Menopause and My Mouth!
I have to go to the dentist soon. I know we need to keep our dental hygiene up and go to all the cleanings. But every so often my dentist says I need to do some kind of deep cleaning to prevent periodontal disease or something like that. Where they numb your mouth and clean one side and then I come back a couple days later to do the other side.
I’ve never had to do that when I was younger.
Is it bc I’m older? I’m aging? I have more $ to spend at the dentist? Or is it my menopause?
There are studies that have found postmenopausal women tend to have more gum inflammation, deeper pockets around the teeth, and a greater risk of periodontal problems.
Estradiol can influence everything from the tips of our toes to the top of our head. But while we are focusing on joint pain, sleep, weight, libido, brain fog, and all the ‘things’ that go with menopause, what about your mouth? Can lower estradiol levels change your teeth, gums, and oral health?
Low Estradiol Can Influence Salivary Gland Function
Salivary glands contain estrogen receptors. So it makes sense that lower estradiol may have a potential impact on oral health.
-
Declining estradiol has been associated with:
- Salivary flow
- Salivary composition
- Dry mouth
But it's not as simple as low estradiol means less saliva. While it can occur as less saliva production, not every menopausal woman has dry mouth or less saliva.
Saliva composition can change in menopause, affecting oral health. It’s the quality of the saliva that can impact oral health.
Saliva Is Not Just “Spit”
Saliva is about 99% water, but the remaining 1% is packed with biologically active components.
- Electrolytes/minerals (like calcium and phosphate) to help remineralize early enamel damage
- Bicarbonate to maintain a healthy oral pH
- Proteins and glycoproteins to lubricate and protect your oral tissues
- Antimicrobial components
- Enzymes like amylase, which begins digestion of starches
- Growth factors and other signaling molecules
- Of course, saliva physically washes away debris
So saliva isn't just water. It’s a mineral-rich, buffered biological fluid that continuously protects your teeth and oral tissues.
Again, What Does Estradiol Have to Do with Saliva?
You may have less saliva (but not always), which reduces saliva's benefits.
The main issue is that declining estradiol levels can affect salivary gland function, which in turn affects salivary composition and, in turn, saliva's benefits.
↓ Estradiol → changes in salivary gland function → changes in saliva flow and composition → reduced protective benefits of saliva → less protection for teeth and oral tissues
So What Happens When the Estradiol Drops?
As estradiol declines, some women may start to experience:
- Dry mouth
- Increased risk for cavities
- More plaque buildup
- Bad breath
- Gum irritation, inflammation, or bleeding
- Increased risk of periodontal disease
- Burning mouth syndrome (this is complex and not always just about estradiol)
Aside from “Spit”... Declining estradiol can affect your bones around your teeth.
Periodontal tissues have estrogen receptors. So as estradiol levels decline, estrogen signals to the gums and periodontal tissues can change. Making the gums more susceptible to irritation, bleeding, and periodontal disease. And with time, this can lead to:
- Gum recession
- Loss of supporting bone around the teeth
- In severe cases, tooth loss
Don’t Forget About Your Mouth
During menopause and the decline of estrogen, even in late perimenopause, your mouth is responding to those changes too. It can affect your saliva, gums, periodontal tissues, the bone supporting your teeth, and even cause stinky breath.
Now, your teeth didn’t suddenly become high-maintenance. But I sure didn’t floss this much, brush this much, buy expensive toothbrushes, or even know what a Waterpik was in my 20s. But now, in my 50s, I know HRT is part of my oral-health picture.
Xo Dr. Valorie
