Perimenopause and your oral health

Perimenopause, the phase in a woman’s life leading up to menopause, brings physical and hormonal changes to a woman’s body. You may not be aware that perimenopause impacts oral health, too.

Here’s what you need to know about perimenopause and the health of your mouth.
 

What is perimenopause?

Perimenopause is a transitional stage leading up to menopause. The ovaries start making less of the reproductive hormones estrogen and progesterone, which causes changes in menstruation until eventually, cycles stop entirely.

During perimenopause, the body's production of estrogen and progesterone, two hormones made by the ovaries, varies greatly.
 

How do you know if you’re entering perimenopause?

Perimenopause begins in some women in their 30s, but most often starts in women in their early 40s. The experience of perimenopause varies greatly among different women, but there are some common signs and symptoms that can help you determine if you’re entering this transitional phase:
 

• Irregular menstrual cycles. One of the hallmark signs of perimenopause is changes to your menstrual cycle. Your periods may become irregular with altering cycle length and flow.
• Hot flashes and night sweats. Sudden intense waves of heat and night sweats are common during perimenopause.
• Mood swings. Hormonal changes brought about by perimenopause can lead to sudden mood changes, difficulty concentrating, irritability, fatigue, anxiety, decreased libido and depression.
• Vaginal dryness. Reduced estrogen during perimenopause can lead to vaginal dryness.
• Difficulty sleeping. The changes brought about by perimenopause can make getting a good night’s sleep more challenging.
• Other bodily changes. Perimenopause affects women differently, and it can bring about changes to the skin and hair, body weight and composition and breast tenderness.
   

Perimenopause is a gradual, transitional process, and no single sign or symptom alone is enough to determine if you’ve entered perimenopause. It’s also important to note that many of the symptoms common to perimenopause can also be caused by other medical conditions.

Be sure to discuss any symptoms with your physician if you believe you may be experiencing perimenopause.
 

How does perimenopause affect the health of your mouth?

Dental health and hygiene become a concern as women get older. Your dentist may be the first person to notice changes related to perimenopause because symptoms of overall bodily changes often first appear in the mouth.

Common oral health changes of perimenopause include:
 

Dry Mouth

The fluctuating estrogen levels associated with perimenopause can result in a reduction of saliva production leading to dry mouth, or xerostomia.

Although the term “dry mouth” may not sound serious, the long-term effects of decreased saliva flow on oral health over time can be devastating. Dry mouth decreases the body's ability to fight off minor infections or maintain a healthy balance of useful and harmful bacteria within the mouth. Painful oral symptoms are frequently associated with reduced saliva, sometimes further aggravated by removable partial dentures. Other potential complications of dry mouth are mouth ulcerations and oral fungal infections.

“Saliva is the natural buffer of your mouth,” says Dr. Karen Horace, Dental Policy Manager at Delta Dental Insurance. “It keeps your mouth healthy. Young people have so much saliva that their teeth are far more protected than adults. The older you are the more likely you are to have dry mouth. On top of that, women experience significant hormone level changes as they age, which increases the likelihood of dry mouth.”

Certain medications, like allergy medications or drugs for osteoporosis, can also impact saliva flow. “The older a person gets the more medications they’re likely taking, regardless of gender,” Dr. Horace points out.
 

Burning mouth

Burning mouth is described as a burning or tingling sensation affecting different areas of the oral cavity, including the tongue, palate, lips and areas of denture support. Hormonal changes during perimenopause contribute to this discomfort.
 

Changes in bone density

Estrogen helps maintain bone density, including in the jawbone. Reduced bone density impacts the stability of teeth and can contribute to tooth crowding and loss over time.  
 

Swollen, irritated gums

When your hormone levels change, your gums can get swollen and irritated. During perimenopause, your gums may be more susceptible to bleeding, because your body's immune system is more sensitive than usual. This can cause inflammation (redness, swelling, and sometimes pain) in the gums.
 

Tooth decay and gum disease

The hormonal changes that take place during perimenopause make the teeth and gums more susceptible to plaque. This leads to a much higher risk for tooth decay, gingivitis (gum inflammation) and advanced gum disease.
 

Maintaining your oral health through perimenopause

Here are the keys to maintaining your oral health while you’re approaching or experiencing perimenopause:
 

1.  Step up your oral health care routine at home.

Practicing adequate oral hygiene is crucial during perimenopause.

“Oral health care should get better with age, not worse,” says Dr. Horace. “The likelihood that you’re going to have tooth decay or a dental issue is always higher the older you are regardless of gender because part of the equation for tooth decay is time.”

To adequately care for your teeth at home:
 

• Brush at least twice a day with fluoride toothpaste using proper technique, paying extra attention to the gum lines and hard-to-reach areas, and floss at least once daily.
• Use an antimicrobial mouth wash to reduce the accumulation of dental plaque and help prevent gum disease and tooth decay.
   

2.  Keep track of your symptoms.

Be aware of the symptoms of perimenopause and how they can affect your oral health. Dr. Horace emphasizes that watching out for the symptoms of dry mouth is essential to protecting your oral health. Ask yourself:
 

• Has the surface of my tongue changed in appearance?
• Does my tongue appear cracked or dry?
• Is my tongue dry to the touch?
• Are my lips sticking to teeth more often?
• Am I producing less saliva?
   

Your dental office can do saliva-flow testing to help determine your rate of saliva flow and the best treatment options.
 

3.  Stay hydrated.

Keeping saliva flowing and the proper pH balance in your mouth is important to oral health. “Drink water or high pH bottled water with nothing else in it,” recommends Dr. Horace. “Don’t mix in anything like juices, flavors or lemons. Water is the next best thing to saliva. It’s partially about hydration, but it’s also about buffering the oral environment and keeping the pH of your mouth controlled.”
 

4.  Communicate with your dentist.

Keeping a healthy mouth through perimenopause and beyond will depend on clear communication about any symptoms you’re having with your dentist. “If you want your teeth to look young and healthy, you need to be talking to your dentist,” says Dr. Horace.
 

5.  Maintain a healthy diet.

Consume a balanced diet rich in vitamins and minerals, particularly calcium and Vitamin D. Limit alcohol, caffeine, sugary snacks or beverages and overly salty foods.
 

6.  Consider hormone therapy.

Hormone therapy is among the most effective treatment options for relieving perimenopausal symptoms such as hot flashes and night sweats. Post-menopausal women who use hormone therapy during menopause have a 24% lower risk of tooth loss than in non-users. Discuss hormone therapy and potential oral health implications with your physician.
 

7.  Manage stress.

High levels of stress can exacerbate oral health issues. During perimenopause, practice your favorite stress-reduction technique or pick up a new one, such as yoga or meditation, to benefit both your oral health and your overall well-being

Last updated August 30, 2023