Adverse Oral and Salivary Effects Associated With Glucagon-Like Peptide-1 Receptor Agonists: Clinical Insights.

BACKGROUND

The expanding use of glucagon-like peptide-1 receptor agonists and the dual incretin agonist tirzepatide for Type 2 diabetes mellitus and obesity has drawn attention to potential oral and salivary adverse effects. This short communication summarizes the available evidence, discusses potential mechanisms, and highlights implications for oral medicine practice.

METHODS

A narrative synthesis of published case reports, pharmacovigilance findings, and indirect experimental evidence was undertaken to discuss reported manifestations, biological plausibility, and existing knowledge gaps.

RESULTS

Reported manifestations include xerostomia, hyposalivation, dysgeusia, oral mucosal discomfort, burning sensations, and throat-related symptoms. Proposed mechanisms include modulation of cyclic adenosine monophosphate-dependent signaling in salivary acinar cells, altered autonomic regulation of salivary secretion, and dehydration secondary to gastrointestinal adverse events. Reduced salivary protection combined with gastric acid exposure from reflux or vomiting may increase susceptibility to dental erosion, although a direct association with these therapies has not been established. Sporadic immune-mediated mucocutaneous reactions and facial soft-tissue changes associated with rapid weight loss have also been described. Evidence remains limited and largely indirect.

CONCLUSION

Potential oral and salivary adverse effects warrant clinical awareness, careful medication history-taking, assessment of salivary function, and individualized preventive care. Systematic reporting and focused clinical and experimental studies are needed to clarify causality, frequency, and underlying mechanisms.