Menopause affects women’s bodies in many ways, and awareness that it’s more than hot flashes and night sweats is growing.
But plenty of us still don’t realize just how wide-ranging the impacts of the change of life can be, reinforcing negative stereotypes and leaving women unprepared.
Some 90% of Brits don’t know there’s a link between menopause and oral health, according to the results of a survey commissioned by independent U.K. health provider Bupa.
Of 2,001 people quizzed for the research, 86% of women and 94% of men didn’t know that changes to their teeth, tongue or gums can be linked to menopause.
In reality, it can lead to gum disease, toothache and even tooth loss. But with the right care and treatment, many oral health issues can be resolved.
Why does menopause affect oral health?
Hormone levels fluctuate as a woman approaches menopause. Estrogen drops and eventually a woman’s periods will stop altogether.
We may think of estrogen as a sex hormone, but it actually plays a key role in all kinds of physiological processes.
“We need estrogen for pretty much every single bodily function that a woman has,” Dr Sam Wild, family doctor and clinical lead for womens’ health at Bupa, told me. “We need it for our healthy teeth, for our bones, for our ligaments, for the membranes inside our mouth as well. So as the levels fall, it makes women more susceptible to oral health problems.”
It can also change the appearance of the mouth, according to dentist Jason B Cellars, who runs Seacliff Dental in California. He told me that reduced blood supply to the gums increases the risk of recession, which can make teeth appear longer and darker.
“The other concern is bone loss from periodontal disease,” he added. “With less defence against infection and disease, bone loss around teeth can lead to cavities.”
Dry mouth
Dry mouth is one of the most common oral health problems women face during menopause.
Menopause is linked both to a drop in the production of saliva and a change in its composition, Bupa Dental Care hygienist and head of hygiene and therapy Caitlin Miller told me.
“Saliva can become quite sticky and thick,” she said. “That causes problems with speech, swallowing, and it can lead to bad breath.”
That’s because having a dryer mouth makes it easier for bacteria to grow. This can lead to tooth decay, gum disease, toothache, sensitivity and ultimately tooth loss.
“Our saliva is what neutralizes our mouths when we eat and it plays a huge role in preventing cavities,” Dr Cellars said. When salivation goes down, the chances of developing cavities “goes up drastically,” he added.
Burning mouth
Another common problem linked to menopause is known as “burning mouth.”
“This is just a constant pain that can be felt anywhere in the mouth and the throat,” said Dr Wild. “It can be really, really debilitating and it can alter people’s taste as well, particularly to salty foods and sour foods.”
Burning mouth is also linked to bad breath, which can be embarrassing and prevent women seeking help.
“A lot of women suffer with mental health issues during menopause and perimenopause,” Dr Wild added. “They lose their self-confidence and their self-esteem because of all these changes that are going on physically and mentally. And then feeling that you’ve got bad breath on top of that is really not good.”
Mental health
Menopause aside, mental health itself is also related to oral health. In addition to its impact on self-esteem, researchers are investigating how bacteria in the mouth might affect other parts of the body.
Improving the health of your mouth, Miller told me, may alter the composition of bacteria in other parts of your body.
“If we’re sorting out bacteria in the mouth, which is the portal to the rest of the body, we’re helping gut health,” she said. And as a growing body of research suggests, the bacteria in your belly may influence the health of your brain and your mental wellbeing.
Maintaining oral health during menopause
Many women don’t know about the impact of menopause on their oral health. They might not realise they can get help from their dentists or hygienist, or that they might need to take more care of their teeth than they used to.
Lots of oral health problems can be improved and even resolved with good oral hygiene. That means brushing your teeth twice a day with fluoride toothpaste and regularly cleaning between your teeth with interdental brushes or floss.
Visiting a dentist or hygienist regularly can help you spot emerging issues as soon as possible. They may recommend products like sprays to help ease dry mouth.
They can also show you how to correctly brush and floss your teeth — something often taught in childhood and never revisited.
“I gave a talk recently to a room of 80-year-olds,” said Miller. “I had a woman come up to me and say, ‘I never knew I should have done it like that.’”
Lifestyle changes like cutting down on alcohol, stopping smoking, eating a healthy diet and getting enough sleep can also help improve mouth health.
Many women going through menopause drink more alcohol to help cope with the symptoms. But in reality, this can make menopause symptoms — including oral health issues — worse.
“It’s really the advice we would give to anybody to a certain degree,” said Dr Wild. “All this normal advice becomes even more important during menopause.”
Medical treatment
Lifestyle, she added “is imperative.” But it isn’t always enough to manage symptoms.
Doctors may ultimately prescribe hormone replacement therapy to help ease the symptoms of menopause and perimenopause — and women may be eligible before they realize.
“I think a lot of women feel that they can’t have HRT until their periods have stopped, and that’s not true,” Dr Wild said.
Reach out to your doctor to get more information about HRT, she added. “Make that informed decitions as to whether treatment is right for you.”
