On The Debbie Nigro Show, I like to dig into stories that make you go, “Wait, what?!”
This week’s head-turner: “Ozempic Teeth.” Yep, that’s the headline making waves, and I knew I had to call in my go-to expert, Dr. John Castanaro of Castanaro Dental in Yonkers, NY, to help get to ‘the tooth of the matter’.
What Are “Ozempic Teeth”?
GLP-1 medications like Ozempic and Wegovy have taken the world by storm for their weight-loss benefits. But dentists are warning about side effects showing up in the mouth. According to Dr. Castanaro:
“It’s not the drug itself causing problems—it’s the side effects like acid reflux, nausea, vomiting, dry mouth, and sometimes malnutrition.”
Those issues can lead to enamel erosion, cavities, swollen gums, and even gingivitis. In short: less saliva = more dental drama.
Prevention Is Key
The good news? Simple changes can protect your smile:
- Drink more water. Dehydration is a big culprit.
- Use products like Biotene (a rinse that coats and protects against dry mouth).
- Chew sugar-free gum or candies to stimulate saliva.
- Stay active. Even light walking helps reduce reflux and nausea.
- Stay on top of dental visits. Dr. Castanaro recommends some patients schedule three cleanings a year instead of two.
As he put it:
“Prevention and being on top of it—being educated about it—is everything. You can’t ignore these signs.”
Dentistry’s Big Trend
Beyond Ozempic teeth, Dr. Castanaro noted a bigger shift: younger generations with fewer cavities are turning to cosmetic upgrades like Invisalign and whitening. Thanks to new tech (hello, 3D printers!), straighter, whiter smiles are now easier and less invasive than ever.
My Takeaway
Ozempic teeth might sound scary, but the fix is refreshingly simple: hydrate, care for your teeth, and don’t skip the dentist. As always, knowledge is power—and I’m glad Dr. Castanaro was here to drop some wisdom (and a little humor).
“At the end of the day, prevention and awareness go a long way.”
Thanks, Doc.
Enlighten yourself in the short podcast of my live conversation with Dr. John Castanaro on The Debbie Nigro Show. If you’d rather read than listen the transcript of the audio is below.
AUDIO TRANSCRIPT:
0:00:01
(Speaker 5)
And now back to the Debbie Nigro Show.
0:00:19
(Speaker 1)
What’s the matter with you today? Hopefully nothing too terrible. Hi, everybody. I’m Debbie Nigro. I’m bringing it. I bring the positive good energy every time I open the airwaves.
0:00:28
(Speaker 1)
And once a week, I bring you great information and often very cool guests who are smarter than me about topics that I’m interested in that I thought might interest you. So today, in the spirit of keeping the living alive and the teeth in your mouth, I wanted to address a story. that I caught this week that the headline kind of took me aback and said, Ozempic teeth, dentists warn of new GLP -1 side effect. I’m like, oh, what is this now? And it seems that people who use Ozempic and other GLP -1 drugs are reporting a complication not listed on the drug’s most common side effects, okay? The dentists are warning they’re seeing cases of something nicknamed Ozempic teeth.
0:01:11
(Speaker 1)
I was like, what is this? I called my dentist, John Castanaro. I’m like, look, are you seeing this? He’s like, yes. I said, all right, let’s talk about it. So here he is, Dr. John Castanero.
0:01:20
(Speaker 1)
Hey, John.
0:01:21
(Speaker 9)
Hey, Deb.
0:01:22
(Speaker 2)
How are you?
0:01:23
(Speaker 1)
Good, buddy. Thanks for taking time. I know you have patients in chairs while you’re talking to me. I love talking to you. I know. I love talking to you, too. So what is this ozempic teeth?
0:01:33
(Speaker 1)
What do you know about it?
0:01:35
(Speaker 2)
So people that take the GLP -1s, The way they work is they slow down digestion and they keep you from getting hungry. And then the weight loss ensues from that. So some of the side effects that come from that is acid reflux, nausea and vomiting, dry mouth. and then in some cases, just a little bit of malnutrition, because again, you’re not taking in, some people are not taking in the proper amount of calories that they need, the amount of vitamins they need, that kind of thing. So all of that has started to show up in the oral cavity. The acid reflux is acid coming back up into the throat and the base of the mouth, so some of the molars are starting to, to decay on the bottom teeth in the back.
