Menopause

Menopause is a normal event in a woman’s life around the age of 50. It is marked by a series of systemic and oral changes related to a reduction in estrogen levels.

Changes in the oral cavity include:

1. Oral discomfort: Some women experience pain and a burning sensation that may be alleviated by estrogen replacement therapy.

2. Dry mouth: It is not clear how hormonal changes related to menopause affects the salivary glands, but many post-menopausal women do experience xerostomia or dry mouth. It may also be caused by the use certain medications. Saliva substitutes are available for people that experience dry mouth.

3. Altered taste perception: Many women report a change in taste perception after menopause. This is especially the case with salty, peppery, or sour foods.

4. Menopausal gingivitis: is characterized by dry, shiny gums that may bleed easily. To reduce the incidence of menopausal gingivitis, all local irritants should be removed and meticulous plaque control maintained.

5. Osteoporosis: affects half of the women over 50 year of age. It is a condition that affects the bone mineral density. Osteoporosis may increase the amount and rate of bone loss around teeth. It may actually increase the severity of periodontal disease when it is a pre-existing condition. Studies have shown that women that have low bone mineral density have fewer teeth.

Osteoporosis also affects the jawbones of women without teeth and results in accelerated loss of the bone that supports a denture. Women with osteoporosis have new dentures made three times more frequently as people who don’t have osteoporosis. Not only can this be costly and time consuming, but it may get to the point where there is so much bone deficit that stable, good fitting dentures cannot be made. This can affect the ability to chew efficiently and result in nutritional deficiencies.

Dental implants have been found to be successful in patients with osteoporosis and they are an excellent alternative to wearing dentures. Dental implants look and function like natural teeth. They should be considered as early as possible after tooth loss so that they can be placed in the best position without the need for additional bone grafting procedures.

Estrogen replacement therapy (ERT): seems to alleviate systemic and oral symptoms related to menopause. In the mouth, ERT reduces the risk for severe periodontal disease and is protective against tooth loss and oral bone loss. However, there are drawbacks to ERT use. These include a possible increase in the risk for breast cancer and some of the oral side effects seen with the use of birth control pills (including gingivitis). The benefits and drawbacks have to be carefully evaluated and the decision as to the use of ERT has to be made with your physician.

As in other times in a woman’s life, changes in hormone levels observed during menopause can have detrimental effects on the oral cavity. To reduce the oral problems related to estrogen deficiency, maintain meticulous plaque control and visit your dental care provider for routine screenings and professional cleanings.