What is menopause

Menopause is defined as the time 12 months after a woman’s last menstrual period. It usually begins between the ages of 45 and 55 and lasts about seven years, but can last up to 14 years. Although “menopause” is often used as a general term, the transition to this period in a woman’s life is technically divided into three phases:

  • Perimenopause: these are the years prior to menopause during which women are likely to notice changes in their monthly cycles, hot flashes or other symptoms for the first time.
  • Menopause: confirmed after 12 months with no period The ovaries stop releasing eggs and the woman can no longer become pregnant.
  • Postmenopause: refers to the 10 years after menopause, with an early postmenopause, covering the first 2 years, characterized by a higher incidence of symptoms.

Worldwide, it is estimated that there will be more than 1.1 billion postmenopausal women by 2025. Hot flashes and mood swings are often the focus of attention during menopause, but many women do not realize that there is an important connection between menopause and their oral health.

As women move through this hormonal stage, understanding this little talked about connection can be an essential component of maintaining a beautiful smile and healthy teeth.

menopausal woman

What is the relationship between menopause and oral health?

According to data from the Oral Health and Menopause in Seniors 2023 Report by Delta Dental, 84% of women over the age of 50 are unaware that some of the oral health symptoms and discomforts they experience could be related to menopause.

Of the more than 1,000 women surveyed, 70% of women in the early stages of menopause reported experiencing at least one or more of the following signs or symptoms of oral problems:

  • Dry mouth (39%)
  • Receding gums (30%)
  • Dental sensitivity or pain (28%)
  • Dental caries (20%),
  • Bleeding gums (16%),
  • Taste changes (13%),
  • Reduced saliva production (13%)
  • Fiery tongue (5%)

Even the appearance of the teeth and smile can be affected. Among the women surveyed, 79% said they had noticed a change in the appearance of their smile as they aged.

However, most of these women did not associate them with hormonal changes. Of the 39% of women who experienced a dry mouth sensation, 77% did not know that it could be related to menopause. The lack of association with menopause was even greater with other symptoms such as reduced saliva production (90%) or the appearance of new caries (88%).

Main dental problems in menopausal women

During menopause, estrogen levels are reduced (the anti-inflammatory effect of this hormone on the gums decreases) and progesterone levels are reduced (reduces bone density). In addition, this estrogenic deficit produces significant alterations in the tissues of the mouth, with reduced secretion and changes in the biochemical composition of saliva, and disorders in the oral flora.

Periodontal disorders such as atrophic gingivitis (with abnormal pallor), postmenopausal gingivostomatitis (shiny, dry gums, easy bleeding and pale to reddish color) and oral discomfort, with burning sensation, dryness and bad taste (“burning mouth syndrome”) are commonly seen in menopausal women.

Some association between periodontitis and osteoporosis has been described, but this seems to occur basically in women with previous gum problems, which would be aggravated as a consequence of menopause.

In this situation, it is essential to maintain low levels of bacterial plaque. Visits to the dentist or periodontist should be made periodically in order to identify any changes at the oral level. In the case of taking oral bisphosphonates, the dentist should be informed so that he/she can adopt the appropriate preventive and therapeutic measures.

Dry mouth

Dry mouth, or xerostomia, affects approximately 25% of menopausal women. due to aging, reduced estrogen levels and taking certain medications, such as allergy or osteoporosis medications, cause a decrease in saliva flow and a decrease in saliva production.

Although the term “dry mouth” may seem unimportant, the long-term effects of decreased saliva flow on oral health can be devastating. Saliva is the mouth’s natural neutralizer.

Dry mouth decreases the ability to fight minor infections or maintain a healthy balance of helpful and harmful bacteria inside the mouth. Painful oral symptoms are often associated with reduced saliva, sometimes further aggravated by removable partial dentures. Other possible complications of dry mouth are mouth ulcers or oral mycosis.

Swollen and irritated gums

During these hormonal changes, the gums may be more susceptible to bleeding because the body’s immune system is more sensitive than usual. Lower hormone levels can cause inflammation (redness, swelling and sometimes pain) in the gums.

Crowding and tooth loss

Menopause affects bone density throughout the body, including the jaw, which reduces its ability to hold teeth in position.

Caries and gum disease

The many hormonal changes that occur during menopause make the teeth and gums more susceptible to plaque. This leads to a much higher risk of tooth decay, gingivitis (gum inflammation) and advanced gum disease (periodontitis).

