Menopause Mouth Signs: Causes and Therapy

Yep, menopause mouth symptoms are definitely a thing. I had no idea my own perimenopause experience would come with sensitive gums, painful canker sores, and dryness. Since their onset, I’ve tried to self-advocate much more while I’m in the dentist’s chair. Sometimes, dentists can even spot the subtle oral health signs that menopause is on its way (or is already here).

Here, learn the most common menopause mouth symptoms that your dentists may point out, why they happen, and what to do to get relief.

What causes oral health issues during menopause?

Menopause mouth, like all symptoms of this pivotal life change, is brought on by hormone fluctuations as a person’s fertility declines. A drop in estrogen levels can cause dryness, and not just the vaginal variety one might normally expect, according to a May 2013 study in the Australian Dental Journal¹.

“During menopause, the body’s estrogen levels decline, leading to a decrease in saliva production,” says Daniel Croley, DMD, chief dental officer of Delta Dental of California and Affiliates. “Saliva is your mouth’s natural buffer—it cleanses the mouth, neutralizes acids, and protects against tooth decay and gum disease. Less saliva can lead to increased tooth decay and altered taste,” he adds.

While dentistry difficulties can happen at any time before or during your menopause transition, many of us don’t know about the connection. A recent survey conducted by Delta Dental found 84 percent of women aged 50 and over are unaware that discomfort in and around your mouth is often linked to menopause.

“Impacts on oral health can occur at any time during the reproductive years,” explains Robin Noble, MD, FACOG, a gynecologist, Menopause Society certified provider, and medical director at Intermed Ambulatory Surgery Center. “But significant impacts are more typical in menopause,” she adds.

6 oral health symptoms of menopause

The effects of “menopause mouth” can vary, and a person may get more than one oral health issue. Here are six of the symptoms most seen by doctors and dentists:

1. Dry mouth

We’ve likely all had a bout of dry mouth at one point or another. It often stems from breathing through your mouth, taking certain medications, or inhaling lots of dry air. But it’s also a common menopause symptom.

It’s estimated nearly half of menopausal women have decreased saliva flow compared to those still getting a period, according to a small November 2018 study in the Journal of International Society and Preventive & Community Dentistry. And as those saliva levels drop, xerostomia, or dry mouth, sets in. It’s an annoying, icky feeling that’s almost like you’ve swallowed sand.

2. Burning mouth syndrome

Burning mouth syndrome is medical-speak for ongoing burning in the mouth (think: on your gums, tongue, lips, inside your cheeks, etc.) without an obvious cause, per the Mayo Clinic. But during menopause especially, some people can feel intense stinging, tingling, and pain in and around their mouth without an injury. In fact, up to 33 percent of people in menopause have burning mouth syndrome, according to an older BMJ Clinical Evidence review.

Other possible secondary causes of burning mouth syndrome (besides menopause) may include the following, per the Mayo Clinic:

• Dry mouth
• Nutrient deficiencies
• Allergic reactions
• Certain medications
• Acid reflux
• Stress or anxiety

3. Cold sores or canker sores

According to an older 2010 study in Maturitas, menopause is associated with suppressed immune function—which is a primary factor in oral health. A lagging immune system often triggers painful eruptions in and around the mouth, including canker sores (I’ve definitely had a few, and ouch!) or cold sores. Some other signs of canker sores to watch out for include the following, per the American Academy of Dermatology Association:

• Burning sensation in mouth
• Sore throat
• Swollen lymph nodes
• Redness and swelling around the sore (on the lips, gums, or inside the cheeks)

4. Bleeding gums

Menopause can also wreak havoc on your gums, leaving them swollen, tender and more prone to bleeding and infection. According to Dr. Croley, hormonal changes can make gums more sensitive to irritants like plaque and bacteria, which increases the risk of periodontitis (i.e., gum disease) and tooth decay down the road.

I’ve personally found cleanings at my dental checkups have become more intense and painful, despite my flossing and brushing regimen. Pro-tip: Don’t be afraid to tell your hygienist to go a bit easier, or if you need a break during the cleaning process.

