Dental Health in Perimenopause: Protecting Your Teeth Through the Transition
Perimenopause can affect gum health, bone density in the jaw, and oral comfort. This guide covers what to expect and how to protect your dental health.
How Perimenopause Affects Oral Health
Dental health is rarely listed among the core concerns of perimenopause, yet oestrogen plays meaningful roles in the mouth, including supporting gum tissue health, bone mineral density in the jaw, and saliva production. As oestrogen fluctuates and declines during perimenopause, women become more vulnerable to specific oral health changes that can affect comfort, function, and long-term dental outcomes. The mouth is a dynamic system, and the hormonal shifts of perimenopause affect it in ways that are distinct from ordinary ageing. Many women notice oral changes during this period without connecting them to their hormonal status, which means they miss the opportunity to address them proactively. Understanding this connection supports better conversations with dentists and more timely protective action.
Gum Sensitivity and Gingivitis
Gum tissue contains oestrogen receptors, and as oestrogen levels shift during perimenopause, the gums can become more sensitive, reactive, and prone to inflammation. Women in perimenopause may notice that their gums bleed more easily when brushing, feel tender or swollen, or recede slightly. These are signs of gingivitis, which is reversible with improved oral hygiene and professional cleaning, but if left unaddressed gingivitis can progress to periodontitis, a deeper infection of the structures supporting the teeth. Periodontitis is associated with tooth loss over time and has also been linked through research to systemic inflammation affecting cardiovascular and metabolic health. During perimenopause, maintaining rigorous oral hygiene, using a soft-bristled toothbrush, flossing daily, and attending dental hygiene appointments regularly, is more important than at previous life stages.
Dry Mouth and Altered Taste
Dry mouth, also called xerostomia, is a less frequently discussed but genuinely common symptom of perimenopause. Saliva plays critical protective roles in the mouth: it neutralises acids from food and bacteria, helps remineralise enamel, lubricates tissues for comfortable eating and speaking, and contains antimicrobial proteins that limit bacterial growth. When saliva production decreases due to hormonal changes or medications taken during perimenopause, such as antidepressants or antihistamines, the risk of tooth decay, gum problems, and oral infections including thrush increases. Women may also notice changes in taste during perimenopause, with food tasting different, metallic, or less flavourful than before. Staying well hydrated, chewing sugar-free gum to stimulate saliva, and using saliva substitute sprays or gels if dry mouth is significant can help manage this symptom.
Jaw Bone Density and the Link to Osteoporosis
Bone loss during perimenopause is most commonly discussed in relation to the spine and hip, but the jawbone, known as the alveolar bone, is also subject to resorption as oestrogen declines. Jaw bone density directly supports the teeth: it provides the structural foundation in which tooth roots are anchored. Loss of jaw bone density increases tooth mobility, can worsen gum recession, and makes successful dental implants more challenging if teeth are lost. Women with osteoporosis or significant bone density loss have a higher risk of tooth loss and poorer outcomes following oral surgery. If you are being investigated for bone density in the context of perimenopause or menopause, it is worth informing your dentist, since they can contribute relevant observations about jaw bone health from X-rays taken for routine dental purposes.
Oral Burning Sensation and Discomfort
Burning mouth syndrome is a condition characterised by a persistent burning or scalding sensation in the mouth, often affecting the tongue, lips, or roof of the mouth, without any visible cause. It is disproportionately common in perimenopausal and postmenopausal women, and while its exact cause is not fully understood, hormonal changes and altered nerve sensitivity are thought to be significant contributors. The sensation can be mild and intermittent or severe and constant, and it often worsens through the day. There is no single established treatment for burning mouth syndrome, but approaches that have shown some benefit include cognitive behavioural therapy for the distress component, alpha lipoic acid supplementation in some studies, and addressing any contributing nutritional deficiencies such as B vitamins, iron, or zinc. A referral to an oral medicine specialist is appropriate if symptoms are persistent.
Practical Steps to Protect Your Dental Health
Several practical steps directly reduce dental health risk during perimenopause. Using a fluoride toothpaste and brushing twice daily with a soft-bristled brush protects enamel and manages gingivitis. Electric toothbrushes consistently outperform manual brushing in clinical studies for plaque removal. Flossing or using interdental brushes once daily reaches the areas between teeth where most gum disease begins. Reducing the frequency of acidic food and drink, including fizzy water, citrus, and vinegar-based foods, limits enamel erosion at a time when enamel remineralisation is already less efficient. Attending your dentist every six months, or more frequently if you have active gum disease, ensures that any developing problems are caught and treated early. Informing your dentist explicitly that you are in perimenopause helps them interpret any changes they observe in the appropriate context.
Hormone Therapy and Oral Health
Evidence from observational studies suggests that women using systemic hormone replacement therapy have lower rates of tooth loss and better periodontal health than women who do not use HRT, likely reflecting the protective effect of maintained oestrogen levels on gum tissue and jaw bone. This is not typically the primary reason women start HRT, but it is one of the systemic benefits that can accompany treatment for other perimenopausal symptoms. For women who are not using HRT or for whom it is not appropriate, topical vaginal oestrogen does not reach systemic levels and would not have the same oral health benefit. Regardless of HRT use, maintaining excellent oral hygiene and regular dental care remains the most important factor in preserving dental health through perimenopause and beyond. Tracking any new oral symptoms alongside other perimenopause experiences can help you spot patterns and give your healthcare team a fuller picture.
Related reading
Get your personalized daily plan
Track symptoms, match workouts to your day type, and build a routine that adapts with you through every phase of perimenopause.