Hormonal shifts that might hit you in the mouth

Hot flushes, sweats and mood swings – the middle years can be a challenging time for many women. And, although most people know about the effects on the body, menopause can also have a big impact on oral health.

To mark Dental Health Week (1-7 August 2016) which focuses on women and oral health this year, rt healthy teeth dentist, Dr Karlien Roper, shares some of the less well-known side effects of menopause.

Dr Karlien says, ‘Most people know that around the middle years, fluctuations in female hormones such as oestrogen can cause a range of problems before, during and around menopause. And, it’s well known that women can become more susceptible to bone problems such as osteoporosis and heart conditions during this time. But there are also a number of related oral health problems.’

Dry mouth

Dipping oestrogen levels affect the amount of water in the body since oestrogen plays a part in controlling fluid regulation[i]  – and that includes the fluid content of the mouth. Couple this with the fact that the body’s ability to conserve water naturally declines with age which means that it’s easier to get dehydrated.

Dehydration can contribute to:

  • Dry mouth
  • Bad breath
  • Tooth decay and gum problems (as oral bacteria produce acids that damage teeth and gums which saliva helps to wash away)
  • Altered taste perception and burning tongue (these could be due to the effects of oestrogen on the nerves that control taste perception).

What you can do

Drinking plenty of water may help keep your body – and your mouth hydrated. Sip some throughout the day – keep a glass or bottle with you. Drinking water after a meal also helps to cleanse the mouth, boosting the action of saliva. Watery foods such as vegetables and fruits are a good choice. But alcohol, advises Dr Karlien, is a natural dehydrator and can make dry mouth worse. So try to dilute alcoholic drinks with water and enjoy water or other non-alcoholic alternatives between alcoholic drinks. Chewing sugar-free gum after eating is also a good idea, as it triggers saliva flow helping to cleanse the mouth after eating.

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Dr Karlien adds: ‘Whatever the cause, if you feel your mouth is dry, see your dentist. Your dentist may refer you to a specialist to find out the cause as dry mouth and taste changes can be distressing. Reduced saliva production also means that oral problems can worsen because bacteria have more time and opportunity to stay in contact with the teeth, causing damage to both teeth and gums.’

Guidance for gums

Some conditions that affect the gums are more common in the years after menopause, again, because of fluctuating levels of hormones that directly affect the oral cavity[ii]. The majority of women – 60 per cent – experience periodontal (gum) problems[iii].

Signs of gum disease include:

  • Sensitive, soft or swollen gums
  • Receding gums
  • A change in colour of the gums
  • Gum pain
  • Bleeding gums.

 What you can do

‘Keep it clean!’ says Dr Karlien. ‘The cause of gum disease is the build-up of bacteria between the gums and teeth and this causes irritation, inflammation and bleeding (gingivitis). So, between-teeth cleaning is vital.’ Because the gums are the foundation for your teeth, a weak foundation could even lead to tooth loss.

‘Gingivitis is not a serious condition,’ continues Dr Karlien. ‘The problem is that it can progress to a more serious form of gum disease, periodontitis. This involves deeper infection and can result in potential tooth loss. Periodontitis is also linked with chronic (long-term) diseases such as heart disease[iv], as bacteria from infected gums pass through damaged gum tissue and enter the bloodstream causing heart problems. This is why it’s vital to keep teeth and gums as healthy as possible not just at home, but with professional dental health check-ups and treatment.’

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Hormones and bones

The risk of osteoporosis increases rapidly just after menopause and the jawbone, like other bones, can be affected. This is because oestrogen blocks the enzyme that causes bone breakdown[v].

What you can do

Get enough calcium and vitamin D. Calcium is the major mineral in bones and teeth while vitamin D is vital for the absorption of calcium. Foods such as cheese, broccoli and tofu are great sources of calcium and you can get enough vitamin D by going outside. This can help to prevent erosion but won’t be enough to restore bone loss. Your doctor may prescribe treatment to rebalance your hormone levels if you have severe bone loss.

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Tips to keep your teeth

Wear and tear is natural with age. And so, protecting your teeth is as vital ever. ‘Twice daily brushing and flossing are great home maintenance habits. But seeing your dentist for a professional clean and check-up are vital too. Small challenges can be picked up early by your dentist and effective treatments can keep you smiling for the long term,’ ends Dr Karlien Roper.

About the author

In her work at rt healthy teeth, Dr Karlien Roper enjoys the variety of services offered to her patients and also has a keen interest in cosmetic dentistry, facial aesthetics and endodontics. Married with two beautiful boys, Dr Karlien enjoys spending time with her family, cheering her family on at the sports fields, having a braai (South African barbecue) with friends and travelling.

Dr Karlien Roper
Dr Karlien Roper, Dentist at rt healthy teeth

[i]  PubMed – NCBI. Sex Hormone Effects on Body Fluid Regulation. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2849969/

[ii] PubMed – NCBI. Menopause and oral health. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195183/

[iii] PubMed – NCBI. Oral Health and Menopause: A Comprehensive Review on Current Knowledge and Associated Dental Management. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3793432/

[iv] WebMD. Periodontal Disease and Heart Health. http://www.webmd.com/heart-disease/features/periodontal-disease-heart-health

[v] ScienceDaily. How Estrogen Protects Bones. https://www.sciencedaily.com/releases/2007/03/070323171448.htm

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