The decrease in oestrogen levels during menopause affects many body tissues, including the gums, jaw bones, salivary glands, and the lining of the mouth.
You have probably heard of the hot flushes and night sweats that accompany menopause, but were you aware that these hormonal changes can also impact your oral health?
“The decrease in oestrogen levels during menopause affects many body tissues, including the gums, jaw bones, salivary glands, and the lining of the mouth,” says Dr Masayi Mackatiani, senior resident in periodontology at the University of Nairobi’s School of Dental Sciences. With the current increase in life expectancy, many women now spend almost one-third of their lives after menopause.
One common complaint among menopausal women is persistent dry mouth. “Reduced oestrogen may alter the function of the salivary glands, resulting in decreased saliva production. Saliva washes away food debris, neutralises harmful acids, lubricates oral tissues and helps prevent the formation of cavities on teeth. Reduced saliva production can make it difficult to swallow, speak, wear dentures or enjoy certain foods,” he says, adding that dry mouth also increases the risk of dental cavities, bad breath and oral infections.
Some women develop Burning Mouth Syndrome, which is characterised by a persistent scalding sensation in the mouth, despite there being no visible sores.
Although the exact cause remains uncertain, Dr Mackatiani says that hormonal changes, altered nerve function, nutritional deficiencies and psychological stress may all contribute to this condition.
“The condition can significantly reduce quality of life by interfering with eating, sleeping and emotional wellbeing.”
Another noticeable change is an altered sense of taste. Foods may seem unusually bitter or metallic. Combined with a dry mouth, these changes may reduce appetite or lead to altered dietary habits that affect overall nutrition.
Dr Mackatiani adds that healthy gums depend on a balanced immune response and an adequate blood supply.
“Oestrogen deficiency alters oral tissues, making them more susceptible to gum disease,” he says.
As a result, menopausal women may experience bleeding or swollen gums, tooth sensitivity, gum recession, persistent bad breath and tooth loss. Without treatment, these issues can lead to gingivitis and progress to periodontitis, a chronic inflammatory disease that destroys the tissues supporting the teeth.
Research has also shown that severe periodontal disease is associated with systemic conditions, including diabetes, cardiovascular disease, and adverse pregnancy outcomes.
“Oestrogen helps maintain bone density throughout the skeleton, including the jaw bones that support the teeth. After menopause, increased bone resorption may contribute to osteoporosis and reduced jaw bone density,” he says.
Loss of jaw bone can increase tooth mobility (which can result in tooth loss) and accelerate periodontal destruction.
Dr Mackatiani says changes in saliva and immunity create favourable conditions for fungal infections such as oral candidiasis (thrush)..
Can hormone replacement therapy (HRT) improve oral health symptoms?
“The accepted view is that HRT may have beneficial effects on the oral cavity by mitigating oestrogen-deficiency-related changes, but it should be regarded as an adjunctive measure rather than a primary treatment for oral diseases,” he explains.
He cautions that many women today choose dental implants to replace missing teeth.
“Menopause alone is not a contraindication for implant treatment,” he says. “However, decreased bone density may influence treatment planning. Dentists may recommend additional investigations, such as three-dimensional imaging, to assess bone quality before implant placement. Where necessary, bone grafting procedures can improve the chances of long-term implant success.”
He also advises women going through menopause to brush twice daily with fluoride toothpaste, clean between their teeth daily with floss or interdental brushes, drink plenty of water throughout the day, limit their intake of sugary foods and acidic drinks, avoid smoking and excessive alcohol consumption, and attend regular dental examinations and professional cleanings.
‘Women experiencing persistent dry mouth may benefit from saliva substitutes, sugar-free chewing gum or medications recommended by their dentist or physician. Maintaining a healthy diet rich in calcium, vitamin D and protein also supports both oral and skeletal health,” he says.
He also recommends regular dental check-ups to allow for the early detection and treatment of gum disease, tooth decay, and oral lesions before they become serious. “The mouth often provides early warning signs of hormonal changes, nutritional deficiencies, and systemic disease.
Menopause should not simply be viewed as the end of reproductive life, but as a new stage requiring greater attention to overall health,” he adds.
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