If you are female and over 50, have you noticed any of the following symptoms?

• Inflamed  and receding gums
• Dry mouth
• Strange taste in your mouth such as bitter or metallic

If so then these symptoms could be menopause-related.

Studies show up to half of the 13 million menopausal women in the UK suffer oral-health symptoms such as painful gums, dry mouth, tooth loss and even phantom tastes – and that these are as common as hot flushes and memory lapses. 

Too few healthcare professionals are aware of the link, leaving patients batted back and forth between dentists and GPs and failing to get treatment that could help.

Experts are recommending that patients request hormone replacement therapy (HRT) from their GP, to replenish the sex hormones like oestrogen and progesterone that diminish after the menopause. 

The facts

Gum disease and dry mouth

A 2017 study found women taking supplementary hormones were 44%  less likely to suffer severe gum disease, the precursor to many common complaints. In some cases, patients may need to be on a higher dose of oestrogen, or take it in a different form, like switching from the patch to a pill.

When the monthly reproductive cycle gradually stops, the dramatic slump in oestrogen creates issues with both the soft tissues and bones in the mouth.

The mouth is abundant in oestrogen-receptor cells, which rely on the hormone to function properly.  Most of these cells sit in the mucus-producing membrane that coasts the mouth and the glands that produce saliva.

These elements keep the area sterile and moist. Without the hormone, the membrane produces less mucus, causing severe dryness and allowing bacteria to build up rapidly. A 2003 Swedish study found that menopausal women with low oestrogen levels had significantly less saliva circulating in the mouth and more bacteria, compared to another group of similarly aged women taking supplementary oestrogen for one year.

Without oestrogen, bacteria soon starts to attack the teeth and gums, causing severe gum disease leading to bad breath, bleeding gums and terrible pain.  If left untreated, the gums start to recede, making teeth loose and increasing the risk they fall out.

A lot of women feel as if they wake up one day and their teeth are suddenly crooked.

Oestrogen is essential for making collagen, which keeps the elastic gum tissue taut and helps to maintain teeth in place.

Strange taste in the mouth

And what of the metallic tastes experienced by many menopausal women? Scientists aren’t quite sure why this happens, but some believe it is related to malfunctioning oestrogen-receptor cells in and around the tongue. For roughly a third of menopausal women this, combined with a severely dry mouth, results in an extreme sensation known as Burning Mouth Syndrome, a scalding or tingling feeling that can affect the lips and tongue and tends to come and go.

But there’s confusion over who is best placed to treat the problems.   A lot of dentists don’t know to ask about the menopause, so they treat the gum disease but don’t address the root of the problem.

Or they might just offer an artificial saliva spray for dry mouth. But when the problem.  Ideally, all dentists should be thinking about it as soon as they see a woman of a certain age.

For most patients, HRT eases symptoms. But for some, including those with Burning Mouth Syndrome, it is less effective. There are other things that can help, such as avoiding toothpastes with a detergent called SLS that further dries out the mouth.  And avoiding acidic, spicy food and alcohol can reduce strange metallic tastes.

Prevention is important too

Pre-menopausal women might wish to over-compensate for what mother nature is about to do. That means a full clean with the hygienist every three months, as opposed to every six along with flossing twice a day, every day, with close monitoring from a dentist.