I can’t walk into a room of age 40+ friends at the minute without the word perimenopause popping up. It’s a hot topic; brain fog, fatigue, breakouts, mood swings, broken sleep, newfound side effects from drinking wine (often insomnia), night sweats…the list goes on. The thing is the signs aren’t always obvious…but they’re there. That’s why, when I started to suddenly feel like my mouth was getting drier, my teeth were looking more discoloured and my gums were receding, I wondered if this was yet another sign my hormones were scuppering my internal equilibrium.
© Getty ImagesCould perimenopause be changing my teeth and gums?
“It’s important not to oversimplify and say that perimenopause and menopause causes bad teeth as the teeth themselves don’t suddenly become weak because oestrogen levels fall,” explains Dr Brandon Nejati, co-founder of the Nejati Clinic. “What the changes in hormone levels does do is alter the environment supporting the teeth – some women notice more sensitive or reactive gums, bleeding, changes in taste, burning sensations or a drier mouth. Saliva is incredibly important as it’s one of our natural defence systems and helps to neutralise acids, protect the teeth and soft tissue, as well as maintain a balanced oral environment so with less of it, you’re more vulnerable to decay and gum disease.”
What Falling Oestrogen Means for Your Oral Health
Bone health is another one to watch as oestrogen levels start to deplete. “Falling oestrogen affects bone density throughout the body, including the jawbone that holds the teeth in place,” says Dr Soumaya Zinet, dentist and founder of Invisible Braces 4U. That doesn’t mean your teeth are going to start dislodging and falling out (thank goodness!), but it makes the environment around them less protective. Side note: there is some research showing that HRT can have beneficial effects on certain periodontal health factors but not enough for it to be prescribed for dental reasons.
As for the discolouration I’ve been experiencing, that is age related but the perimenopause can’t be to blame for this. “From our forties the changes are usually gradual so many people don’t notice them until something feels or looks different,” continues Dr Zinet. “Enamel naturally wears thinner so more of the yellower dentine underneath shows through and teeth can look duller. Gums also often begin to recede which can make teeth look longer and create small dark gaps that expose the root surfaces around the gum line which are then more prone to sensitivity,” Basically, everything I’ve been experiencing.
© Getty ImagesHow to protect your teeth and gums during perimenopause
Popular treatments such as professional teeth whitening and Invisalign only alter our smile cosmetically, they don’t really get to the crux of perimenopause mouth. “Day to day, the foundations make the biggest difference – brushing twice a day with a fluoride toothpaste, ideally using an electric toothbrush, cleaning between your teeth daily with interdental brushes or floss. Toothpastes containing nano-hydroxyapatite, a mineral similar to the one that makes up enamel are increasingly popular and can help with sensitivity too,” says Dr Zinet.
There’s also a wave of new in-clinic approaches that are far more targeted and bespoke to certain symptoms caused by age and life stages. “There’s growing research into techniques that stimulate the salivary gland themselves, rather than simply replacing moisture in the mouth - electrical stimulation is one, although larger studies are still needed before it becomes routine,” says Dr Rhona Eskander, cosmetic dentist. “Another emerging area is low-level laser therapy, sometimes called photobiomodulation, which is being studied as a treatment for burning mouth syndrome.”
Beyond whitening: A more holistic approach to oral care
Enter the treatment I tried – the Oral Detox & Cleansing Treatment at Nejati Clinic which has given my mouth and in turn, my smile, a new lease of life. No drilling or bonds or veneers or harsh whitening formulations in sight. Taking a far more holistic approach to oral health and longevity, the treatment is the brainchild of founders Dr Masha and Dr Brandon Nejati and uses various methodologies to brighten teeth, improve the oral microbiome and care for gums.
“We look at the mouth as a whole environment and a gateway to the rest of the body and using photobiomodulation and LED technology is part of that. This treatment combines red and blue wavelengths as red light is being studied for its role in tissue healing and inflammation while certain blue wavelengths have antimicrobial applications,” says Dr Masha Nejati.
What happens during the 45-minute treatment?
Traditionally dentists aren’t especially pleasant environments – sterile, clinical, functional and not somewhere one wants to frequent regularly. The Nejati Clinic is more like a spa. Herbal tea on arrival, a blanket over you to keep you cosy while you have your treatment and the choice of what you want to watch projected above you. There’s even a curated soundtrack.
