How Menopause Affects Your Mouth: Tips for Teeth, Gums & Dry Mouth

A whopping 84% of women 50 and older are unaware of the menopause-oral health connection.

Perimenopause and menopause can affect your mouth, teeth, and gums. As estrogen and other hormone levels fluctuate and decline, some women experience dry mouth, changes in taste, burning or sensitive gums, bleeding gums, and other oral health changes.

Yet the connection between menopause and oral health isn’t widely recognized. In a survey conducted by Delta Dental, 84% of women aged 50 and older don’t know how menopause affects their oral health.

“Hormonal changes can alter saliva, the soft tissues of the mouth, the gums, and the bone supporting your teeth,” says Dr. Mary Claire Haver, a board-certified OB-GYN, Menopause Society Certified Practitioner, and founder of The 'Pause Life.  That can help explain symptoms you might not immediately connect to menopause, like waking up with a bone-dry mouth, noticing that coffee suddenly tastes metallic, or seeing blood when you brush your teeth.

Below, we break down what happens to your mouth, teeth, and gums during perimenopause and menopause, the symptoms to look for, why they may happen, and what you can do to protect your oral health.

Key Takeaway: Estrogen receptors exist directly in the oral mucosa and salivary glands. Falling estrogen during perimenopause and menopause directly impacts oral health by lowering saliva production, altering oral tissue, and decreasing bone density. This can lead to dry mouth (xerostomia), burning mouth syndrome (BMS), increased risk of cavities, bleeding gums, and tooth shifting or loss.

Four Ways Menopause Can Affect Your Teeth and Gums

During perimenopause and menopause, the estrogen levels fluctuate and eventually decline, which can cause a variety of changes that affect oral health. These are a few you may notice:

1. Menopause and Dry Mouth

Estrogen receptors exist directly in the oral mucosa and salivary glands. For women in perimenopause or menopause, it’s common for the makeup of the saliva to change, and the most noticeable change might be a decrease in saliva production.

Dry mouth (xerostomia) can make your mouth feel arid and sticky. It can cause trouble chewing, swallowing, or talking. Some people may also experience bad breath, a dry throat, and other symptoms. When your mouth is dry, it can be uncomfortable but it can also come with more serious oral health issues. 

Saliva is important to your oral health because it helps:

• Wash food and bacteria away from your teeth

• Neutralize acids

• Protect teeth and oral tissues from cavities (especially when you’re using fluoride toothpaste)

• Make tasting, chewing, and swallowing easier

All that’s to say that when saliva production decreases, the risk of cavities and oral infections also rises.

But note that these changes aren’t always simply due to menopause. According to the American Dental Association (ADA), a wide variety of medications can reduce saliva flow, including antidepressants, blood pressure medications, overactive bladder medications, GLP-1 receptor agonists, antihistamines, decongestants, and pain medications. Dry mouth is twice as likely to occur for people taking daily medication than it is for people not taking medication.

Certain conditions can also cause dry mouth, such as diabetes, Sjogren’s disease, Alzheimer’s disease, and Parkinson’s disease.

It’s important to talk to your healthcare practitioner about your dry mouth, to be sure it’s not caused by an issue that should be treated. It’s also important to tell your dentist about the medications (both prescription and OTC) and supplements you’re taking.

To help you cope with dry mouth, you can chew sugar-free gum, or suck sugar-free candies or ice chips to help boost saliva production. Drink plenty of water and try to avoid caffeine, if it seems to make dry mouth worse.

2. Burning Mouth Syndrome

During perimenopause and menopause, changing hormones may affect nerve cells and how our brains perceive pain. Researchers believe this could be a potential reason many women begin to experience burning mouth syndrome (BMS) during perimenopause or after reaching menopause. In some cases, it can be caused by a health condition that can be treated.

As the name suggests, burning mouth syndrome can cause a burning, tingling, or painful sensation in areas of the mouth or tongue. You could also experience a strange or metallic taste in your mouth. Often with burning mouth syndrome, the mouth looks normal, so your dentist or an oral specialist may need to run some tests to find the cause. 

It may also help to avoid foods and drinks that make the burning worse, such as hot, spicy, or acidic foods. Treatment options for burning mouth syndrome can include pain medication, or anxiety or depression medication.

Note: BMS is a diagnosis of exclusion, meaning that your dentist or clinician makes the diagnosis when symptoms are present but no visible lesions or underlying medical conditions like vitamin B deficiency, thyroid dysfunction, or thrush are found. 

3. Other Soft-Tissue Problems

Menopause may cause changes to the soft tissues of the mouth, putting you at higher risk for problems like:

• Oral thrush, fungal infection caused by a yeast overgrowth of the mouth also known as candidiasis

• Autoimmune conditions that cause oral blisters or sores, such as pemphis vulgaris (PV) or a benign mucosal pemphigoid

• Lichen planus, an inflammatory condition causing web-like patterns or ulcers on the mouth and discomfort when eating and/or drinking

• Oral ulcers, known as cancer sores or cold sores

All these issues are worth discussing with your dental care provider, so you can work to manage and prevent symptoms when possible.

4. Gum Disease During Perimenopause

Gums swelling or bleeding when you brush or floss? That’s a common sign of gum disease (called gingivitis). This, too, can emerge during perimenopause or menopause due to changing hormones. But it can also be affected by plaque on your teeth, diabetes, smoking, and dental history.

Gum disease is important to look for and get treated. If gum disease becomes advanced (periodontitis), it can affect how teeth attach to the gums and jawbone. To make matters worse, menopause-related hormone changes can speed up bone loss. Both of these factors can cause tooth loss.

If your gums are newly tender, bleeding or receding, or a tooth feels loose, book a dental evaluation. Regular cleanings can help prevent and treat advanced gum disease. If caught early, gingivitis can be managed with proper at-home oral care.

How to Care for Your Teeth and Gums During Perimenopause and Menopause

Are dental problems or tooth loss inevitable during perimenopause and menopause? No, says Dr. Haver. To prevent or minimize oral problems, it’s important to practice good oral care, to help protect your teeth and gums. This includes:

• Brushing your teeth twice a day, for two minutes each time, with fluoride toothpaste

• Cleaning between the teeth with floss or another method once a day

• Eating a balanced diet

• Avoiding smoking

• Seeing your dentist for regular checkups

“If your mouth begins to feel different during perimenopause or menopause, bring it up with your dentist so it can be properly evaluated,” urges Dr. Haver. Research shows that dental history, gum disease, plaque, smoking, diabetes, and other health factors also matter.

“Menopause should be considered as part of oral health care, alongside these other risk factors,” Dr. Haver says.

How to Talk About Perimenopause and Menopause With Your Dentist

While oral symptoms like dryness, burning, patches, bleeding, sores, and loose teeth can have other causes, if they began around perimenopause, the timing is worth mentioning.

Tell your dentist:

• Where you are in the menopause transition

• What changed and when it started

• Every medication and supplement you take

Ask whether hormones, medications, or something else could be contributing to your symptoms and if you need any additional protection against cavities or disease progression. The bottom line is that menopause belongs in your dental history. Any persistent symptom, like pain, burning, white patches, or a loose tooth deserves a dental evaluation.