Dry Mouth, TMJ, or Burning Tongue?
You would think the symptoms of this whole menopausal transition would stop with hot flashes or insomnia. But, nope. It turns out many women get all sorts of symptoms that impact their mouth, jaw, and oral microbiome. Both estradiol and progesterone play a role in the “gateway to the body” known as your mouth! Thankfully, I’ve had the pleasure of interviewing some amazing integrative or holistic dentists who break down the stats, what they see in their office and most importantly, what you can do! I’ve also pulled some date from this 2024 article in the Journal of Midlife Health on Menopause and Oral Health.
First, let’s get into the numbers:
50% of you experience dry mouth
Up to 60% have increasing gum disease
Up to 40% burning mouth or tongue (like…wtf. Who thought of this!?)
There is an overall increased rate of cavities at this age
Some women report altered taste - specifically a metallic taste
I also see and hear of an increased rate of TMJ (temperomandibular joint) and jaw pain/tenderness
As I said, the decline in both estradiol and progesterone play a huge role in the mouth, jaw, and oral microbiome. Declining estradiol results in decreased salivary flow from the saliva glands. This changes the microbiome and increases the risk of dry mouth, cavities, and gum disease. Burning mouth and burning tongue also seem to be due to the loss of estradiol.
The jaw or TMJ pain and tenderness can be attributed to either (or both) estradiol and progesterone. In fact, I personally noticed as my own progesterone crashed that my TMJ pain increased close to my cycle.
It’s important to be proactive about the health in your mouth as it holds all that bacteria that is swallowed down into your stomach and intestines. This means if your bacteria is healthy, you’re swallowing “good bugs.” But if you have periodontal disease, cavities, or overall unhealthy bacteria in your mouth, each time you swallow you’re swallowing it into your stomach and intestines. This could worsen any stomach or GI symptoms you’re having.
What can you do?
So much! My dental friends have been overly generous with tips and tricks.
Regular dental cleanings - this might increase in number in perimenopause! Make sure your dentist and dental hygienist knows your age and that hormones impact oral health!
Floss regularly. My friends suggest flossing on waking before food or caffeine. As needed in the day. And before bed.
After flossing, brush your teeth. My favorite toothpaste has hydoxyapetite in it. It’s also good for your microbiome! It does not contain fluoride.
Tongue scraping - this one might seem weird but I swear it works! You can get a basic tongue scrapper here. Start near the back of your tongue (watch that gag reflex!) and gentle scrape the length of your tongue. Gross stuff might come off! Be careful if you have dry mouth or dry tongue not to cause damage.
Be careful of the mouth washes with all the colorings, artificial flavorings, and fluoride. If you have dry mouth, dentist Dr. Leedia suggests 1 tsp of organic baking soda mixed in a glass of water. Then swish and spit to help alkalinize the mouth.
Try oil pulling. This Ayurvedic technique discussed in my interviews with Dr. Shivani Gupta and Dr. Leedia explain how 1-2 tsp of organic coconut oil melted in the mouth and swished around for 5-20minutes can make a huge difference in oral health. I know 20 minutes can feel like FOREVER. If you’re new, go slow or stick to shorter times twice a day. Do NOT spit this oil in the sink as you don’t want that in your pipes. Spit it in the trash.
Evaluate your nutrients - Vitamin D, magnesium, Vitamin K2, and B vitamins play a role in the health of your teeth.
Hormone replacement therapy - while there isn’t great data on this yet (there will be!), anecdotally the dentists can tell an improvement in women who are on estradiol and progesterone therapy.
Lastly, several of my colleagues and I have had TMJ tenderness reduced with progesterone cream or oil rubbed into the joint on the skin (it sits in front of your ears). Again, I don’t have studies on this but the positive feedback has been nice!
I know it can feel like one more thing to assess as you get older but this is your mouth we’re talking about! Time to call your dentist (or find one who understands this) and be proactive about your oral microbiome!
Other helpful resources:
I’ve compiled my list of favorites here to make it easier for you!
YouTube video on this very topic here!
Podcast Interview with Dr. Staci Whitman - brilliant dentist answering your Q’s and busting myths. Listen here on apple or here on Spotify.
Podcast Interview with Dr. Bahar Esmaili - she discusses your breathing and the changing shape of your jaw. Listen here on apple or here on Spotify