Oral Health and your Menopausal Transition

Have you ever considered the impact of your menopausal transition on your dental health?

The menopausal transition is linked with 3 main areas of dental concern including bone loss, lower production of saliva, and thinning of the oral mucosa.

You may have previously considered the role of estrogen in your bone health, hopefully, you are taking proactive steps to keep your structural bones strong, but have you considered what may happen if you lose bone density in your jaw? In our jaw we have a thick ridge of bone called the alveolar bone and its job is to hold your teeth. Changing levels of estrogen with menopause can promote the loss of alveolar bone. This can also promote periodontal disease which may lead to tooth loss. And nobody wants that. Just as I would suggest strength training for your structural bones, consider how often you are chewing, and I mean really chewing your food, as this is the equivalent of strength training for your jaw. Hard dense foods like chewing on a raw carrot or chomping on a crisp apple can help improve the density of your jaw bones. 

Did you know the oral and vaginal mucous membrane structure is similar? Just as we can experience vaginal dryness we can also experience dry mouth at this stage of life. It is thought that up to 40% of women transitioning into menopause may experience this.

A fun fact for you is that in fertile women the saliva produces a fern pattern that mirrors the vaginal mucus changes with approaching ovulation and saliva samples can be used as a way to predict fertility. Maybe baby is an example of this kind of fertility test. Knowing that the oral cavity and the vaginal cavity mirror each other's fluid secretions it's not surprising to see an increase in dry mouth at this stage of life. But it's not just the quantity of the saliva that changes its also the composition, the microbiome, and the pH.

These salivary changes can impact oral health in many ways. It can predispose a woman to plaque, oral infections, taste disturbances, difficulty swallowing, and periodontitis. As digestion starts in the mouth, it can also be reduced in the absence of adequate saliva.

But menopause isn’t the only reason why midlife women can get dry mouth. Some medications can cause it, some foods can too. Just think about how you feel after a particularly salty snack. Alcohol and smoking are other major causes. Then again your dry mouth could be due to the presence of another underlying health condition such as sleep apnea, Sjogren's, diabetes and the list goes on.

Then there is a conditional called “menopausal gingivostomatitis” this refers to a pale-looking, fragile mucosa that is easily damaged and bleeds readily. Ouch. If this is you please seek professional help. Here are a handful of my favourite nutrient considerations, all the fat-soluble vitamins (vitamins A, D, E, K), COQ10, and hyaluronic acid. Hyaluronic acid is a hydrating, cell-renewing, anti-inflammatory, and anti-bacterial nutrient.  It’s mostly used in the skin care industry, but its use is rapidly expanding. In regard to dentistry, some dentists will inject it into your gums, some may recommend a mouthwash or topical gel to apply yourself. It's used to help regenerate the tissue in your gums, it reduces inflammation, reduces the risk of infections, and decreases bleeding while assisting with wound healing.   

I know this hasn’t been a fun conversation but the moral of the story is to stay on top of your dental health. Always start with a trip to your dentist, as prevention is 100 times better than trying to correct the problem afterward.

If we were to consider a diet for dental health, it would be one high in crunchy, chewable fruits and vegetables. It would be high in beneficial natural fats and fat-soluble nutrients. It would also include lots of protein and collagen sources like slow-cooked meats and bone broth. Fermented foods to boost probiotics are another good idea. On the other hand, it would be very low in sugary, processed foods, and in processed dangerous vegetable oils.

The key nutrients I would include are all your fat-soluble vitamins, which include vitamins A, E, D, K, and important minerals like calcium, magnesium, potassium, zinc and other nutrients like COQ10 and hyaluronic acid.

Then there is oil pulling, an ancient Ayurvedic practice. Have you tried it? It involves placing 1 tablespoon of oil into your mouth. Coconut is the most frequently used oil but you can also use sesame oil. Pull the oil through your teeth and swish it around your mouth for about 10 minutes. When you are finished spit it into an old tin or jar. Do not spit it down the sink. (Remember coconut oil is solid at room temperature and you don't want to block your drain and have to call a plumber.) Then clean your teeth as normal afterward.

Teeth cleaning should include flossing, brushing, and tongue scrapping at a minimum.

I can't encourage you enough to look after your oral health. Your mouth is so much more than just your smile. You may not realize it but the health of your mouth impacts your entire body. There are over 50 health conditions linked with poor oral health. I think I have already scared you enough today to list them all out. Just know health isn't segmented, everything works together and a weakness in one area impacts other areas. A good example of this is menopause, I bet you had never considered that your menopausal transition could impact so heavily on your oral health until today. 

Previous oral article : Burning mouth and menopause

If you need a hand with your menopausal transition, please consider booking a consultation. 

References

Menopause, skin, and common dermatoses. Part 4: oral disorders

https://academic.oup.com/ced/article/47/12/2130/6966194?login=false

Effect of menopause on saliva and dental health

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280573/

Menopause and the oral cavity

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3401754/

Hyaluronic acid: perspectives in dentistry

https://pubmed.ncbi.nlm.nih.gov/27280412/