Menopause proof your SMILE

From collagen powders to crunching celery, how to...

As a child of the seventies, I grew up in the decade that dental hygiene forgot.

a childhood visit to the dentist involved having molars extracted to seemingly hasten the growth of adult teeth. and the mantra wasn’t cavity prevention, but drill and fill (with mercury).

I’ve lived with the legacy of bad dental education, spending a fortune on replacement white fillings. But now in my late 40s, I’m staring down another challenge to my already fragile smile — menopause.

‘as women, our teeth are affected by any hormonal changes and menopause is a key marker for oral health,’ says dentist Dr Uchenna Okoye.

‘Hormonal changes alter the environment of the mouth and women are often surprised that during the menopause they seem to need more fillings or have to work harder to stave off gum disease.’

Thankfully, as you can see here, there is much we can do to help . . .

MAKE FRIENDS WITH FLUORIDE

FallIng oestrogen levels during menopause cause a drop in saliva production, our first line of defence against acid attack from plaque bacteria and acidic food and drink.

‘For menopausal women, teeth cleaning needs to be phenomenal,’ explains Dr Okoye ( londonsmiling.

com). ‘The night-time clean is the most important as it’s when our saliva production drops naturally.’

Menopause is often the time when women seek out natural remedies — but steer clear when it comes to teeth, cautions cosmetic dentist Dr Rhona Eskander: ‘ I have seen women who turn to herbal toothpaste have problems with decay because they don’t have fluoride.’

Instead, she says, you should ask your dentist if you might benefit from Duraphat, a high fluoride prescription toothpaste.

You could also try an electric toothbrush with a sensitive setting such as the Philips sonicare Diamondclean (£249.99, boots.com). as gums recede, gentler brushing is essential.

and if you want to go the extra mile, the trendy ayurvedic practice of oil pulling, where a tablespoon of coconut oil is sloshed around the mouth for 20 minutes a day, is said to be anti-bacterial and to whiten teeth. Dentist Dr David Cook ( london

holisticdental.com) says there’s no hard evidence that it works, ‘but I have several patients who do it and whose gum condition has definitely improved’.

However, never use it as a substitute for cleaning.

MOISTURISE YOUR MOUTH

In MEnOPaUsE dry skin can be a problem — and that includes the inside of your mouth. low levels of saliva can make it hard to swallow and chew.

‘Optimum hydration is important,’ says Dr David Cook, ‘but often people with dry mouths drink more sodas and juices, which cause acid erosion. stick to non-fruit herbal teas, which lower acidity, or water.’

It’s also a good idea to cut back on your nightly glass of sauvignon as alcohol can be seriously dehydrating.

To boost your hydration levels, you could also eat more celery and broccoli, which are made up of more than 90 per cent water and require a lot of munching. Chewing stimulates saliva flow, says nutritional therapist Daniel O’shaughnessy ( bodhi maya.com).

artificial saliva sprays and gels such as Bioxtra Dry Mouth Oral gel (£6.33 amazon.co.uk) lubricate the mouth and act as an acid buffer, and chewing sugar free gum with xylitol increases salivary flow and prevents bacteria from sticking to teeth, says Dr Cook. Try Hylamints (£15

victoriahealth. com) which contain xylitol and hyaluronic acid to moisturise the mouth.

BOOST YOUR COLLAGEN

FallIng oestrogen levels during menopause cause collagen to unravel, including in our gums.

‘Our teeth are held in place in a bed of connective tissue, which is mostly collagen,’ explains Dr Okoye. ‘The gums lose their grip and your teeth start moving and crowding.

‘Many women invest in a retainer or braces to prevent movement or correct changes. Once the teeth are straight, an orthodontist can permanently attach a fine titanium wire to keep them in place.’

supplements can boost collagen. Daniel O’shaughnessy recommends Collagen Hydrolysate (£40.99, greatlakesgelatin.com) a tasteless powder that’s added to soups, porridge and coffee.

PROTECT YOUR JAWLINE

FallIng collagen levels can also make jaw joints less stable, which can eventually lead to tooth loss. ‘You start to notice pain, noises in the joint, restricted opening, difficulty chewing and headaches,’ says Dr Cook.

‘I see twice as many women with jaw problems as men, peaking between the ages of 48 and 55, so there is clearly a major hormonal effect.

‘Joint instability can lead to bite changes increasing the risk of abnormal tooth wear, tooth fracture and grinding.

‘Massaging the jaw joint can reduce pain. good hydration helps lubricate the joint and I have seen many patients who have taken the supplement glucosamine & Chondroitin (£10.95, healthspan.co.uk) experience a dramatic improvement.’

AVOID THE DAILY GRIND

anxIETY is a classic trigger for teeth grinding, and even in perimenopause (the five to ten years of declining sex hormones leading up to menopause) 61 per cent of UK women complained of anxiety, according to a survey by vitamin company Healthspan.

‘We see an increase in teeth grinding causing shorter, worn teeth or chipped and fractured teeth — and even increased tooth sensitivity,’ says Dr Okoye.

Teeth grinding is also a secret sleep disrupter.

Early intervention is key. a custom-made bite splint worn at night to stop the molars meeting is expensive at around £1,000 — ‘but it’s cheaper than losing your teeth’, says Dr Cook.

Try the following exercise by yoga teacher Karin lilleberg to release teeth-grinding tension:

‘Make fists with both hands and place under your jaw, around where your rings would sit. Resisting with your fists, push down with your jaw to open your mouth as wide as possible. Do this ten to 15 times on waking. Repeat throughout the day when you feel the jaw tightening.

STEP AWAY FROM SNACKS

IT’s not fully understood why tastes change during menopause. ‘Everything in the body is changing. Women will have different taste sensations or complain that their mouth is burning or that they suddenly have cravings,’ notes Dr Okoye.

‘I have seen women who have never had a sweet tooth suddenly craving sweet things and snacking more. It could be they taste things less, or that want to relieve a dry or burning mouth.’

stress is also a factor, says Daniel O’shaughnessy. ‘The stress hormone cortisol makes us crave sweet and salty foods.’

snacking is terrible for teeth as each time you eat it creates a new acid attack, says Dr Cook.

‘The only safe snacks are raw nuts, cheese, plain yogurt and raw crunchy vegetables such as celery and carrots or a boiled egg, as these foods don’t cause plaque bacteria and are not acidic.’