Oral Health & Inflammation in Women Over 35
Is Dental Health Overlooked In Women Over 35?
The short answer is yes.
Unfortunately women and healthcare workers alike do not prioritize oral health.
Many women regard this as something that can be ignored.
Physicians are not proactive in addressing its importance.
I’m a board certified obgyn and certified menopause practitioner, quite literally an expert, and I'd never formally learned about oral health in women.
So, why is oral health important particularly for the midlife woman?
Oral Health, Heart Disease, and Metabolic Health
I went to my dentist last year and had some inflammation that required a deep clean. They tested my oral microbiome to look for dangerous bacteria. As she showed me the results, she pointed to one and said, “this bacteria can cause heart attacks but your level for that one is fine."
Oral bacteria causing heart attacks? I'd never heard of such a thing.
She was referring to the "Red Complex” bacteria, three strains of bacteria primarily responsible for periodontitis.
There's increasing (though incomplete) evidence that the Red Complex leads to atherosclerosis, the hardening of blood vessels linked to cardiovascular disease. In particular, P. gingivalis (Pg) is linked to platelet accumulation and foam cells, steps in blood vessel plaque formation.
P. gingivalis has also been associated with:
Alzheimer's disease
Diabetes mellitus
Rheumatoid arthritis
I'm glad I didn't have an elevated Red Complex. But I did have some abnormalities. Why should that matter?
Oral Health as Preventive Medicine for Midlife Women
There are more than 800 species living in our mouths, including bacteria and fungi. When dental plaque builds up, “bad” bacteria can proliferate. The underlying inflammation also allows bad bacteria to thrive.
Poor oral health in general is associated with high blood pressure, likely because of oral inflammation.
If there's anything that's underpinning many disease processes of our time, it's inflammation.
These inflammatory substances and pathogenic bacteria can gain access to the blood stream and from that, anywhere in the body.
Gum Disease, Hormones, and Chronic Disease Risk
Chronic diseases already skyrocket for women after menopause owing to unique changes that happen to women.
Gingivitis is reversible inflammation in the mouth, the response to plaque build-up.
Periodonitis is when this inflammation spreads to the teeth and its surrounding tissues including bone and ligament. It's a chronic inflammatory disease.
Women who take hormone therapy have been found to have less:
Gingival inflammation
Plaque scores
Loss of attachment
Is it because these women are routine about taking their hormone therapy or routinely performing dental hygiene? Hard to say.
The relationship between oral health and chronic disease is a two-way street. One increases the risk of the other and vice versa.
How Menopause Impacts the Oral Microbiome
As usual, we pin this on declining estrogen. Estrogen has an anti-inflammatory effect. Once it significantly declines in menopause, underlying inflammation can come to light or start from scratch.
In a similar way to menopause leading to osteoporosis, the bones of our mouth can be affected. Osteoporosis is actually a risk factor in itself for periodontal disease.
Declining estrogen leads to:
Increased inflammatory cascade
Decreased collagen
Bone resorption
Daily Oral Habits That Protect Whole-Body Health
Don't worry, the beauty is that we have a lot of agency over this.
I had a deep cleaning by my dentist, the rest was up to me with habits like:
Regular visits and cleanings at the dentist
Brushing teeth twice per day (I use this toothpaste. If you’re ever in a pinch and need a DIY toothpaste just mix coconut oil and baking soda. It won't taste great but gets the job done.)
Manual flossing (I use this silk floss to avoid toxic PFAS, flavors and dyes)
Mechanical flossing (I use this Waterpik, like a power wash for teeth and gums)
Oral probiotic (I use this as suggested by my dentist)
Avoiding mouth breathing
Avoiding inflammatory substances: processed foods, tobacco, alcohol
I was already doing most of that. With the addition of the probiotic and Waterpik, my microbiome levels were normal when they were rechecked.
If you want a light, comical read about oral and gut health, try this book: Gut. It helped me appreciate our gut health from beginning to end in a lighthearted way.
Gut health, starting with oral health, is not something to be overlooked especially for midlife women.
Oral health is just one piece of the inflammation puzzle for women over 35—especially during perimenopause and menopause.
If you’re looking for a comprehensive, evidence-based approach to hormone health, inflammation, and disease prevention, I offer telehealth care focused on midlife women.
Resources:
Some of the information contained in this article is the result of my training, medical knowledge, and personal experience without a specific source to be cited.
The author can earn commissions through affiliate links.
Disclaimer: This is not medical advice. This is for educational purposes only. Discuss with your doctor.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12336276/
https://www.ccjm.org/content/ccjom/76/8/467.full.pdf
https://pmc.ncbi.nlm.nih.gov/articles/PMC12336276/
https://pmc.ncbi.nlm.nih.gov/articles/PMC11869639/
https://pmc.ncbi.nlm.nih.gov/articles/PMC10262359/