Modern medical solutions for diabetes and weight loss have evolved to be highly effective tools for combating these conditions. Ozempic, Trulicity, Victoza and Muonjaro (known as GLPs) are the latest iterations of drugs that are effective at mimicking the humble Gila Monster, a desert reptile, in its ability to stabilize its blood sugar and suppress its appetite. This is because a peptide in the Gila monster’s saliva suppresses its appetite, slows down its gastric emptying time, and stabilizes its glucose levels. Incretins are these hormones or peptides that can do the same thing in humans.
According to pharmacologist Tom Viola, who recently discussed these issues on the ADA podcast, Mounjaro is more effective than Ozempic. Mounjaro targets two incretins, gastric inhibitory polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), which are responsible for weight loss, while Ozempic targets only one.
There are several ways in which GLPs can affect oral health. Here is how they can affect you and how Dr. Singletary ensures the safety and comfort of all of his patients:
Why dentists are interested in knowing more about GLPs and the known systemic effects on overall oral health:
A dentist who learns that a patient is taking GPLs may operate under the assumption that the patient is diabetic or prediabetic, and approach the treatment planning from that standpoint without realizing the patient is using it for weight loss.
Another potential issue arises when a patient does not inform the doctor of the drug at all, despite the fact that the drug can cause hypoglycemia. Nobody likes to eat before the dentist, but when a person is in a stressful situation and they haven’t eaten, a patient using GLPs could have lowered glycogen levels and be subject to hypoglycemia.
Additionally, a person may have a tendency to over-use these drugs in order to combat their weight.This can lead to stasis, and ultimately gastroparesis. This is because the body has suppressed the gastric emptying time so much that there’s no digestive movement. This means that the food doesn’t go anywhere and either the user must expel whatever they’ve eaten or it simply sits in the stomach causing bad breath; this is where the term “Ozempic Burp” comes from.
How Dr. Singletary approaches these issues for the health of the patient:
Dr. Singletary conducts a thorough consultation with the patients in order to learn everything he needs to maintain the safety of the patient and be fully informed on how to proceed.
First: Our office takes a complete medical history.
Second: If a patient uses a GLP drug we ask important follow-up questions related to the purpose for taking that medication.
Third: We ensure that we are prepared for a patient experiencing hypoglycemia, which can be due to the medication or the stresses involved in a dental visit.
Fourth: Dr. Singletary notes what is necessary to look for in the mouth. For example, there may be xerostomia due to elevated blood sugars and therefore frequent urination.
Dr. Singletary believes it is important to be able to spot the differences between a person using GLPs and a patient experiencing GERD, an eating disorder, or even cannabinoid hyperemesis syndrome (vomiting daily from excessive cannabis).
Interactions that GLP medications may have with other drugs
There are very few direct drug interactions, however there are a few indirect interactions.
While we know that GLPs can cause hyperglycemia, there are also some medications in dentistry that can alter blood glucose levels like corticosteroids (anti-inflammatories). For instance, epinephrine can raise blood glucose levels.
With a full medical history and an informed approach, our office can work to mitigate any negative interactions that otherwise might be possible.
The positive side of GLPs
GLP medications have helped many people treat type 2 diabetes and to lose weight in a healthy and responsible way. While clinicians must be able to recognize the potential pitfalls, it’s also important to recognize the positive qualities that GLPs offer.
GLP medications are approved by the FDA as safe and effective. Dr. Singletary encourages that if you’ve been prescribed a drug by your physician, take advantage of it, and use it responsibly. Finally, it’s important to avoid discounting the role that dentists play in good healthcare, not just oral healthcare alone.
For more information on this topic, listen to the Gum Guru Podcast by clicking the link below:
Popular Weight Loss Drugs Like Ozempic: How They Can Affect Your Oral Health