Oral health

The NHS website lists sensitive teeth, painful gums and other mouth problems among the symptoms of menopause and perimenopause. It is one line on a long page, and it is easy to miss.

The research behind that line is still thin, but it is growing. A 2025 scoping review by Labunet and colleagues pulled together 30 studies on the mouth around menopause. It found dry mouth and changes in taste to be the most common changes, followed by gum disease, and found postmenopausal women at greater risk of gum disease, tooth loss and loss of bone in the jaw.

Saliva is at the centre of it. The review concludes that saliva flow and taste sensitivity fall after menopause. One study it includes, by Ojo and colleagues, found too little saliva in 14.3% of postmenopausal women against 5.7% of premenopausal women, and long-term gum disease in 54.3% against 37.1%.

A dry or sticky mouth, lips that crack, food tasting different, thirst that water does not quite fix. Teeth that twinge with something hot, cold, sweet or sour. Gums that bleed when you brush, floss or bite into something hard, or that look red and swollen. Bad breath or a bad taste that will not shift.

The NHS website lists the gum signs; the review describes the dryness and the taste changes. The Oral Health Foundation, the UK dental charity the NHS points to on sensitive teeth, describes the sting as a short, sharp pain or a longer ache set off by hot, cold, sweet or acidic food and drink.

Some women also feel a burning in the mouth or on the tongue, which has its own page: burning mouth.

The review links the changes to falling hormone levels, which affect saliva flow, and to bone changes after menopause, which can reach the bone that holds the teeth. It also names age, medicines and treatments for menopause symptoms as factors in a dry mouth, and found that patchy knowledge of oral care and infrequent dental visits make things worse.

Saliva protects the teeth, which is why a dry mouth matters beyond comfort. The NHS dry mouth page says you are more likely to get tooth decay when your mouth is dry. It lists the everyday causes too: not drinking enough or sweating a lot, medicines, breathing through your mouth at night, and anxiety. A dry mouth that does not go away may be linked to diabetes or Sjögren's syndrome, it says.

The NHS website says gum disease is caused by plaque building up on the teeth and irritating the gums. The Oral Health Foundation says teeth turn sensitive when the enamel wears down or the gums pull back and expose the layer underneath. It lists brushing too hard, gums pulling back, acid from fizzy drinks, juice and citrus, gum disease, and grinding your teeth among the causes, and says sensitivity becomes more common with age as gums recede.

For a dry mouth, the NHS dry mouth page lists:

• drink water regularly and keep some by your bed; suck ice, or sip cold, unsweetened drinks
• chew sugar-free gum or suck sugar-free sweets, and use lip balm if your lips are dry
• brush twice a day and use an alcohol-free mouthwash
• do not drink lots of alcohol, caffeine (it names tea and coffee) or fizzy drinks
• do not eat food that is acidic (it names lemons), spicy, salty or sugary
• do not smoke, and do not sleep with dentures in
• do not stop a prescribed medicine without medical advice, even if you think it is the cause

It says a pharmacist may be able to suggest gels, sprays or lozenges to keep the mouth moist. If your day runs on chai, chai and caffeine covers what the guidance says about tea, and hydration covers water.

For teeth and gums:

• The NHS website lists brushing with fluoride toothpaste, cleaning between the teeth every day with floss or interdental brushes, and regular check-ups with a dentist and hygienist, especially for people with type 2 diabetes. See diabetes risk.
• It also lists not smoking as a way to prevent gum disease. The Pakistan Menopause Society notes that naswar is common in Khyber Pakhtunkhwa and that shisha is often seen as less harmful, and asks doctors to address both (Table 7). See smoking, naswar and shisha.
• The review's authors say regular dental visits and good oral hygiene can keep many of these changes in check, and that bone health is worth watching. See bone health.

The NHS website says to see a dentist if your gums bleed when you brush or eat hard foods, if they are painful and swollen, or if you have bad breath. Ask for an urgent appointment if your gums are very sore and swollen, a tooth is loose or falling out, or you have ulcers, red patches or a lump in your mouth or on your lip.

The Oral Health Foundation says to see a dentist about sensitive teeth if the pain is severe, lasts more than a few weeks, is in one tooth only or starts suddenly, because it can be a sign of decay, a cracked tooth or gum trouble.

The NHS dry mouth page says to see a GP if a dry mouth makes it hard to talk or eat, if it has not settled after a few weeks of trying things at home or from a pharmacy, if you keep having problems with taste, if your mouth is painful, red, swollen or bleeding or has sore white patches, if you think a medicine is the cause, or if it comes with other symptoms such as dry eyes or needing to pass urine more often.

Even without problems, the NHS advises regular dental check-ups, and says to see a dentist if it has been two years since your last one.

In some families paan, chhalia or naswar comes out after meals and at gatherings. If you use any of them, tell your dentist. They cannot help with what they do not know about.

In Ramadan a dry mouth during the fast is expected, and the NHS tips on sipping water and sucking ice have to wait for iftar. Women ask about miswak, toothpaste and mouthwash while fasting. Those are questions for a qualified scholar. A mouth that stays dry after iftar is one for your dentist or GP.