Menopause and dental health are intrinsically linked. Menopause brings with it a range of changes to a woman’s body, one of which is decreased estrogen levels. This drop in estrogen can in turn impact dental health.
What is Menopause?
Most women go through menopause from the ages of 47-55. Menopause involves the end of menstrual cycles, with symptoms including hot flushes, night sweats, body aches and urinary frequencies. Additionally, decreased estrogen levels increase the risk of developing heart disease, stroke, Alzheimer's disease and osteoporosis.
Menopause and dental health
As the body experiences many changes, menopause and oral health is a topic we can often overlook. Due to changes in hormone levels, changes in the oral cavity can also occur during this time.
Estrogen can affect the oral cavity directly or indirectly. Women tend to experience menopause mouth symptoms such as a dry mouth, burning mouth syndrome, gum inflammation and altered taste in the mouth.
Menopause and dental health: Dry Mouth (Xerostomia):
Saliva acts as a defence mechanism in the mouth to prevent decay. Therefore, a reduction in salivary flow can cause bacterial colonisation as dryness and irritation of gums. Dry mouth can be triggered by a few factors:
- Medications (muscle relaxants, antidepressants, sedatives, pain relief, anxiety meds etc)
- Sjogren's syndrome (an autoimmune disease that affects salivary and tear glands)
- Surgical removal of the salivary glands
- Radiation therapy for head and neck cancers/tumours.
To alleviate dry mouth, water intake must be increased. Chewing sugar-free chewing gum can also induce salivation. The use of salivary substitutes may be required in severe cases.
Menopause and dental health: Burning Mouth Syndrome (BMS):
When undergoing menopause, there is potential to experience a burning sensation in the mouth. This can affect the anterior two-thirds of the tongue, palate, lips, floor of the mouth and any surface under dentures.
The initial management for BMS is topical anaesthetic gel/mouthwash, gargles, topical estrogen or artificial saliva. If there is no improvement, systemic medications may be required.
Menopause and Periodontal Disease
During the menopausal stage, gums may exhibit symptoms of swelling, menopause teeth pain, uneasiness, bleeding and dryness. Gingivitis is a reversible inflammatory response to bacterial plaque build-up. If uncontrolled at the early stage, gingivitis can progress to periodontitis, a disease caused by inflammation of gums and supporting structures.
To avoid gingivitis and periodontitis, bacteria in the oral environment must be reduced. This reduction is achieved through consistently good oral hygiene.
During menopause, a reduction in saliva production an gingivitis can cause changes in taste bud function. As a result, this can cause alterations in taste perception. Women also tend to have reduced perception of sucrose which can alter eating habits, such as an increased preference for sweeter foods.
Osteoporosis is a disease characterised by low levels of calcium, resulting in weakened bones. After menopause, many women are at risk of developing osteoporosis.
Estrogen plays a part in regulating calcium levels in the body. The reduction of estrogen can result in porous and fragile bone causing fractures. Osteoporosis is considered a risk factor for gum disease, tooth breaking and loss in menopausal women.
Bisphosphonates are drugs used to prevent the resorption of bone in postmenopausal osteoporosis. A patient should have a full dental examination and complete any required dental treatment before commencing bisphosphonate therapy.
Managing Menopause Dental Problems
Hormone Replacement Therapy (HRT) helps to manage menopausal symptoms. When considering hormones and oral health, HRT can also be used to reduce gum disease and prevent tooth loss. Studies have shown that the rate of gum disease was significantly lower in those receiving HRT, with many seeing a 44% improvement in gum health.
Maintaining good oral health habits can alleviate many post-menopausal symptoms:
- Brush twice daily with fluoride toothpaste to remove bacterial biofilm.
- Replace your toothbrush every three months.
- Clean between teeth with floss or interdental brushes.
- Maintain regular dental examinations and cleans.
- Maintaining a balanced diet; and
- Avoid smoking and alcohol intake.
Menopause is a time for some extra self-care. If you're affected by any of the above, never be afraid to book an appointment with us and start a conversation with your favourite Bite team member.