See How to properly clean fixed and removable dental prostheses

Hot mouth

Burning mouth syndrome (BMS), also known as glossodynia or stomatodynia, is described as a burning sensation affecting different areas of the oral cavity, including the tongue, palate, lips and denture support areas. Affects menopausal women seven times more often than it affects men

Maintaining Oral Health During Menopause

First of all, it is important if you are experiencing menopausal symptoms to tell your dentist so that he or she can add the information to your medical history. Communicate any symptoms related to oral health such as dry mouth, burning tongue, changes in taste, and medications you are taking is important so the dentist can find the right treatment.”

In addition, there are a number of factors that will help you maintain your oral health during menopause:

1. Take better care of your oral health at home.

For all menopausal women, practicing proper oral hygiene is crucial.

  • Brush at least twice a day with fluoride toothpaste using proper technique, paying special attention to gum lines and hard-to-reach areas, flossing at least once a day.
  • Use an antimicrobial mouthwash to reduce dental plaque buildup and prevent gum disease and tooth decay.

See How to prevent and eliminate dental tartar. A complete guide

2. Controls dry mouth symptoms.

Pay close attention to dry mouth symptoms to protect oral health.

  • Do you have a cracked or dry tongue?
  • Does your tongue feel dry to the touch?
  • ¿Se te pegan los labios a los dientes con más frecuencia?
  • Do you notice that you have less saliva in your mouth?

Your dental clinic can perform saliva flow tests to help determine your saliva flow rate and the best treatment options.

3. Stay hydrated.

Maintaining saliva flow and proper pH balance in the mouth is important for oral health. Drink plain water or high pH bottled water without adding anything else. Water is the closest thing to saliva. It provides hydration, but also cushions the oral environment and keeps the pH of the mouth under control.

4. Maintain a healthy diet.

It is important to eat a balanced diet, rich in vitamins and minerals, especially calcium and vitamin D. Limit alcohol, caffeine, sweets or sugary drinks, and overly salty foods.

5. Visit your dentist regularly.

Maintaining a healthy, youthful mouth during and after menopause will depend heavily on maintaining clear communication with your dentist about any symptoms you have.

6. Manage stress.

High levels of stress can exacerbate oral health problems. Doing yoga or meditation can benefit both your oral health and your overall well-being.

7. Consider the use of hormone therapy.

Postmenopausal women who use hormone therapy during menopause have a 24% lower risk of tooth loss than those who do not. Talk to your doctor about hormone therapy and the possible implications for oral health.

One third of women over 65 years of age suffer from osteoporosis, which may justify the use of hormone replacement therapies (combination of estrogen and progesterone). While osteoporosis may be a risk factor for gum disease, hormone replacement therapy may offer some protection against tooth loss and reduce gingival bleeding. Consult your doctor for the best option for your case.

Tips for osteoporosis prevention

Osteoporosis is one of the diseases that most affect menopausal women and can have serious consequences on your oral and general health, it can be prevented by introducing some lifestyle guidelines:

  • Consume more calcium. Eat more calcium-rich foods, such as dairy products and almonds, or take supplements. Women should ingest 1,200 mg and men 800 mg of calcium every day. This figure increases to 1,500 mg, for both men and women, when over 65 years of age.
  • Take more vitamin D. Sunbathing is the easiest way to increase vitamin D levels, but eggs, salmon and mushrooms are also good sources.
  • Get more physical activity. Weight lifting and muscle strengthening are especially helpful in combating osteoporosis.
  • Quit smoking. Smokers are more likely to have osteoporosis compared to non-smokers. Recovering from fractures is also more difficult.
  • Decrease caffeine and alcohol consumption. Decrease bone density

Beware of bisphosphonates in menopause

Some women with osteoporosis take a group of drugs known as bisphosphonates, which increase the risk of a rare disease known as “osteonecrosis of the jaws”. It is important to advise your dentist or periodontist of its use prior to dental treatment.

In the case of taking oral bisphosphonates, the specialist should be informed so that he/she can take the appropriate preventive and therapeutic measures. Visits to the dentist or periodontist should be made periodically in order to identify any changes at the oral level.

As you can see, menopause is a complicated time for women’s health. The hormonal decline that accompanies it generates a whole series of symptoms and problems that should not be taken lightly. It is very important that you talk to your dentist so that he/she can help you combat all the problems that we have seen in this article and that can lead to gum disease, cavities and other more serious problems that are difficult to solve.

If you have doubts about how menopause can affect your smile and oral health, call us at +34 669 154 020 and we will inform you without obligation.

You can also read:

What is gingivitis and how is it cured?

Jaw pain. Causes and treatments

Periodontitis. 5 tips to prevent it

 

Dra. Yasmin Raslan
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