The Menopause & Your Mouth: What No One Told Us

As a certified integrative health coach, with a speciality in hormones and fertility, I am, of course, the one all of my girlfriends come to when the conversation turns to menopausal health.

But as a 51-year-old woman, five months into menopause myself, there was one thing I hadn't truly considered:
The relationship between menopause and oral health.

I only realised it when I was trying to meet a group of girlfriends in London. One had just been to the dentist. Another was going. One was dealing with mouth ulcers. Another with gum disease. Two had cracked a tooth, and one had bleeding gums.

And I remember thinking:
What is going on?
Then it clicked.
We were all perimenopausal or menopausal.
That was our one and only commonality.

What Happens to Your Mouth During Perimenopause & Menopause?

During perimenopause and menopause, oestrogen doesn't gently decline — it drops off a cliff. Progesterone lowers. Testosterone often declines too.
These hormones don't just influence mood, sleep, or metabolism.

They also affect:

• Bone density
• Inflammation
• Collagen production
• Immune response
• Saliva production
• The balance of bacteria in the mouth

And the symptoms my friends were experiencing? They aren't rare.
Research shows that around 70% of women report oral health symptoms alongside menopausal symptoms.
The 2023 Senior Oral Health & Menopause Report, which surveyed over 1,000 women aged 50+, found:

• 84% of women over 50 were not aware of the oral health impacts of menopause
• 70% experiencing oral symptoms did not realise they were menopause-related — just like my friends
• Only 2% had asked their dentist about menopause-related concerns
• Just 1% had asked their dental hygienist

We are experiencing it, but we're not talking about it — because for many of us we have not connected the dots. Even your dentist may not have.

Why Hormones Matter for Oral Health

When oestrogen is in short supply, several things happen:

1. Your Immune Response Shifts

Oestrogen plays a role in regulating inflammation and immune defence. Lower levels can reduce your body's ability to fight harmful bacteria effectively, making gum infections and inflammation more likely.

2. Your Oral Microbiome Changes

Your mouth contains a delicate balance of beneficial and harmful bacteria. Hormonal shifts can disrupt this balance, increasing susceptibility to:

• Gum disease
• Infections
• Inflammation
• Sensitivity

3. Bone Density Declines

We know menopause affects bone health — but it's not just your hips you need to invest in. Think of the jawbone. The jawbone supports your teeth and is not exempt. Reduced bone density can increase the risk of tooth instability and loss over time.

4. Dry Mouth (Xerostomia)

Reduced estradiol, progesterone, and testosterone can decrease saliva production.
Saliva is protective. It:

• Neutralises acids
• Washes away bacteria
• Protects enamel
• Supports remineralisation

When saliva decreases, the mouth becomes a breeding ground for infection.
Some women even experience burning mouth syndrome — a sensation of burning on the tongue, lips, or cheeks due to increased inflammation and nerve sensitivity.

So What Can We Do?

Yes, brushing twice a day matters.
But how we brush and what we use matters even more in this phase of life.

1. Tongue Scraping (Before Coffee or Tea)

Before your morning cup of tea or coffee, use a copper tongue scraper — ideally a copper one.
Why?
Overnight, bacteria accumulate on the tongue. If you drink first, you swallow them back into the body.
Copper is naturally antimicrobial. It helps reduce bacterial load while being gentle on the tissue.

How to do it:

• Stick out your tongue
• Place the scraper at the back (not too far to trigger gag reflex)
• Gently pull forward
• Rinse and repeat 5–7 times

It reduces bacteria, supports fresh breath, and contributes to a healthier oral microbiome.

2. Brush — Don't Scrub

Many of us have been brushing the same way for 40 or 50 years.
But aggressive brushing can cause more harm than good.
Think of it as massaging the gums, not scrubbing the teeth. Gentle circular motions support gum health and circulation without damaging enamel or causing recession.

3. Consider Hydroxyapatite

Hydroxyapatite is a naturally occurring mineral form of calcium that makes up the majority of your enamel and dentin.

In toothpaste, hydroxyapatite:

• Supports enamel remineralisation
• Helps reduce sensitivity
• Strengthens teeth
• Supports enamel repair

For menopausal women experiencing increased sensitivity or enamel weakening, it can be the powerful addition we need to add to our daily care.

4. Support the Oral Microbiome Throughout the Day

Your oral microbiome has changed even if your brushing routine hasn't.
Incorporating prebiotic, probiotic, and postbiotic support can help.

Prebiotic Foods (feed good bacteria):

• Garlic
• Onions
• Asparagus

Probiotic Foods (contain beneficial bacteria):

• Live yoghurt
• Kefir
• Sauerkraut

Postbiotics
Postbiotics are the beneficial compounds that support inflammation regulation, microbial balance — and help you remineralise your teeth between brushing. Bonus.

Can HRT Help?

Yes, Hormone Replacement Therapy (HRT) can improve oral symptoms for some women by stabilising hormone levels.
But it is not the only lever.

Diet, supplementation, and micronutrient optimisation matter.
This is a time to check:

• B Vitamins (especially B12 and folate)
• Vitamin D
• Omega-3 fatty acids

The Bigger Conversation

When you see your dentist — have this conversation about the menopausal microbiome.
When you see your GP — have this conversation about the menopausal microbiome.
Because the more we bring it up, the more we educate. And sometimes, we educate them too.

We deserve:

• To be investigated
• To be treated with awareness
• To receive targeted care
• To be seen as menopausal women — not 25-year-olds

Our mouths are not the same as they were at 25.
So we shouldn't be treated as if they are.

Menopause is not the end of vitality.
It is a transition into the next phase of womanhood.
And we deserve to carry a bright, confident smile well into our later decades.

With awareness.
With support.
With education.
And with the confidence that our oral health evolves — just as we do.

— Liberty Mills is a certified integrative health coach specialising in hormones and fertility.