Dental Care for Patients on GLP-1 Agonists: Updated Protocols & Oral Health Tips

Read Time:4 Minute, 13 Second

You’ve probably seen the headlines. Medications like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) are changing the landscape of weight management. As a dental professional, you’re not prescribing these GLP-1 receptor agonists—but your patients are increasingly arriving for their cleanings and procedures while on them.

And that means our clinical playbook needs an update. The oral and systemic effects of these powerful drugs create a unique set of considerations, from appointment timing to emergency protocols. Let’s dive into what you need to know.

Table of Contents

Why Dentists Can’t Ignore the GLP-1 Trend

Here’s the deal: these aren’t just “diet pills.” They work by mimicking a hormone that slows stomach emptying, increases insulin release, and tells the brain you’re full. The results for weight loss and blood sugar control can be dramatic. But that very mechanism of action—especially the slowed gastric emptying—has direct implications in the dental chair.

Think of the stomach like a slow-draining sink. Everything just… sits there longer. For a patient under sedation or even just leaning back, that’s a critical factor. Honestly, it’s become one of the most common questions in our practice now: “Doctor, I’m on one of those new injections. Does that change anything for my dental work?”

Key Oral Health Side Effects and Patient Conversations

Beyond the big procedural protocols, there are day-to-day oral side effects you should be discussing. Patients might not connect these dots to their medication.

The Xerostomia (Dry Mouth) Connection

It’s a frequent complaint. Dehydration from reduced fluid intake, coupled with potential medication side effects, can create a dry oral environment. And you know what that means: a higher risk for caries, candidiasis, and just general discomfort. Your dietary counseling for these patients has to be spot-on.

Acidic Oral Environment and Erosion Risk

This is a big one. Nausea and vomiting are common, especially when starting the medication or increasing the dose. That exposes the teeth to stomach acid repeatedly. We’re talking about a real risk for significant enamel erosion, particularly on the palatal surfaces of the maxillary teeth.

Your advice here is crucial. Don’t brush immediately after an episode—that can abrade softened enamel. Instead, rinse with water, a baking soda solution, or a fluoride mouthwash. Wait at least 30 minutes before brushing. It’s a simple protocol that can save a lot of tooth structure.

The Major Protocol: Managing Aspiration Risk for Sedation

This is the cornerstone of new dental considerations for GLP-1 patients. The slowed gastric emptying significantly increases the risk of regurgitation and pulmonary aspiration during procedures involving sedation, general anesthesia, or even deep scaling where the patient is supine.

Old fasting guidelines? They’re potentially insufficient now. A patient who took their weekly injection a few days ago might still have a full stomach, even after following traditional “NPO after midnight” instructions.

Updated Pre-Procedure Fasting Recommendations

Based on guidance from anesthesia societies and emerging dental consensus, here’s a practical approach:

Medication Dosing	Recommended Protocol
Daily GLP-1 Agonists	Hold the dose on the morning of the procedure.
Weekly GLP-1 Agonists	Consider the patient as having a “full stomach” regardless of fasting. Discuss holding the dose for one week prior to elective sedation. This needs physician coordination.

For any non-emergent sedation, a clear conversation with the patient’s prescribing physician is non-negotiable. It’s about shared responsibility. For routine hygiene or restorative appointments without sedation? Standard protocols apply, but positional comfort is key—a slightly more upright chair position can ease patient anxiety about nausea.

Integrating GLP-1 Status into Your Health History Workflow

Your health history form needs to catch this. A generic “list your medications” line might have it buried. Consider adding a specific, prominent question:

“Are you currently taking any medication for weight management or diabetes, such as Ozempic, Wegovy, Mounjaro, Zepbound, or similar injectables?”
Follow-up: “If yes, what is your dosing schedule (daily/weekly) and when was your last dose?”

This isn’t just a checkbox. It’s a conversation starter. It allows your team to flag these patients for review, adjust scheduling if needed, and provide targeted oral hygiene instruction. Frankly, it shows you’re on top of current health trends.

A Collaborative Care Mindset

Your role is evolving. You’re a key part of this patient’s healthcare team. Noticing unexplained erosion? It might be your questioning that helps a patient connect it to medication-related nausea. Seeing fantastic glycemic control in a diabetic patient? Their improved periodontal health is a direct benefit.

That said, stay in your lane. We’re not managing their medication. But we are managing the oral consequences and the procedural risks. A quick, informed call to their physician to coordinate care for a planned implant surgery or sedation—that’s gold-standard practice now.

The landscape of medicine, and by extension dentistry, shifts. These medications are powerful tools for patient health, but they come with a new set of rules for our operatory. By adapting our protocols and deepening our conversations, we don’t just avoid complications—we provide truly integrated, thoughtful care. And that, after all, is the point.