5. Tooth trouble

You’re at a higher risk of bone loss as your estrogen dips—including the weakening of bones in your jaw and teeth. People in menopause who also have gum disease are then hit with a double-whammy that may put their pearly whites at risk of damage or decay, per the Cleveland Clinic Journal of Medicine. And even if you don’t have gum disease, you may experience more tooth sensitivity during menopause (especially when eating hot or cold food).

6. Lip sensitivity and thinning

Last but certainly not least, your lips are often affected by menopause, too. Your kisser can get thinner, more sensitive, and prone to infection or inflammatory conditions. That includes angular cheilitis—a condition where the corners of the lips can become cracked and painful, according to a January 2022 review in the International Journal of Environmental Research and Public Health⁵.

How to treat oral health issues from menopause

While irritating and often painful, there are effective and easy ways you can treat, and sometimes even prevent, menopause mouth symptoms. This includes:

Keeping a healthy dental routine

Experts agree maintaining a healthy dental routine during menopause is critical to avoid or mitigate menopause mouth symptoms. That means brushing and flossing on the regular and getting in to see your dentist for checkups and cleanings. Bottom line: What you learned back in preschool about taking care of your teeth still applies, and it’s more important than ever!

“We’ve been given this one set of adult teeth,” says Dr. Noble. “It’s so important that people learn at a young age to take care of their dental health.”

Staying hydrated

Decreased saliva caused by hormone fluctuations may lead to plaque buildup, irritating the teeth and gums. In between brushing and flossing, drink adequate amounts of water, try to cut down on sugary or flavored beverages, and consider keeping sugar-free chewing gum at the ready so that plaque doesn’t sit on your teeth for too long.

Stocking up on mouthwash and toothpaste

There are many over-the-counter (OTC) products specifically designed to address and treat mouth sensitivities—including toothpastes and mouthwashes. These are effective and relatively inexpensive ways to make a big difference in your oral care and comfort. Personally, I’ve had good results with Sensodyne toothpaste, and anti-inflammatory mouthwash with hydrogen peroxide to soothe my gums. But your dentist may also recommend prescription-strength treatments, depending on the severity of symptoms.

Pain-relieving meds like ibuprofen can also work well to decrease gum and mouth pain in general, as do anesthetic topical gels and sprays (like Orajel).

Trying home remedies

Surprisingly enough, your kitchen might also offer other relief options. A good, old-fashioned saltwater gargle works wonders for mouth soreness of all sorts, per the NHS. Sucking on some ice chips can also temporarily ease burning mouth syndrome, per the Mayo Clinic, and clove oil applied directly to the gums or mouth ulcers reduces irritation, per a May-June 2014 comparative study in the Journal of Indian Society of Periodontology.

Considering hormone therapy

If you’re having other menopause symptoms alongside mouth problems, it might time to talk with your doctor about a low dose of estradiol or other hormone replacement therapy (HRT). It may just help out your teeth, too. While the research is limited, one older 1998 study in Compendium of Continuing Education in Dentistry found women who used HRT during menopause had a 24 percent lower risk of tooth loss than those who didn’t take it.

You and your doctor will be able to decide whether trying HRT is right for you, based on your symptom severity.

When to see the dentist about oral health issues in menopause

If you’re in perimenopause or menopause and start to have dental issues like swollen and sore gums, mouth ulcers, dry mouth, or tooth sensitivity, you’ll want to flag them with your dentist and your OB/GYN or primary-care doctor. That way, your entire team can help determine if hormones are the culprit, or another underlying health issue.

And if you’ve got severe pain, swelling, or trauma to your teeth or gums, get in to see your dentist as soon as possible, says Dr. Croley. You should never put off true emergencies. Quick dental care can help prevent permanent complications down the road.

“Menopause is a time to double down on healthy habits, preventative care, and empower women to make the healthiest choices for themselves, with shared decision-making and guidance from trusted providers,” Dr. Noble says.