Toothy Tales

Toothy Tales

Impact of Menopause on Oral Health

Cheers!! Happy Women’s Day.

All of us go through several milestones in our lives. Just like how a new-born learns to crawl, sit, stand and finally begins to walk, the onset of puberty (menarche) and the end of menstrual cycles (menopause) are important milestones in a women’s life.

A lot of information is available about changes experienced by women during menopause. These range from weight gain, hot flushes, night sweats and anxiety to osteoporosis and dryness of skin to name a few. This writeup highlights oral changes that may be experienced by women during menopause, and also more importantly provides useful tips and suggestions to reduce and overcome its impact on day-to-day life.

The most common noticeable challenges include:

• Dry Mouth – Reduced levels of estrogen hormone seen in menopausal women result in reduced quantity and change in composition of saliva. This reduction in salivary production can lead to increased susceptibility to tooth decay, bad breath, poor gum health, difficulty in speech and swallowing, and also difficulty in wearing dentures.
• Increased Tartar Deposition – Menopausal women have higher levels of calcium in their saliva, which in turn results in increased tartar deposition on tooth surfaces. Tartar makes teeth look more yellow and unsightly. In addition, tartar causes gum disease and loss of supporting bone which in turn can cause tooth mobility.
• Oral Infections – Hormonal changes associated with menopause cause reduced salivary defense mechanisms. This may lead to imbalance between good and bad microbes in the mouth with subsequent increased chance of oral infections.
• Burning Mouth Syndrome (BMS) – This is a common complaint seen in postmenopausal women, where there are no specific noticeable changes in the mouth. Burning pain is usually felt on the tongue, may afflict lips, gums and the surface under dentures. A thorough evaluation of medical and drug history is required to rule out other possible diseases and to confirm this diagnosis. Many of these women also suffer from anxiety, irritability and depression.
• Osteoporosis – Osteoporosis or weakening of bones is quite common in menopausal women due to depleting estrogen hormone levels. When this affects the alveolar/part of the jaw bone that supports the teeth, it results in reduced anchorage for the dentition. Tooth loss is 3X more likely in women with osteoporosis. These women may also need more frequent denture fabrication than others.
• Medication Induced Osteonecrosis of Jaws (MONJ) – A class of medication used to treat osteoporosis, bisphosphonates result in poor healing outcomes especially after tooth removal. Hence, it is very important to share your drug history with your attending dentist for optimal care.

What Can You Do?

• Regular Dental Check-Ups – These go a long way in preventing, and also in early diagnosis and treatment of oral health issues pertaining to menopause. Bi-annual visit is recommended. In addition, meticulous maintenance of oral hygiene, using soft tooth brush, proper brushing technique and flossing will be highly beneficial.
• Maintain Denture Hygiene – Dentures must be removed at night and stored in a closed container in clean water. The denture must be cleaned daily with a denture cleaning brush. Dentures can also be given to the dentist for removing scales that may form with prolonged usage. Yearly evaluation of fit of dentures is mandatory.
• Topical Fluoride Application – This may be useful in women experiencing dry mouth to reduce chance of developing dental decay. We recommend it twice a year along with your bi-annual dental visit.
• Keep Your Mouth Moist – Use of sugar-free gums, lozenges or candies can help in increasing salivary flow. These are available in a variety of flavours like mint, citrus or even cinnamon. Taking frequent sips of water also helps. Limit the amount of caffeine intake. Over-the-counter topical application gels are available; these may provide relief from dry mouth. Avoid using alcohol-based mouthwashes. Sometimes changing the brand/flavour of toothpaste may also help.
• Balanced Healthy Diet – Have a balanced nutritious diet rich in vegetables and fruits to obtain essential minerals and vitamins. You can supplement these with vitamin D and calcium after measuring the serum levels of the same. Talk to your family physician about requirement and dosage prior to usage.

Given the challenges faced by peri and post-menopausal women with respect to oral health, we women need to proactively focus on oral health care management to improve our overall quality of life.

We women, keep tending to the health and needs of significant others, as mothers, daughters, sisters and as wives. Women need to prioritize their health to keep mentally, physically and dentally fit.

Let’s keep smiling!!!