0:02:33
(Speaker 2)
The vomiting, which is the stomach contents coming back up, are also highly acidic. And it’s the same thing that we see in patients that are bulimic, which is the constant vomiting leads to enamel erosion and cavities, things of that nature.
0:02:48
(Speaker 1)
That is so gross.
0:02:49
(Speaker 6)
The dry mouth.
0:02:50
(Speaker 1)
The what?
0:02:51
(Speaker 9)
That’s so gross.
0:02:53
(Speaker 2)
Well, it is. And then the lack of nutrition and the dry mouth is causing gingival recession and swollen gums and gingivitis and things like that. The thing is the GLP -1s themselves do not cause the problem. It’s the side effects from the GLP -1 that are causing things to happen in the mouth.
0:03:15
(Speaker 1)
So it’s not that ozempic itself is causing the cavities or the gingivitis or the recession. Okay, question. Yeah, yeah, question. Apparently, the medications are cause people to drink less water because they feel less thirsty.
0:03:31
(Speaker 2)
Are you hearing that? And I mean, look, you know, I mean, you know, my secret we and I’m fine with it. We can. I take it.
0:03:42
(Speaker 1)
I’ve been on Zepfound for five months.
0:03:49
(Speaker 2)
And you look beautiful, by the way. Thank you. I mean, look, it’s a highly in the right dose, done the right way.
0:03:58
(Speaker 1)
It is a highly effective way to become healthier. Awesome. Dumb question, dentist extraordinaire.
0:04:04
(Speaker 2)
Do you see anything in your own mouth happening as a result of this? No. So I make sure that I take in the proper amount of water.
0:04:14
(Speaker 1)
I still drink almost a gallon a day.
0:04:16
(Speaker 2)
Oh, that’s really cool. I think that if you’re not hungry, taking the vitamin supplements is a big key.
0:04:25
(Speaker 1)
And then for people that do have the nausea and the vomiting and the acid reflux, I found that in the beginning I had the same thing, but I try to walk two miles a day, even at a slow pace, just to keep the body moving, keep the stomach moving, and I have almost no side effects anymore. Oh, that’s great. I did read that it kind of shows up. in the first couple of months. I think that’s something people need to know about.
0:04:53
(Speaker 2)
It’s not something down the road if you take it forever, right? Right. The first, for me, the first month was, you know, and then my body got a little bit used to it.
0:05:04
(Speaker 1)
And again, you start looking to compensate in ways, a little bit of a plainer diet, less spices, less cheeses, less oils, that kind of thing. And again, the activity, simple walking on a Peloton or on a treadmill, whatever, really did make a big difference. Yeah and then the ozempic teeth you know what they said in the article that I sent you that I said want you to comment on from newsnationnow . com is that one simple way to prevent ozempic teeth is just to drink more water because the damage to your teeth might not be reversible even if you stop taking the medication. So I wanted to put that out there and you as a professional and I know you’re a super professional you teach tell everybody what you teach.
0:05:46
(Speaker 2)
I think it’s important that people know you’re not just in an office you’re out there teaching your knowledge. Yeah, we teach, you know, general dentistry at Montefiore to the residents.
0:05:57
(Speaker 1)
Some of the cosmetic cases and some of the, you know, just tricks that we’ve learned along the way.
0:06:02
(Speaker 2)
I’ve been doing this now in the blink of an eye, it’s been 19 years.
0:06:05
(Speaker 1)
Wow. Which is amazing. And you learn from the best.
0:06:09
(Speaker 2)
Tell everybody about your father.
0:06:10
(Speaker 1)
I put his picture up too because he was the main guy there.
0:06:13
(Speaker 2)
I’ve been doing it for 40, it’s going to be 47, so he’s been doing it for 48 years.
0:06:18
(Speaker 1)
Wow. And there is no better teacher. He’s a wonderful person and a terrific professional too, your father. And then do other dentists now, are they talking about this? Are there notifications being sent out to your industry?
0:06:33
(Speaker 8)
Because it basically was saying that dentists need to be aware of this.
0:06:37
(Speaker 2)
Now, you and I are talking about it and obviously you knew, but do you think the industry knows? Yes.
