As we well know by now, perimenopause is when our oestrogen and progesterone levels start declining. This obviously has a multitude of effects on our bodies. But while we have read about the impact of perimenopause on our skin and bones, not enough has been written about how it affects our mouths. Yes, oral health is also affected during perimenopause.
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Firstly, what oral changes should we be looking out for during perimenopause?
Dry Mouth
Lower oestrogen levels may decrease the production of saliva which can lead to oral dryness or dry mouth. And when our salivary glands don’t produce enough saliva to rinse cavity-causing bacteria off our teeth, germs can build up increasing our risk of gingivitis and tooth decay.
Gum inflammation and gum disease
Watch out for gum inflammation because this could lead to a serious gum infection that can damage your gums and destroy your jawbone. Sounds pretty harsh, doesn’t it? But while the main cause of gum disease is poor oral hygiene, menopause can put you at a higher risk because hormone changes cause more sensitivity in the gums. So it’s worth knowing that our hormones are also responsible for the health of the periodontium (the tissue that surrounds and supports the teeth).
Gum disease can increase the risk of cardiovascular disease, kidney disease and rheumatoid arthritis so keep tabs on this.
You could also experience bleeding gums and sometimes altered taste.
Loose teeth and tooth loss
Osteoporosis is the loss of bone density, making your bones weaker and more susceptible to breaking. And when it comes to oral health, a sign of bone loss can be as simple as receding gums. When your gums recede, more of your tooth is exposed and is at risk. So ultimately, during perimenopause, we can be more susceptible to loose teeth and tooth loss.
A burning sensation in your mouth
Oral mucosal disorders happen when the mucosa thins (thanks to declining hormone levels) and can result in burning mouth syndrome.
Trigeminal neuralgia
A chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain.
Ageing and shifting teeth
During these years, like everything else on our bodies, our teeth age and shift. You might also find that stress during midlife causes you to grind your teeth or clench your jaw. (Because midlife can be emotionally and physically challenging.)
Changes to the jaw
It’s also worth mentioning that our jaws change as we age. So you might notice changes in your bite, the way that your top and bottom teeth come together, and you might have more overcrowding and overlapping.
So how exactly does perimenopause affect oral health?
Research shows that if women are experiencing perimenopause (or menopause) symptoms, they are likely to have oral symptoms too. The reason being – our mouths contain oestrogen receptors and because hormones affect our body as a whole, that includes our mouths too.
So menopause affects a woman’s oral and dental health for the same reasons as it affects other body systems.
The two main hormones that play a role in oral symptoms of menopause are oestrogen and progesterone.
Oestrogen decreases bone resorption and plays a vital role in the mouth (with the gums, the inner lining of the mouth and the salivary glands) and progesterone is a bone formation stimulating hormone.
So when there is a decrease in oestrogen levels, this can lead to thinning oral tissue, inflammation of the gingiva (gums) and reduced levels of clinical attachment. Oestrogen also has anti-inflammatory properties so when those levels decrease, inflammation can increase. And when progesterone (and oestrogen) levels drop off, this can have an adverse effect on the bones in the jaw.
One of the consequences of our declining hormone levels during perimenopause is the loss of bone density. But when we think of bone density loss we often forget about the bones in our jaws.
When it comes to self-care during midlife, we should be including our oral hygiene.
Why good oral health is important during perimenopause:
Because ageing, and the perimenopausal changes in our hormones can make a big difference to our teeth, gums and mouths.
So what can we do about it?
Speak to your dentist and oral hygienist about any symptoms you may have and work out whether there is anything that needs to be done.
Dry mouth solutions
- Suck ice chips
- Eat sugar-free gum/sweets
- Use prescription-strength fluoride toothpaste to fight cavities.
- Avoid salty, spicy and sugary foods
- Cut back on alcohol, tobacco and caffeine because they make it worse
Periodontal disease
During perimenopause, visit your dentist regularly and maintain good oral hygiene.
Osteoporosis
Get enough calcium and Vitamin D in your diet.
Best ways to look after ageing teeth
- Prevention is better than cure!
- Use an electric toothbrush for a better clean, and to be gentle on your gums.
- Brush for 2 minutes at least twice a day.
- Floss at least once a day.
- Rinse.
- Have regular professional teeth cleanings.
- Check your fillings, crowns and veneers regularly.
- Look into getting a nightguard to help protect your teeth from grinding.
- Cut back on alcohol, tobacco, sugary food and drinks.
- Eat a balanced diet.
- Get regular dental check-ups.
You may also want to read: How to tell if you’re in perimenopause
What to do about shifting teeth
You can look at getting braces (or Invisalign)! Getting braces (or Invisalign) is not only for teenagers. In fact, getting orthodontics in midlife is now a growing trend. (Watch this space – I’m starting my Invisalign journey next month!)
As we age, teeth move, change and suffer wear and tear. And gradual bone loss in the jaw can push the teeth inwards which can lead to overcrowding. Crooked, crowded teeth and a badly aligned bite aren’t only cosmetic concerns. They’re linked to increased gum and bone loss, tooth decay and the erosion of tooth enamel. They can also lead to headaches and jaw joint pain.
So while many older people might start orthodontic treatment for aesthetic reasons, they soon realise that there are many health benefits to having good, strong, straight teeth. Because crowded, crooked teeth are more difficult to clean causing more dental plaque to form which can ultimately cause cavities.
So braces or Invisalign can improve the function and health of the teeth and mouth which in turn benefits the whole body.
Hormone Replacement Therapy
And last but not least, HRT has been shown to improve perimenopause symptoms and therefore by extension, also any oral symptoms you may experience. It helps to strengthen the structures that support the teeth, increases saliva production, rebuilds bone mass and can lessen oral discomfort.
In conclusion
It’s probably fair to say that dentists/oral hygienists might need more education/training about how menopause affects our oral health and to approach our treatment pro-actively. (This is probably true for all medical departments, really.) And when looking at menopause from an overall medical point of view, oral health should be included in the whole picture.
Because ageing and hormonal changes do affect our teeth, gums and mouths – and we need to be aware of this.
Forewarned is forearmed. And good oral health during perimenopause is essential. So, let’s get out there and show our pearly whites to the world, ladies!
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