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The 'Pause
The menopause podcast with unfiltered conversations about the symptoms you hate, the changes you didn’t see coming, and the hilarious moments midlife can bring. You've got questions and we've got the experts to answer them.
The 'Pause
Hot Flashes in Your Mouth? Your Teeth are Going Through Menopause Too
Perimenopause affects your oral health in surprising ways, creating symptoms like dry mouth, bleeding gums, and persistent bad breath due to changing estrogen levels in your body.
• Estrogen receptors exist throughout the body, including the mouth, affecting salivary glands, gum tissue, and jawbone
• Decreased estrogen can cause dry mouth, bleeding gums despite good hygiene, and unexplained bad breath
• Symptoms often start during perimenopause but become more consistent and noticeable after menopause
• Hormone replacement therapy (HRT) may help improve oral health symptoms for some women
• Regular dental visits with x-rays are crucial to detect early bone loss and gum changes
• Using fluoride toothpaste, xylitol products, and pH-balancing mouth rinses can help manage symptoms
• Carry Free mouth rinse combines fluoride, xylitol and pH elevators to combat bacteria and increase saliva flow
• Many dentists may not connect oral symptoms to perimenopause, so patients should initiate the conversation
• Supporting oral health includes eating well and taking supplements like calcium and vitamin D
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Welcome to the Pause, the menopause podcast, with unfiltered conversations about the symptoms you hate, the changes you didn't see coming and the hilarious moments midlife can bring. I'm your host, Val Lego, and I've been a dedicated health reporter for 25 years and I wanted to normalize something that every woman goes through menopause, that every woman goes through menopause All right, so you are in the perimenopause space. You know it, because you've got hot flashes, you've got night sweats, you've got achy joints. You're checking off all the boxes that say, yep, I probably am there. I'm going to add one more to that space that's really going to make your jaw drop like, literally, gum disease, your mouth and perimenopause Something that nobody talks about really, and that's another part of your body that you're going to have to start paying attention to now that you're in this space. So welcome back to the Pause, where we pull back that curtain on what's really happening to your body during perimenopause and menopause.
Val:I'm your host, Val Lego. I'm a health journalist with 25 years of experience in the health world. I am also a fellow hormone rollercoaster rider of yours, which is why I wanted to start this podcast, because once I started developing the symptoms, listening to my girlfriends develop the symptoms. I'm like we have got to get the information out there that they're craving and that you're craving. So today we are diving into the surprising ways that your mouth and I'm going to say this again because you probably are still hung up on the what? Yes, your mouth, your teeth, your gums, the whole mouth affected by the hormonal changes happening during midlife. Joining me is Dr Manisha Javia from Desert Vista Dental in Scottsdale, arizona. She is here to break down what's normal, what's not, and how to protect your smile through the chaos of shifting hormones. Welcome, Manisha.
Manisha:Thank you. Thank you for having me Val Welcome, manisha. Thank you.
Val:Thank you for having me, Val. Do you have women ask a lot in your dental seat about perimenopause, or do you think they don't even realize it's affecting their mouth?
Manisha:I think most of them have no idea that it's affecting their mouth. There's just this disconnect Everyone thinks that the body is separate from their mouth, and so I rarely have anyone ask me about or tell me that they're even going through perimenopause or menopause.
Val:And so some of the symptoms include dry mouth, bleeding gums, that type of thing. When you see that happening in a woman, what's the first thing that you see? When they're your patient in a woman, what's?
Manisha:the first thing that you see when they're your patient. Well, you know, now is because I'm going through it myself, I'm seeing things in a different lens. I'm looking at things, you know, I'm not looking at it just as, oh, you've got dry mouth, you know, are you on some medications? You know, we're kind of diving deeper into why could they have this? Because they're not telling me this, so I've got to look into it. And so, as you all know, you know there's estrogen receptors throughout our whole body, including our mouth, and so the three different areas that are often affected are going to be your salivary glands, your gum tissue, like you mentioned, and then the bone, you know, the bone that supports your teeth, the jawbone.
Val:And so estrogen, when it lowers, is affecting all of this. So if you're starting to feel like your mouth is a little bit dry, or when you're flossing, that your gums are bleeding like maybe that's another sign women should be looking for that this could be perimenopausal. In addition to that, they have the hot flashes and they can't sleep at night.