0:06:45
(Speaker 1)
I mean, I think that, you know, I mean, What you see is, I mean, so many patients that I’ve been treating for so many years, you know, 10 plus years, are all coming in and, you know, quite honestly, everybody’s a little bit skinnier, a little bit healthier.
0:07:00
(Speaker 2)
You know, these drugs came on the market not that long ago and have kind of taken the world by storm and, you know, almost at least twice a day in the office now we see patients that are actively taking them or just started taking them. Really? And, you know, I think education is a big part of it, you know, we get them to drink more water, we get them to You know, in some cases, I have patients that I’ve asked to do three cleanings a year instead of just two. And, you know, I mean, prevention and being on top of it, being educated about it, knowing what to look for. If you start to feel like you really do have acid reflux from the medicine, you know, you either start jumping on a Nexium or a Prilosec or talk to your doctor. and see if there’s an alternative to whatever one you’re taking.
0:07:50
(Speaker 1)
I know some of them cause more side effects than others.
0:07:54
(Speaker 2)
You know, I mean, there’s a variety of things, but like anything in the body, you can’t ignore it. You can’t ignore it. Yeah, I mean, I love, I love biotein, biotein sold at every Walgreens, CVS, whatever. Um, it coats the mouth, uh, especially at night switch with it at the mouth rinse. Um, very effective for dry mouth. Uh, we’ve been prescribing that and, and, and, uh, been fans of that since even before this, this GLP one thing, um, you know, it was great for chemo patients that had dry mouth or diabetics that had dry mouth.
0:08:27
(Speaker 2)
So, um, that is always an effective tool.
0:08:30
(Speaker 1)
Also sugar free gum and sugar free candies. cause saliva production to increase. Okay, this is very important. This is important because what they were saying in the article that was causing the problem here is because semaglutide affects the salivary glands. So that’s the key there. And by stimulating the salivary glands, you can keep your mouth moist and you don’t have to have all these other issues with cavities and gum disease that come out of having some great thing that you’re taking change and make you healthier in other areas of your life.
0:09:04
(Speaker 1)
So I’m just happy you weighed in on this and that we’re getting the word out. And I’m a little sad that I’m not taking this GLP drug. I gotta be honest with you. I’m like, I don’t know why I haven’t taken it yet because I struggle for sure. up and down, up and down with the weight. It’s like I bloat hourly.
0:09:23
(Speaker 1)
What is that now?
0:09:24
(Speaker 2)
What is that, John? Terrible. At the end of the day, I weigh now what I weighed in freshman football in high school, which is crazy. It is a very effective tool.
0:09:40
(Speaker 1)
managed properly.
0:09:43
(Speaker 2)
It really does cut away a lot of the cravings that you have during the day.
0:09:48
(Speaker 1)
What are you doing with all your free time when you’re not craving food and going to eat and drink?
0:09:52
(Speaker 2)
I’m working harder.
0:09:55
(Speaker 1)
That’s funny. The lack of eating now is replaced with exercise. Oh, there you go.
0:10:01
(Speaker 2)
No wonder you look so good.
0:10:02
(Speaker 1)
You look really good.
0:10:04
(Speaker 2)
Putting aside a half hour, 45 minutes a day now to, you know, and to be really disciplined about getting on that treadmill or if it’s a nice night walking outside.
0:10:15
(Speaker 1)
Yeah, I gotta tell you too. little eight -year -old bestie that keeps me on my toes, too. Yeah, he’s adorable, little best friend of yours. I just read two things that might be of interest to this conversation for people listening, having to do with lifestyle, right? One was that the bars in New York City are kind of empty at night and instead all the young people are out running around tracks and at their gyms late at night. I was like, wow.
0:10:41
(Speaker 1)
And the other thing I read was that I forget what airline it was, is going to start charging you to pay for an extra seat if you are a little heavier and needed a little more room.
0:10:52
(Speaker 7)
They’re like, sorry.
0:10:53
(Speaker 2)
So a couple of things that might be going on with people’s lifestyle having to do with weight and activity that are now new pieces of information.
0:11:02
(Speaker 6)
So I’m just throwing that out there.
0:11:03
(Speaker 2)
I think there’s a definite, you see a definite shift in the younger generations as far as health now. Absolutely. Everybody’s at the gym.
