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ForumsSide Effects & ManagementDental erosion from nausea/vomiting on GLP-1 — prevention strategies

Dental erosion from nausea/vomiting on GLP-1 — prevention strategies

JennaRN Mon, May 4, 2026 at 1:44 AM 6 replies 490 viewsPage 1 of 2
JennaRN
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May 4, 2026 at 1:44 AM#1

Collecting this in one place because it comes up every few weeks and the answer is always assembled from scratch. It is about nausea, and it is deliberately narrow — everything I am not confident about is marked as such.

What is actually established

The line between titrate-through and stop is not severity, it is trajectory and what else is present. Nausea that peaks and improves within a week is the expected pattern. Nausea that is escalating, or that comes with severe upper-abdominal pain radiating to the back, or that prevents fluids for more than a day, is a different conversation and belongs with a clinician the same day.

The condition it depends on

The meal advice is right and incomplete without the hydration point. People stop drinking because drinking makes them feel full, then attribute dehydration symptoms to the drug.

The practical version

Trial-level incidence runs roughly 20 to 25% for nausea at the higher dose tiers and 12 to 17% for diarrhoea, with most events mild to moderate and concentrated in the weeks after each escalation.

What I am not sure about

The narrow version of the question is what distinguishes the nausea you can titrate through from the nausea that means stop. Numbers rather than impressions, if you have them.

— JennaRN · corrections welcome and will be edited into this post with credit
50 20Dr.KarenChen, Dr.NateNeph, PharmD_Rodriguez and 47 others
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Dr.PeteFamMed
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May 4, 2026 at 3:48 AM#2
JennaRN said:
The line between titrate-through and stop is not severity, it is trajectory and what else is present.

JennaRN has the substance of this right. The condition it depends on is worth stating. The practical protocol is dull and it works: smaller meals, stop eating at the first sign of fullness rather than at the end of the plate, drop the fat fraction of meals in the two days after dosing, and do not lie down straight after eating. Most of what people call unmanageable nausea is a meal-size and meal-composition problem interacting with a stomach that is emptying slowly.

Last edited: May 4, 2026 at 4:48 AM
49 19tommy_boulder, hyun_seoul, jim_asheville and 46 others
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Dr.SleepRoch
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May 4, 2026 at 5:52 AM#3
JennaRN said:
The line between titrate-through and stop is not severity, it is trajectory and what else is present.

I dislike how confidently this board tells people to push through. Incidence figures around 20 to 25% at the higher doses are class-typical, but the trials also had a discontinuation column, and "manageable with protocols" is not the same as manageable for everyone.

Last edited: May 4, 2026 at 9:52 AM
48 18Dr.NephBHM_UK, kim_atl_prep, sarah_TO and 45 others
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Dr.EndoEP
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May 4, 2026 at 7:56 AM#4

Answering the narrow version, because the broad one does not have a single answer. Holding genuinely reduces total burden rather than redistributing it, because the gastric-emptying component adapts. Receptor-level tachyphylaxis to the delayed-emptying effect develops over weeks while the central appetite effect persists, so the same dose is materially more comfortable at week six than at week two. A slower ladder therefore reaches the same dose with less cumulative nausea, not the same nausea spread thinner.

That is the short version; the long version is somebody else's post.

47 17Dr.BariatricHTX, LindaRN_retired, tommy_boulder and 44 others
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wei_SG
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May 4, 2026 at 8:14 PM#5
Dr.PeteFamMed said:
The practical protocol is dull and it works: smaller meals, stop eating at the first sign of fullness rather than at the end of the plate, drop the…

Can confirm. Same sequence, different timescale.

46 16JenPlateau, SallyK_inj, CryptoCarl and 43 others
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