Manisha:Yeah, you know, I think when patients really start to question, is there something else going on? Is because they're doing everything that they should. You know they're thinking okay, I'm coming in regularly, I'm brushing my teeth, I'm flossing my teeth, you know why are my gums still bleeding? That's when they're starting to question, or that's when we are starting to. We meaning myself, my hygienist are saying okay, let's what's going on here. You know why is this? We've got to dig deeper.
Val:Do you think that these symptoms happen more in perimenopause or postmenopause?
Manisha:I think they start during perimenopause but because your hormones are fluctuating, you may not recognize it. You may have dry mouth maybe one day or one week and then it kind of goes away and you don't think about it. Most of these symptoms are going to actually happen during postmenopause. They're going to be a lot more consistent and you're going to recognize it. It's going to bother you. We're going to notice it regularly when you're coming in to see us going to bother you.
Val:We're going to notice it regularly when you're coming in to see us. Are there certain symptoms that you would want women to really be aware of that they can talk to you about when they come to their next dental visit? Is there something they should be looking for? Are they going to have maybe more plaque on their teeth? Maybe they get done brushing their teeth and like geez, they don't even feel clean. I mean, is it just going to be the bleeding Like? What? Are some of the symptoms that they really should not ignore?
Manisha:Symptoms like dry mouth. They're just like they're having a difficulty swallowing. They've got that burning sensation in their mouth. Those are all, just you know, side effects of long-term dry mouth. Other symptoms are definitely you know you're brushing and flossing regularly, but then your gums are still bleeding. That's a sign of something else might need to be treated. You're also going to find that when you come in, another big symptom actually is that bad breath. You know, again, you're doing everything you're normally doing and you've got this bad breath.
Val:I'll tell you what my husband will often say to me, and I don't always have it, but sometimes I'll close talk to him and he'll be like woo oh that's a lot there, right there, back it up a little bit.
Val:I mean, he says it in the most loving way. I'm kind of like painting a him in a bad picture at the moment. But yeah, he does realize it. He'll be like wow, I just want to let you know maybe some extra mouthwash today. I don't, it's like coming from like within. I don't know where it's coming from and it's not all the time. But I'm glad you brought that up because that is definitely like something to be aware of, like your besties should be letting you know. Hey, here's some gum.
Manisha:Yeah, yeah, exactly. Well, what's happening there is, you know, when you have that dry mouth or you just feel like just you can't drink enough water, the bacteria, the balance of the good bacteria and the bad bacteria, is altered and you have more acidity in your mouth, and that's part of the reason of why you feel like you know you have bad breath, gotcha.
Val:So do you think hormone replacement therapy helps to reduce these symptoms? Do you see women who maybe started coming to you and you were noticing, you know, the changes in their gums and then maybe they went on hormone replacement therapy without? Maybe then they just mentioned it on the way to the next appointment like, hey, I want to let you know I started HRT. Do you start to see like a benefit to that for oral care.
Manisha:Yeah, you know, I think HRT is a great option. You know, again, you got to talk to your medical provider but on a few of the patients that we've actually had this full discussion, there has been some benefits. So I think it's something definitely to talk to your provider about.
Val:Wow, that's really. That's good to know that. That is like another benefit, you know, for those women who are considering it which I'm glad that there are more and more women who are willing to have that conversation now and just the fact that it could also affect your oral health and perhaps improve that. We talk about a lot, you know heart disease and bone health, but now also gum health, so that's another reason to perhaps consider having that conversation. So what would you say women should be doing differently in perimenopause for their oral health? Is there something you'd want? Would you want them to brush more, or are there different products perhaps they can use?
Manisha:Yeah. So you know I think it's important to come into the dentist regularly. So from the provider standpoint or from the dentistry standpoint, you're going to want to come in at least twice a month. You're going to want to have your hygienist take x-rays regularly, which is at least once a year, and sometimes I'm starting to take them twice a year. You want to diagnose early bone loss. You want to have your gums evaluated regularly and there's that you probably hear them going three, two, three. You know what they're doing is they're measuring the attachment of your gums to your tooth. There's like a little pocket around each tooth and when those numbers start to increase and go into the fours and fives, those are signs that there's some bacterial destruction that's starting to occur. And when those numbers jump even higher, you're starting to get bone loss. And that is difficult. We always call periodontal disease like a silent disease. Very seldom do patients actually come in and tell us hey, they may notice their gums bleeding a little bit, but sometimes you don't actually even have these symptoms that are visible to you as a patient. But for us we've got some tools that we can do to, you know, kind of figure out, you know, could you be starting to form periodontal disease. So that's, you know a few things that we can do.
