Our aging population presents with certain challenges in regards to their dental treatment. As the metabolism slows and our ability to recover and repair diminishes, our bodies become more susceptible to disease and dysfunction. In addition, women will undergo a decrease in hormone production. The reduction of hormone levels, combined with the cessation of menses for one year is termed menopause[i].
Menopause is surrounded by pre and post menopause periods. Each of these phases present their own sets of conditions. In the premenopausal period, some women experience pain or a burning sensation in their mouths. Other may have an altered taste perception or swollen gums. Yet, 30-50 percent of women can transition into menopause with any symptoms whatsoever.
The post menopausal period may present with the most significant changes in a women’s health. Due to the lack of estrogen, women become more susceptible to osteoporosis and heart disease. Osteoporosis is defined as a reduction in bone mass. This may lead to deformity, fractures, and occasionally pain[ii]. Throughout life, our bones go through a natural cycle of bone formation and breakdown. However, post menopause, the scales tip toward breakdown. This may become evident in the mouth causing bone loss around teeth resulting in tooth loss. Although some risk factors for osteoporosis like race and family history cannot be changed, other factors are modifiable. Taking calcium supplements and increasing regular exercise as well as quitting smoking will all reduce the chance of developing osteoporosis.
After menopause, many women may also experience a condition called burning mouth syndrome. The symptoms often present spontaneously and may last for years. Unfortunately, little is known about the cause. The treatment includes alleviating any additional condition that may have precipitated the syndrome. These include treatment of any inflammation, chronic infections, nutritional deficiencies or symptoms of pain or dry mouth.
Dry mouth caused by a decrease in salivary flow is not age-related but rather caused by an increase in medications, medical treatments, or systemic conditions. Dental management of dry mouth is important to prevent rapid breakdown of the dentition. Improved oral hygiene and supplemental fluoride as well as a low sugar diet will help prevent dental caries.
Thyroid disease is another condition affecting women five to eight times more often than men. Women entering menopause are more likely to present with hypothyroidism indicating an underactive thyroid gland. Additionally, these women may present with enlarged salivary glands, an altered taste perception, an enlarged or swollen tongue and compromised health of gums and bone. Systemically, an imbalance can also affect heart rate and weight. Therefore, it is important to see your physician to have your hormones levels evaluated and discuss with your dentist any treatment for this condition you may be undergoing.
Although the menopausal period of a women’s life can bring some distinct challenges, knowing how to address these will make the transition thru these years more pleasant. Our bodies are comprised of a group of systems and do not work independently from each other. Therefore, treating any condition as soon as it arises will have a positive effect on your overall health. Although affects on oral changes have been predominately discussed here, it is important to keep in mind that total overall health and maintenance will improve all aspects of our bodies and minds.