Augusta University
Stacey Hudson
Medications such as tirzepatide and semaglutide are changing the treatment landscape for obesity, diabetes and, more recently, obstructive sleep apnea. A Dental College of Georgia researcher at Augusta University is examining another question that has received far less attention: What might these medications mean for oral health?
Dr. John C. Comisi, professor in the Department of General Dentistry at the Dental College of Georgia, reviewed existing research on obstructive sleep apnea (OSA), the oral microbiome and glucagon-like peptide-1 (GLP-1) receptor agonist medications. His review was published in the September 2026 issue of Clinical Oral Investigations.
The oral microbiome includes hundreds of types of bacteria that help maintain healthy teeth and gums. OSA can disrupt that balance through repeated drops in oxygen, inflammation, mouth breathing and dry mouth. Changes in blood sugar and acid reflux associated with OSA may further alter the oral environment.
“OSA affects much more than sleep,” Comisi said. “The changes that occur throughout the body can also change the environment in the mouth. As we increasingly use medications to treat OSA, we need to understand what those treatments may mean for oral health.”
In December 2024, the U.S. Food and Drug Administration approved tirzepatide for adults with moderate-to-severe OSA and obesity. Clinical trials found that the medication reduced the frequency of breathing interruptions during sleep and helped some participants achieve remission of OSA.
Comisi’s review suggests that treating OSA could benefit the oral environment by reducing mouth breathing, reflux and other factors that affect oral health.
At the same time, GLP-1 medications may affect salivary function. Reports involving semaglutide have identified dry mouth and possible changes in saliva, although they do not establish a cause or frequency.
That raises an important question: Could the oral benefits of treating OSA be offset, at least in some patients, by medication-related changes in saliva?
“There are potentially competing effects happening at the same time,” Comisi said. “Treating sleep apnea could improve several conditions that contribute to an unhealthy oral environment, while the medication itself could potentially affect salivary function. We simply do not have the prospective human studies yet to know what the overall effect will be.”
No prospective human study has yet tracked patients with OSA from the start of GLP-1 therapy while monitoring their oral microbiome. Comisi says dentists should monitor saliva, cavities and gum health as patients begin treatment.
The review also calls for collaboration among dentists, sleep specialists and medical researchers. Future studies could track changes in saliva, oral bacteria, cavities and gum disease over one to two years.
GLP-1 medications also can slow gastric emptying, making medication use important to consider when planning dental procedures involving sedation or general anesthesia. Overall, Comisi says more research is needed before determining the medications’ effects on oral health.
“GLP-1 therapy is rapidly becoming part of the treatment landscape for patients with sleep apnea,” Comisi said. “That gives dentistry an opportunity to be part of the conversation from the beginning. We need to understand how these medications affect the mouth so we can identify potential problems early and make sure patients receive comprehensive care.”