Manisha:What you can do on your end is just be cognizant. You know healthy mouth. Healthy or sorry, healthy body. Healthy mouth. So you want to. You know, eat well. You want to take supplements like calcium and vitamin D. You're going to want to use a toothpaste that has fluoride. You're going to want to use mouth rinses. One of my favorite mouth rinses is called Carry Free. It's something you can actually purchase over on Amazon. You cannot buy it over the counter currently, but what I like about it is it includes three ingredients One is fluoride, one is xylitol and the other is a pH elevator, and those three ingredients really help to kind of just combat that bad bacteria.
Val:Oh, so that's a really good. What I'm hearing, I think, is a bad breath fighter.
Manisha:Yes, it's a bad breath fighter. It helps to increase saliva flow. When you've got that dry mouth, it neutralizes that bacteria. You know again, when you're going through perimenopause and postmenopause you've got that decrease in saliva flow is acidic and that acidic pH is what creates cavities as well, and you just want to try to neutralize as much as you can.
Val:Wow, that is some really great advice. I love everything that we've talked about here. I think one of the things that concerns me a little bit is that you know, do. Are all dentists thinking about perimenopause when their female patients are coming in and and you know, having these these symptoms Are? Is this something that you would like to see women start having an open conversation with with their dentists?
Manisha:Absolutely. You know, and I have to say I'm guilty, I'm 53. I I've, like my best friend, actually talk to me about burning mouth and she's been asking me about it for probably two years and every time I'm looking at her I'm like your mouth looks great, everything looks great. Go talk to your MD, maybe there's a vitamin deficiency. And then it was only in the last probably a year, year and a half, that I started having more patients. Just mention it to me and then you know. Once you're going through it, you're like wait a minute, you know. And so I think, um, I think it's kind of new um, that this relationship of perimenopause, menopause to oral health, um, but I think, um, as one of your listeners of your listeners, definitely talk to your dentist about it. They may be slightly aware of this link, but I think what it will do is push them into wanting to learn more about it and be able to help so many patients that they see regularly that don't ask them about it or don't talk to them about it.
Val:Yeah, because it's not really top of mind for anybody to link perimenopause, postmenopause with, you know, gum health. So any final thoughts before we say goodbye to you today.
Manisha:Well, you know, I think some of you mentioned a couple of the products you know, and I mentioned the Xylitol. The Xylitol is found in those breath mints and mouth rinses. You're going to want to look for that sugar-free, you know. Mints to help, you know, utilize when you can't get to that toothbrush, you know so. And if you're having that morning coffee, you know again that's acidic, you know. Pop a mint in for that reason as well, just to kind of neutralize that bacteria. And then just remember, we've been through this before. You know, we've had hormone changes when we were adolescents, when we had babies, you know. So we've survived it, we'll survive this too.
Val:Yes, we will. With enough supportive women and smart women like you help guiding us through it. There's not a doubt in my mind, we will. With enough support of women and smart women like you help guiding us through it, there's not a doubt in my mind, things will change for the generation that comes after us.
Manisha:for sure, For sure, yeah, thank you for being such an advocate as well.
Val:Thank you, oh, I appreciate that, Manisha, and thank you today for joining us and shedding light on this well-overlooked topic about gum disease, dental health and perimenopause. So much information here to unpack. It's really been great. Hey, if this episode has made you go wait, that is totally happening to me. You are not alone. Come share your story or ask questions in the Pause Diaries. That's our private Facebook group where the menopause conversation is always open, honest, supportive. The women in there are great. They help each other out. There's close to 700 women in there and growing, and we love each and every one of them. So lots of extra information that I often put in there. So please pop over and join the Facebook group. Remember menopause is not the end of anything. It's the beginning of the rest of your life and we are going to talk about it. The Pause Podcast is for informational purposes only and not intended as medical advice. Always talk to your health care provider about any questions or concerns. Views shared by guests are their own and don't replace the personalized care from a qualified professional.
