Orofacial adverse events associated with Glucagon-like peptide-1 receptor agonists: a real-world multinational retrospective matched cohort study.

“Orofacial adverse events associated with Glucagon-like peptide-1 receptor agonists: a real-world multinational retrospective matched cohort study. Oyewole SO(1), Owosho AA(2). Author information: (1)College of Medicine, University of Cincinnati, Cincinnati, OH, USA. (2)The Robert Ebert and Greg Stubblefield Head and Neck Tumor Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, USA; Oral Medicine, Dental Oncology and Urgent Care Unit, Missouri School of Dentistry and Oral Health, A.T. Still University, Kirksville, MO, USA. Electronic address: adepitanowosho@atsu.edu. BACKGROUND: This study quantifies orofacial adverse event risks associated with Glucagon‑like peptide‑1 receptor agonists (GLP-1RAs), addressing public concerns like "Ozempic teeth/mouth/tongue" Using a large-scale matched cohort, it clarifies associations between GLP-1RA therapy and oral health. MATERIALS AND METHODS: We performed a retrospective cohort analysis within the TriNetX research network, comparing GLP‑1RA users with age‑ and sex‑matched controls in a 1:1 propensity‑matched design. Individuals with prior orofacial conditions or predisposing therapies to adverse outcomes were excluded. ICD-10 codes identified orofacial adverse outcomes across mucosal, salivary, neuropathic, and dental categories. Odds ratio (OR) and 95% confidence intervals were calculated to assess orofacial adverse event risks. RESULT: A cohort of 226,485 GLP‑1RA users was analyzed after exclusions and matching. Gastroesophageal reflux disease (GERD) (5.36%) was the most frequent event, while most conditions were rare. Compared with controls, GLP‑1RA therapy did not increase risk for most outcomes and showed significant inverse associations for multiple mucosal, neuropathic, salivary, and dental conditions (OR = 0.893-0.295). Only GERD (OR = 1.329 [1.291-1.367]) demonstrated significant increased odds. CONCLUSION: The findings of this observational data suggest that GLP-1RAs do not increase the risk of most orofacial conditions and may be inversely associated with mucosal, neuropathic, salivary, and dental disorders. However, clinicians should monitor for GERD-related symptoms. Further prospective research is required to validate these associations. Copyright © 2026 Elsevier Inc. All rights reserved. Conflict of interest statement: DECLARATIONS OF INTEREST None.”