GLP-1 receptor agonists have transformed weight management for millions of U.S. adults, but the same medications driving dramatic before-and-after photos may be quietly destroying patients' teeth.
In this episode of the Dental Assistant Nation podcast, produced in partnership with DrBicuspid.com, host Kevin Henry speaks with Tom Viola, RPh, dentistry's go-to pharmacology educator, for a candid conversation about two medications that are creating a vomiting crisis hiding in plain sight in dental chairs across the country.
Viola makes the connection explicit: Patients using GLP-1 and GLP agonists -- drugs like Ozempic, Wegovy, and Mounjaro -- experience slowed gastric emptying that can trigger chronic acid reflux, halitosis, and, in some cases, outright vomiting.
Patients and clinicians often have no idea the drug is behind it. Some have been misdiagnosed with gastroesophageal reflux disease (GERD). Many patients don't mention they're taking GLP-1s because they obtained them outside traditional clinical channels -- through compounding pharmacies, telehealth platforms, or overseas sources. The result is a patient population presenting with unexplained acid erosion, asking why their breath smells bad and reaching for sugar-laden mints that only compound the problem.
The second drug Viola raises is less discussed but increasingly urgent: Cannabinoid hyperemesis syndrome, a condition triggered by high-concentration cannabis use that causes cyclical vomiting, sometimes up to 12 times a day. The cruel irony, Viola explains, is that many cannabis users have been told cannabis helps with nausea. So they vomit, use cannabis to manage it, and vomit again.
When Viola first raised the topic at dental conferences to poll oral health professionals about their knowledge of these two drugs and their side effects, almost no hands went up in the audience. At his most recent events, far more did.
For dental assistants, the message is practical: When a patient presents with halitosis, acid erosion, or complains about bad breath, the conversation should start. Ask about GLP-1 use. Ask about cannabis. Look for the signs. The dental assistant is often the first person in the room -- the first to notice the smell, the first to hear the complaint, the first opportunity to have a conversation that could protect a patient's dentition while they work to improve their systemic health.
Tom Viola can be reached at TomViola.com. Listen to the full conversation below.
