Oral Adverse Effects of Semaglutide Therapy: A Narrative Review

Semaglutide, a glucagon-like peptide-1-receptor agonist, is widely used for the management of type-2 diabetes mellitus and obesity. Despite its increasing clinical use, the drug's oral adverse effect profile remains inadequately characterized. This narrative review aimed to analyze the current evidence on semaglutide-associated oral adverse effects, with emphasis on mechanistic pathways, integration of pharmacovigilance and clinical data, and emerging implications for oral health and dental practice.

A comprehensive literature search was conducted across PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar. Keywords related to semaglutide and oral adverse effects were used. Eligible studies included clinical trials, pharmacovigilance analyses, observational studies, case reports, and preclinical research reporting oral adverse effects or relevant mechanistic insights. Studies lacking oral health correlates were excluded. Findings were narratively reviewed in accordance with Scale for the Assessment of Narrative Review Articles guidelines.

Xerostomia or hyposalivation is the most consistently reported oral adverse effect, although its prevalence varies across studies. However, xerostomia often occurs secondarily to gastrointestinal symptoms including nausea, reduced oral intake, and delayed gastric emptying. Additional manifestations included dysgeusia, dry throat, oral paresthesia or hypoesthesia, halitosis, frothy saliva, and increased dental caries. Pharmacovigilance data show significant signals for dry mouth and altered taste. Case-series confirm semaglutide-associated hyposalivation. Limited evidence suggests increased susceptibility to oral candidiasis. Early experimental and observational data indicate potential modulatory effects on inflammation, tissue repair, and bone metabolism.

Semaglutide therapy is associated with oral adverse effects, mainly xerostomia and sensory disturbances, which may compromise oral health. Awareness of these outcomes highlights the need for interdisciplinary oral health monitoring.