How menopause eats your teeth

And what to do about it

We defang the menopause this week by looking the damage it does - somewhat surprisingly - to dental health, and how we can combat that.

In my forties some of my teeth started mysteriously cracking, like the buildings of of declining civilisation. My dentist Sunita papered over those cracks, so to speak. I had absolutely no idea that this decline could have anything whatsoever to do with perimenopause, and didn’t really clock the estrogen-bone-jaw-teeth connection until I started researching menopause and tanking up on HRT (which then improved my dental disaster zone).

Now, I have thoroughly researched the science on how hormones affect the jaw, teeth, saliva, and oral microbiome, since I was invited onto the Dentistry Talks podcast (for professional dental staff across the UK, 80 per cent of whom are women) to chat about my books and menopause. While a Dentistry Talks appearance was not on my lifelong bucket list, I loved talking to Patrick Johnston, a former Reuters journalist who is a great interviewer, and we took a snap. (The show will be out in the autumn and I’ll link to it then.)

Podcast studio: note the no-teeth smiles

Basically, estrogen keeps the party happening in your mouth, and when it starts to drain away in, on average, the late forties of perimenopause, your mouth gets drier, your teeth get wobblier, and the bone density of your jaw goes down. We know osteoporosis risk starts in perimenopause, and over the menopause transition, women lost 10 to 20 per cent of their bone mineral density on average. So your jawbone can shrink a bit too, plus lack of estrogen increases inflammation risk in the gums, making them more reactive to plaque, and more likely to bleed. Your protective mouth microbiome changes too, often with an increase in harmful bacteria.

The good news is that your dentist can perhaps spot perimenopause coming down the pike before you can - if only they were all trained in such hormonal expertise. I hope that’s changing and dentists will soon be Perimenopause Detectives showing us how to take early holistic and hormonal action. After the paywall, I’ll discuss the mystery of ‘burning mouth’ in menopause, and add some practical takeaways on the extra care you can take on oral health.