Menopause can be a distressing time for women – the list of potential symptoms goes on and on, and the information online is endless, leaving many with a simple question: Is what I’m experiencing normal?
But women dealing with menopause have another resource, and it’s one they may not expect: their dentist.
“Dentists are really the first line of defense,” says Joan Monaco, Horizon’s Director of Dental Operations. “Think about it –we see you twice a year, to get your teeth cleaned, and we always take an X-ray. Compare that to your well visit to your doctor – he or she is not going to take an X-ray unless you tell them there’s something wrong.”
The condition of your mouth tells a story
In women – moreso than men – hormones fluctuate, often having to do with a phase or event. The onset of menstruation, pregnancy, and menopause are natural milestones that cause hormonal imbalance. Physical problems like malnutrition, reduced liver function, lack of exercise and stress will also cause hormonal imbalance.
“All these things take a physical toll on your body,” says Monaco. “And that physical toll on your body is very evident when the dentist looks in your mouth. The tissues in your mouth –the oral mucosa, the gum tissue –are very susceptible. They're full of receptors. And for women, they're full of estrogen receptors. So when your hormones are out of balance and there's too much or too little, that affects the bacterial flora and the pH in your mouth.”
There are several conditions people experience that they might bring up with their dentist, and when it’s a woman in the chair, some of these conditions are dead giveaways. For instance, some experience dry mouth, and feel the urge to suck on cough drops or candy to get their saliva flowing again. Dry mouth can be caused by hormonal imbalance. Other effects in a similar vein, such as burning mouth syndrome or canker sores, can also be brought on by hormonal imbalance. Some patients may notice a white coating or substance on their tongue – that's yeast, which can grow in your mouth if your bacterial flora or pH is out of sync, due to hormones. Seeing a pattern here? A dentist observing these or other symptoms can put together the pieces and deduce that the patient is premenopausal or going through menopause.
By the same token, when a woman informs her dentist that she is going through menopause, that tells the dentist to be on the lookout for menopause-associated conditions like the ones mentioned above.
While a primary care doctor is also capable of determining when a woman is premenopausal or menopausal, the tactic is different – it's really more of a conversation or interview. A doctor asks whether a woman is feeling a certain way, or whether she has noticed this or that. We have all had the experience of going to see the doctor, being asked questions, and drawing a blank on the answer. Or we are asked if we notice something happening – and the truth is, the thing is happening, but we just didn’t notice it.
Because menopause has so many symptoms, and each woman’s experience is different, there’s no simple menopause test. After all, menopause is a phase or process, not a disease. While conversations with a primary care doctor can paint a picture of what’s happening, a dentist’s perspective can also be hugely informative.
Dentists are particularly attuned to bone density
During menopause, a lack of estrogen can lead to a decrease in bone density – and as a consequence, many women develop osteoporosis, the “brittle bone disease.” A primary care doctor is likely to tell a woman what she can do, preventively, to mitigate bone density loss – dietary precautions, estrogen therapy, and so forth – but probably won’t give her an X-ray at every annual well visit. The dentist, on the other hand, takes an X-ray at each cleaning, which should occur twice a year.
“As we get older, our bone density changes, and that includes the bones in your mouth,” says Monaco. “So dentists see bone density changing over time, and it’s to be expected to some extent. But they are also capable of noticing a rapid or unusual loss of bone density. They’re more likely to see it than your primary care doctor. The dentist will often be the one to bring it up, saying ‘Hey, you’re losing some bone density, and that’s natural. However, we're seeing this exacerbated situation in your mouth where you're losing bone fast and here's what we need to do.’”
Knowledge is power, so talk and ask questions
When a woman visits the dentist, it’s important to discuss conditions like dry mouth or canker sores, and to ask questions about what the dentist may be noticing, like bone density. And if she thinks or knows she is menopausal, she should absolutely mention that to the dentist, as menopause can affect oral health in so many ways. When in doubt, talk it out –and take notes, because the dentist may be giving information that her primary care doctor would find very informative.
Horizon Health News is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