0:11:10
(Speaker 1)
Everybody’s got a weighted vest on.
0:11:14
(Speaker 2)
making a commitment, I think, to way less alcohol consumption.
0:11:18
(Speaker 1)
Oh yeah, the alcohol industry is down. And even Hollywood is really kind of weighed in on, you know, I’ve been sober for five years, I’ve been, you know, not that they were addicted, but just that they’ve completely given up alcohol for their lifestyle.
0:11:32
(Speaker 2)
Yeah, a lot of it’s going on right now. I think it’s a good thing. I do think it’s a good thing because yeah, you know young people There’s no reason to go out on a Friday night and get absolutely, you know hammered I really do.
0:11:53
(Speaker 1)
I mean the gym memberships are crazy.
0:11:55
(Speaker 2)
I went to buy a rowing machine for my basement and They told me it was like a month wait because they had so many on order that they wouldn’t stall. That’s crazy. You really see it kind of coming up.
0:12:06
(Speaker 1)
I think it happened after. I mean, I think COVID had that was the one positive effect of COVID. Sure. Hey, John, what else?
0:12:12
(Speaker 2)
Just from a dentist perspective, what else is trending in your world real quick before we leave each other today? You know, what’s happening? Cosmetics.
0:12:22
(Speaker 5)
right now.
0:12:23
(Speaker 2)
I mean, you know, the younger generation doesn’t really have a tremendous amount of cavities anymore or dental complications just because of where hygiene and technology has taken them with the water picks and the electric toothbrushes and all the advances in toothpaste and mouthwashes and things like that. So what we get now is a lot of people who are like, you know, even my age, 47 years old, want to get Invisalign finally. Really?
0:12:47
(Speaker 1)
Want to have straighter teeth, want to have whiter teeth, want to have, you know, prettier smiles, things like that. And dentistry has allowed us to do this with, you know, minimally invasive procedures now, even where technology has taken veneers and those kind of things where we really don’t need to manipulate the tooth structure a lot. So, you know, I mean, the real trend now is everybody wants that really pretty, white, healthy smile, which is great.
0:13:14
(Speaker 2)
Yeah, it’s great. And you can make teeth right there in your place.
0:13:17
(Speaker 1)
That’s fascinating to me.
0:13:19
(Speaker 2)
Yeah, I mean, those machines, those 3D printers and that technology of scanning the mouth and being able to design a crown and print it and, you know, crystallize it right in the office.
0:13:30
(Speaker 1)
It’s just fantastic. It’s fantastic.
0:13:33
(Speaker 2)
It’s really changed the way we’ve done things.
0:13:35
(Speaker 1)
I know. And you have saved me from myself a million times and will continue to save me.
0:13:41
(Speaker 2)
We’re still saving you from yourself.
0:13:41
(Speaker 1)
You’re still saving me from myself. You talked about biotin just real quick, which is your preferred choice as a dentist of a mouth What does it do, moisten your mouth, biotin?
0:13:54
(Speaker 2)
Yeah, and it leaves a coating on the teeth, you know, according to them, that prevents erosion from dry mouth and things of that nature.
0:14:02
(Speaker 1)
Yeah, and I took that during chemo. And so I was like, okay, I guess I need biotin.
0:14:06
(Speaker 4)
I think I told you about it.
0:14:07
(Speaker 1)
Yeah, you did tell me about it. But yeah, John took care of me and still takes care of me. I had a lot of side effects from chemo with my teeth.
0:14:14
(Speaker 3)
And the whole family now.
0:14:16
(Speaker 1)
Yeah, he’s been a really, really good Heartfelt professional in his care for me and everybody who goes to him and he’s beloved and also really brilliant So thank you for your time today. I know somebody’s sitting in a chair get back there Always a pleasure. Always a pleasure. Dr. John Castanaro, Castanaro Dental, if you need a really good dentist, he’s in Yonkers, New York. He weighed in on ozempic teeth today and how medications like ozempic and Wagobi are leading to dry mouth because of the semaglutide and causing, you know, problems like gum disease and cavities and basically, you know, drink more water, okay? It’s all about your mouth being too dry.
0:14:53
Drink more water, get some biotin and sugar -free stuff to suck on. All right, back in a moment here on the Debbie Nigro Show.
