Amy Cuevas Schroeder, 50, started perimenopause — the years-long lead-up to menopause — in her early 40s. Since then, she’s dealt with a tooth fracture, headaches and neck, shoulder and jaw pain. Her dentist said she grinds her teeth and diagnosed her with a temporomandibular joint, or TMJ, disorder.
Now, Schroeder sleeps with a mouth guard and visits her dentist four times a year for a deep cleaning.
“My dentist never mentioned perimenopause being a potential culprit,” said Schroeder, who lives in Phoenix and is the founder of the Midst, a digital platform for women over 40. But after working with a nurse practitioner who specializes in menopause, Schroeder learned there’s a connection.
“Estrogen loss is the central factor that causes all of the downstream effects that we see in the mouth,” said Purnima Kumar, an expert spokesperson for the American Dental Association and chair of the Department of Periodontics and Oral Medicine at the University of Michigan School of Dentistry.
More than 40 percent of women report oral discomfort, including dry mouth, decreased saliva, lower pain tolerance and an altered sense of taste, during menopause compared with 6 percent of premenopausal women, according to one study. They’re also at higher risk for oral health problems, including dry or burning sensations in the mouth, osteoporosis in the jaw, gum inflammation and tooth decay.
Here’s what to know about how menopause can impact your mouth, and what you can do about it.
How hormone changes manifest in the mouth
Estrogen receptors exist all over your body, including in your mouth, explained Mary Rosser, an OB/GYN and director of the Fazzalari Women’s Health Center at NewYork-Presbyterian The One, a medical center in White Plains, New York, and Columbia University Irving Medical Center. When estrogen levels decline, it can affect your oral health in a few different ways.
Dry mouth is one. Studies suggest that 50 percent of women experience dry mouth, technically known as xerostomia, during and following menopause.
Decreased estrogen affects the oral mucosa, the soft tissue lining your mouth that’s similar to the vaginal lining, Rosser said. Specifically, lower estrogen can lead to decreased saliva production or thickened saliva, said Adila Baig, director of the special care and geriatrics clinic at the University of Maryland School of Dentistry. Both can leave your mouth feeling chronically dry.
The feeling is unpleasant and it can affect your sense of taste, Baig said. Additionally, decreased saliva raises your risk of cavities, gum disease and tooth sensitivity, said Whitney White, owner of an Aspen Dental practice in Las Vegas. “The function of saliva is to wash away bacteria, plaque and tartar, and it also neutralizes the pH of the mouth,” she explained.
Low estrogen levels can also cause the tissue in the mouth to thin, potentially leading to gum recession, Kumar said.
Bone loss and osteoporosis — another common side effect of declining estrogen levels in menopause — can also affect your jawbone, Baig said. “With that, you’ll see that the teeth start shifting,” she said.
Many women also experience TMJ disorders during menopause, but the exact link isn’t well-established. Kumar said it may be related to bone-density changes, joint inflammation, collagen loss or teeth grinding or clenching.
Stress, anxiety and sleep problems (which are all common during menopause) might cause you to grind your teeth, potentially contributing to TMJ disorders or “microfractures in your teeth,” Baig said.
Gum disease is also common during menopause, Baig said. “Patients will come in complaining, ‘My gums have never bled before, but now, all of a sudden, they’re bleeding.’”
How to manage your oral health during menopause
Perimenopause and menopause affect every woman differently, Rosser said. You can’t predict how estrogen loss may affect your mouth, Baig said.
If you’re wondering if hormone therapy can help, the jury’s still out. One small study published in the Journal of Periodontal Research in 2024, suggested that hormone therapy may be associated with lower inflammation for postmenopausal women with gum disease and slower jawbone loss. But Baig said more research is needed on the topic.
For now, hormone therapy is usually prescribed for hot flashes and vaginal dryness — not dry mouth alone, Rosser said.
Working with your dentist is the most effective way to treat oral health problems during menopause, Baig said. For example, she often prescribes toothpaste with a higher concentration of fluoride than what’s available over-the-counter to combat the potential damaging effects of dry mouth.
Women experiencing gum or teeth changes during menopause may need more frequent and deeper teeth cleanings, known as a scaling and root planing, Baig said.
If you grind your teeth, dentists may recommend a night guard, a dental appliance that you wear over your teeth while you sleep, Baig said. It can minimize wear and tear and reduce headaches, jaw pain and other TMJ disorder symptoms. They may also suggest jaw exercises, pain medications or surgery to treat TMJ disorders, Baig said.
Additionally, it’s important to take care of your oral health at home. White said to focus on the basics: brushing twice a day with a fluoride toothpaste, flossing daily and swishing with an alcohol-free mouthwash that contains fluoride, which can strengthen teeth and prevent bacteria that can cause cavities.
Drinking plenty of water throughout the day can help combat dry mouth, Kumar said. It also keeps your mouth clean and washes away sugar and bacteria that may cause cavities, according to the American Dental Association.
Since oral health is closely linked to overall health, Rosser recommended following the American Heart Association’s “Essential 8”: eat healthy, exercise, quit smoking, get plenty of sleep and manage your weight, cholesterol, blood sugar and blood pressure. Also, managing stress could minimize teeth grinding.
Finally, if you notice any changes — your gums bleeding, jaw pain or other changes in your mouth — see your dentist. “The earlier we catch a problem happening, the sooner we can fix it,” Kumar said.
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