorption rate.
The NHS says adults aged 19 to 64 need 40mg of vitamin C a day.
Vitamin B12
Adults (aged 19 to 64) need about 1.5micrograms a day of vitamin B12.
A deficiency can cause mouth ulcers and an inflamed, purplish tongue.
A review published in Frontiers in Nutrition showed that lower vitamin B12 levels significantly raised the risk of tooth decay, tooth loss, and dental disease.
The best food sources are meat, fish, poultry, eggs, and yoghurt. Or you can try Healthspan Vitamin B12 (£20.99 for 240 tablets).
Vitamin D
Vitamin D is essential for good oral health.
A review published in BMC Oral Health found that vitamin D deficiency can increase the risk of dental caries (tooth decay), periodontitis and gingival inflammation (gum disease).
Always take vitamin D3 in combination with vitamin K2.
This ensures calcium, also needed for strong teeth, is correctly absorbed in the body.
The best food sources are oily fish (e.g. mackerel, tuna, salmon, herring), egg yolks and mushrooms.
Children from the age of one and adults need 10micrograms of vitamin D a day.
From about late March or early April to the end of September, most people should be able to make all the vitamin D they need from sunlight.
But during the autumn and winter, the NHS recommends taking a supplement.
You could try Viridian Vitamin D3 with K2 (£30.05 for 90 capsules).
Other diet pitfalls to be aware of
“GLP-1s are not the only weight loss trend that may have a negative effect on oral health,” says Dr Goolnik.
Here, he gives a run-down of other things to look out for…
1. Intermittent fasting, which involves cycling between periods of fasting and eating.
For example, the 16:8 method (fasting for 16 hours and eating during an eight-hour window) and the 5:2 approach (eating normally for five days and consuming 500 to 600 calories on two days), can reduce inflammation and lead to improved glucose response.
But when you fast, this also decreases salivary flow, which increases the risk of caries, dry mouth and halitosis.
2. The ketogenic diet induces ketosis, where the body uses fat for energy instead of carbohydrates.
This can lead to ‘keto breath’ due to the production of ketones.
This can smell like acetone, chemicals, or have a sweet, fruity odour.
Drinking plenty of fluids and reducing protein intake can help to mitigate keto breath.
It’s also worth bearing in mind that not eating wholegrains, fresh fruit and vegetables can also result in deficiencies in vitamins and minerals that are crucial for oral health.
3. Vegan diets tend to be low in nutrients such as vitamin B12, iron, and omega-3 fatty acids.
These are not readily available through plant-based sources, and this can affect dental health.
Some studies suggest that vegans may be more prone to dental erosion (from eating a high quantity of acidic fruits and vegetables), while a lack of dairy increases the potential for calcium and vitamin D deficiencies, both of which are needed for healthy teeth.
