‘Ozempic teeth’: The Invisible Price of Perfect Weight Loss

Opinion article written by Pedro Cosme, dentist at MALO CLINIC Lisboa. 

“ For years, medicine has pursued an almost obsessive goal: losing weight quickly. Now, with the explosion of drugs like Ozempic and other GLP-1 drugs, it looks like we finally found the magic formula. Less appetite, less weight, quick results. The problem? The price could be a lot higher than we thought... and we're not just talking about a number on the scale. But it is possible to lose weight without impacting other aspects of our health.

While social networks celebrate impressive physical transformations, doctors and dentists begin to warn of a silent phenomenon, but increasingly visible: the impact of these drugs on oral health and facial aesthetics. And the signs begin to be difficult to ignore: dry mouth, cavities, dental wear, extreme sensitivity, gingival irritation, bad breath and even structural changes in the face. Terms such as ‘Ozempic face’, ‘Ozempic mouth’ or ‘Ozempic teeth’ are no longer just viral expressions and began to enter the clinical conversations.

One of the main problems created by these drugs is the increase in acidity in the oral environment, caused not only by the decrease in the rate of digestion, which can lead to an increase in gastric reflux, but also by the reduction in salivary flow and nausea that are a secondary effect of this type of drugs. This can lead to lesions of demineralization of the dental structure, which increase the sensitivity and risk of caries, weakening the teeth. The gums also suffer, when dehydrated they become more sensitive and increase the propensity for tartar accumulation. 

Often, associated with the taking of Ozempic and similar, anxiolytics and antidepressants are also prescribed to reduce the accesses of hunger and ill-disposition. One of the main effects of these medicines is also extreme dryness of the mouth. The combination of the two drugs further enhances this effect. Maintaining hydration of the mouth is one of our most important defense mechanisms: protects the teeth, controls bacteria and neutralizes acids. When it disappears, problems begin to arise.

For reasons that cannot yet be explained, there are also those who make this treatment an increased risk of developing dental tightness and gnashing of teeth, also known as bruxism. If we associate this effect with the increased fragility of dental structure and sensitivity, this may have catastrophic effects on oral health.

Fast weight loss leads to a marked loss of facial fat and, if food and exercise are not adequate, there is a decrease in muscle mass and tone, and the consequent accentuation of facial wrinkles and grooves, laxity of the lips, enclosed cheeks and an early aging appearance: the ‘Ozempic-face’.

The face loses support, leading to a change in smile, which causes many patients to begin to notice a more tired and aged appearance. This is precisely the opposite of the healthy image that they seek to achieve through an almost miraculous formula.

There is another issue which is rarely mentioned and which may be one of the biggest culprits in these unwanted effects: the speed of transformation. The human body barely adapts to extreme and rapid changes, especially when they involve significant weight loss in a short time. The oral cavity, facial muscles and supporting tissues are not different and also suffer this impact. Many patients end up seeking corrective treatments not because they lost weight, but because they stopped recognizing their own image in the mirror. These aesthetic treatments may eventually be necessary, but the body eventually gets used to nutrition, especially protein and fat, and exercise practice is strongly recommended to counteract the effect of decreased muscle mass. Losing weight with the help of these drugs is great, but it does not mean starving or not eating an adequate amount of nutrients. Otherwise, not only do we end up more fragile, but we also increase the risk of regaining weight when we stop the medication.

The most worrying thing is that this conversation is still a long way from reaching the public. There is talk of metabolic benefits, rapid results and celebrities who have lost weight in a few months, but hardly anyone talks about the impact on oral health, tissue quality or how these medicines can accelerate existing dental problems.

At a time when aesthetics occupies an increasingly central place in society, it is contradictory to ignore precisely one of the most visible areas of our image: smile. We remain obsessed with numbers on the scale, but forget that health, youth and well-being are also reflected in skin quality, facial harmony and oral health. And none of these factors should be sacrificed in the name of quick results.

Losing weight should not mean losing health, aging your face or compromising your smile. Perhaps it is time for the conversation to stop being just about losing weight quickly and focusing on the real invisible cost of this speed.”.