What to expect for your Oral Health during Menopause

By now, you realize that menopause changes your body in many ways. However, one change that you might not expect is menopause and dental health. From hormones and gum recession to menopause sensitivity to menopause gingivitis and so on, menopause mouth issues are something you should expect.

Menopause signifies a significant change in women's hormones, making you more susceptible to conditions affecting your oral health, such as dry mouth, gum recession, tooth pain, gum disease, and more. In this article, we learn about what to expect regarding menopause and gum disease, what's typical regarding menopause and teeth issues, and when to see a dentist about problems that arise with menopause and oral health. To learn more about women's oral health during different life stages, read our blog on Women's Oral Health at all Life Stages.

Your teeth and gums are susceptible to changes in hormones. When these changes occur, your body might have a challenging time fighting off minor infections or keeping a balance between the beneficial and harmful bacteria in your mouth. This situation can lead to complications in your oral health. Researchers discovered that menopause affected periodontal health the most at 60 percent per the literature on the topic. Following gum health, menopause correlates with dry mouth (25 percent) and glossodynia, aka burning mouth (15 percent), which can increase the risks of oral mucosal and dental disease like candidiasis.[i]

You might already know how menopause affects other parts of your health, but here's how menopause affects oral health. The critical factor for menopause mouth symptoms, or perimenopause mouth problems like bleeding gums and sensitive teeth, is the changes in your hormone levels. The skin inside your lips and cheeks, called the oral mucosa, is like the skin inside your vagina, not only in tissue makeup but also in how it responds to a lack of estrogen. In a review of the literature from 1976 to 2013, the Journal of Midlife Health, researchers explain the oral cavity's soft tissue responds to the lack of estrogen that leads to many symptoms.[ii]  

A common side effect of changing hormones during menopause is dry mouth, or what dental professionals call xerostomia. Menopause and dry mouth are associated with decreases in estrogen and progesterone, leading to your mouth not producing enough saliva. In other words, when you feel like your mouth is full of cotton, a decrease in female sex hormones is why.

Menopause causes many other mouth issues, too. For example, some women describe the sensation that their mouth or tongue is burning or tingling, referred to as BMS (or burning mouth syndrome). Interestingly, women can feel BMS, but there is no change in the oral cavity. In other words, no one can see signs of it in your mouth. For this reason, it is often hard to pinpoint a cause for BMS. However, it is most common in postmenopausal women, usually from 50-70 years old and about three to twelve years past menopause.[iii]

Some women also experience menopause tongue problems. Some say they feel a burning sensation in the tongue or a change in taste. While there is no causal relationship established by research, experts suspect that hormonal changes contribute to these problems.[iv] One study suggests that the complex relationship between estrogen and our nervous system causes many of these menopause mouth issues.[v]

Menopause teeth problems are common, too. For example, low estrogen levels contribute to an increase in cavities. Also, some women complain about menopause sensitivity, where their teeth are hypersensitive to food and beverage temperatures.

Menopause and periodontal disease have an association as well. Changes in hormone levels can also be responsible for gum recession, gum disease (gingivitis, periodontitis), and weakened jaw bone.[vi]

Researchers in the Annals of Medical and Health Sciences Research suggest that hormone changes also contribute to deteriorating gum health. The hormone levels increase the blood flow to the gums, making the tissue swollen and more susceptible to plaque and, consequently, gum disease. Gum disease can lead to gum recession and, if left untreated, tooth loss. [vii]

These hormone changes can also be responsible for a decrease in saliva production. Inadequate saliva has a few health consequences. Without the normal amount of saliva present to clean the bacteria off your teeth that cause decay, you are at higher risk for cavities. Also, dry mouth can lead to many oral health problems like jaw problems, gum recession, mouth sores and fungal infections (yeast). [viii] Having a dry mouth can also leave a bitter taste in your mouth, which some women describe as metallic or “having a bad taste in their mouth.”[ix] Also, the lack of saliva can make it more difficult to chew or swallow. Moreover, saliva has components that break down nutrients for the body, which means if you don’t have enough of it, you could have nutritional deficiencies over time. For example, the enzyme amylase helps break down starches. Without enough of it, the starches can be harder for you to digest. [x]

These changes in your oral health are just a few amongst many going on in your body. However, menopause and teeth issues can be uncomfortable and hard to resolve. One of the most important things you can do to prevent uncomfortable menopause mouth symptoms is to maintain or implement a rigorous home care routine. Some examples include:

• Brushing twice a day, once during the day and once at night, for at least two minutes with fluoride toothpaste.
• Reducing the consumption of sugar and sugary food and drinks
• Flossing or cleaning between teeth daily
• Using a fluoride rinse after brushing and flossing once a day
• Seeing your dental team at least once every six months for a check-up

Some women have seen improvements to their menopause teeth problems with Hormone Replacement Therapy. Talk to your doctor to see if this is right for you.

When it comes to the bitter taste in your mouth during menopause because of dry mouth or BMS, there are a couple of things you can try. Some women find sucking on ice chips or sugar-free candy, or chewing sugar-free gum, is a way to increase saliva production. Others drink more water or consume fewer spicy foods and alcoholic beverages. Another option that might help menopause and dry mouth is to rinse your mouth with water or a mouth rinse after you eat. Using a humidifier, especially at night, can help, too. You can also talk to your dental professional about any mouth gels or sprays that can help increase the oral cavity moisture levels.

Per the American Dental Association (ADA), you should talk to your dentist if your mouth is feeling dry. Your dental team might prescribe a medicine to help produce more saliva or a prescription toothpaste with more fluoride than regular toothpaste that can help prevent decay.[xi]

Another reason to see the dentist is if your gums are receding. As more of your tooth is exposed, it means that it is at a higher risk for decay, a risk further compounded by dry mouth.

Moreover, gum recession is an indication of bone loss, which is to be expected by the decrease in estrogen you experience at this time. When you lose bone in your jaw, it can lead to serious conditions, like advanced gum disease, called periodontitis. Untreated periodontitis can result in tooth loss.[xii] In fact, a 2010 study out of the University of Buffalo suggests that nearly 30 percent of women will experience tooth loss within five years of menopause. Furthermore, research suggests that women with diabetes or a high BMI (Body Mass Index) are at an even higher risk of tooth loss, as were smokers and women with a history of gum disease and tooth loss.[xiii]

Seeing your dentist will allow them to take an X-ray and assess the progress of your condition. Then, your dental team will work with you to ensure that you get enough calcium and vitamin D to prevent further bone loss and treat the disease responsible for it. They will also likely advise you to drop unhealthy lifestyle factors, like smoking and heavy alcohol use. [xiv]

Menopause causes significant changes in your hormone levels that affect your health in many ways, including detriments to your oral health. From bleeding gums from hormones and gum recession to menopause sensitivity to other menopause mouth problems, like gum disease and tooth loss, there are many relationships between menopause and dental health. Therefore, in addition to maintaining excellent home care, you must talk to your dental team about any changes in your mouth. Discussing your menopause mouth symptoms with your dentist or hygienist can help you improve your quality of life as you experience the change in life that menopause signifies.