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Hot flashes and night sweats are some of the most notorious maladies of menopause. But you should also pay attention to your teeth and gums. “I’m not sure people are aware of this,” said Dr. Thomas Sollecito, chief of oral medicine at the University of Pennsylvania. Hormonal changes — mainly a sharp drop in estrogen — can decrease bone density and saliva production and harm your gums. All of these can affect your teeth. Oral care experts say there are ways to combat these effects and keep your menopausal mouth healthy.
Menopause, premenopause and dental symptoms
Menopause occurs when a woman goes 12 consecutive months without a menstrual period. But some hormone-related dental problems can begin during perimenopause, when the ovaries gradually make less estrogen, said Dr. Myra Hister-Cockrell, a dentist at the University of Texas Health San Antonio.
One of the biggest concerns is reduced saliva, which Sollecito called “one of the most important fluids in our body.” When saliva flow slows, it can cause dry mouth, which leads to mouth pain, oral yeast infections and a higher risk of cavities. These risks are even higher when people take medications for high blood pressure or diabetes that can also cause dry mouth, Heister-Cockerell said.
Less saliva also means less bacteria-killing enzymes and fewer teeth-strengthening minerals, said Dr. Sally Cram, a periodontist in Washington, D.C. She added that when your mouth is dry, “bacteria are growing and your teeth are more susceptible to decay.” And if decay progresses, tooth loss is possible.
Decreased bone density and receding gums further exacerbate these problems. If the socket holding a tooth is less dense, it’s more vulnerable to bone loss, Sollecito said. And receding gums leave some tooth surfaces without the enamel that protects them from cavities. Women are also more likely to develop periodontal disease at this stage of life, when plaque and bacteria accumulate under the gums and around the teeth.
“The gum tissue starts to get red and swollen,” said Cram, a spokesman for the American Dental Association. “It starts to bleed and pull away from the teeth, creating deep cracks around the teeth that are difficult to keep clean.” Some people experience “burning mouth syndrome.” The burning can spread to the tongue, palate and lips, Heister-Cockrell said. “As you can well imagine,” Sollecito said, “this can all get really out of control.”
What can you do?
The first line of defense, experts said, is good oral hygiene and nutrition. Eat a balanced diet that’s low in sugars and high in calcium-rich foods. Brush carefully with fluoride toothpaste at least twice a day and floss regularly. “An electric toothbrush may be more helpful than manual toothbrushing,” Cram said. “See your dentist regularly and ask them: Am I doing a good job? And if I’m not doing a good job, what can help me do a better job?”
Patients should also ask their dentists if they should visit the dentist more than twice a year, and also consider in-office fluoride treatments and prescription high-fluoride toothpaste to strengthen the surface of their teeth. At home, treating dry mouth is a priority, experts said. So stay hydrated.
“None of us probably drink enough water in an entire day,” Cram said. People can also use over-the-counter dry mouth sprays, lozenges or rinses. In severe cases, Sollecito said they can ask their dentist about prescription medications that increase the amount of saliva in the mouth but come with side effects. There are also prescription medications for burning mouth syndrome. Cram said, “The most important thing is that most oral conditions and problems during menopause are completely preventable” by paying attention, taking good care of your teeth at home and visiting the dentist regularly.
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