Lasting around 45 minutes, the treatment starts by using GBT – Guided Biofilm Therapy. A blend of superfine salt and minerals that’s sprayed on with warm water, it’s like a gentle exfoliation and works to lift away the biofilm layer that sits in gums and teeth and is where harmful bacteria are often found. After this, Dr Masha removed any stubborn plaque and deposits, but in such a manner that’s incomparable to when I’ve been to a hygienist before, and my saliva runs red with blood when I rinse. This time, there was nothing.
Once all deposits and plaque had been dealt with, a herbal antiseptic and anti-inflammatory serum was applied onto my teeth and 10 minutes of blue and red LED light therapy exposure began. A layer of antiseptic serum containing hydrogen peroxide was applied to finish.
The Results: A brighter smile and healthier-feeling gums
I was amazed at the results when Dr Masha handed me a mirror. My teeth were noticeably whiter (the procedure breaks down the carbon bonds that cause discolouration), there were no dark gaps, no plaque around my gumline and running my tongue across my teeth, no lumps and bumps. They even looked straighter in my opinion.
My new morning and evening oral care routine
Post-treatment I was given an aftercare regime – a separate am and pm toothpaste – the MASHA Rose Quartz toothpaste, £65, for morning (yes it does contain gemstones) and Resinous Amber toothpaste, £65 for night. Both work in conjunction to maintain enamel integrity and manage the oral biofilm in order to reduce bacteria and calm inflammation. Dr Masha also advised using a tongue scraper every morning and an interdental stick (both of mine are from The Humble Co) to boost results.
I feel like my smile ‘looks’ younger, if that’s even a thing, and my mouth hasn’t been as dry since the treatment. I’ve also incorporated a few other extras into my oral routine. Before using the MASHA products I was trialling the latest innovation from Oral-B – the Pro-3D White Clinical Intensive Whitening Radiant White Toothpaste, £20 that creates a whiter appearance in just one day – it’s good for a quick fix but doesn’t have the longevity, and every night I now use SENSEE Perfect Smile Duo, £119.99 as a top-up.
Essentially recreating the LED section of my in-clinic treatment, it combines blue, red, deep red and near-infrared lights in one device that you wear for just five minutes. With three modes – lips only/teeth only/both, it has been designed to whiten the enamel, freshen breath, reduce sensitivity and smooth fine lines around the lips. I often struggle to commit to devices but five minutes sitting in bed while I set my alarm and do some life admin makes it easy to slot in.
The future of dentistry: from AI to personalised oral care
Besides LED devices and crystal infused toothpaste, the world of oral care is evolving, especially as we lean into longevity, personalisation and preventative methods. At Nejati Clinic they offer saliva testing which analyses your saliva microbiome to understand your oral environment and create a programme around that, as well as offering 3D scanning. “Digital scanning means we can create a 3D baseline of somebody’s mouth and compare it over time and I think we’ll see much more of this combined with salivatory diagnostics, microbiome analysis, biomarkers and AI-assisted monitoring,” explains Dr Brendon Nejati. “It means you can establish your baseline in your 40s and then monitor how your mouth changes at 45, 50, 60 and beyond.”
At-home devices are leaning into AI technology too. “Cameras, AI-assisted imaging and longitudinal tracking could let dentists compare what’s happening between appointments rather than relying on one examination every 12 months,” says Dr Deepak Aulak. “We need to shift dentistry from repairing damage to identifying risk earlier and giving dentists more opportunity to spot changes.”
I won’t mention the infamous Dyson toothbrush, but Toothfairy has recently launched the ‘Wand’ (£95) that works in synergy with its app. A sonic toothbrush that has a small camera clipped onto the handle, it scans your teeth and gums as you brush. The app sends the images to a registered Toothfairy™ dentist who reviews the images and reports back on areas you're missing when brushing and any ‘watch out’ signs. You can both then track your gum health over the upcoming months.
Why Your Dentist Needs to Know You're in Perimenopause
Since taking a deeper dive into the dentistry world, it’s evident we’re on the cusp of exciting new tools and procedures designed to help navigate perimenopausal mouth, and like me, don’t be afraid to flag it, either. “My biggest piece of advice is to tell your dentist if you’re going through perimenopause, It’s not something women necessarily think to mention at a dental appointment but it’s useful information for us to have,” says Dr Rhona. “Changes are happening elsewhere in the body and oral health needs to be part of the conversation rather than waiting until women develop significant gum disease or tooth decay before taking their symptoms seriously.”
