Blame the hormones: Here's why older women suffer more oral issues than men

Some of the main issues which affect menopausal and post-menopausal women and which about 60 per cent of women get, include dry mouth and burning mouth, gum issues and complications of osteoporosis and its medications.

The signs of dry mouth are oral dryness and burning, difficulty articulating words and swallowing/eating dry foods like crackers and crisps. It's normally related to medications such as antidepressants, antihistamines and blood pressure drugs.

Dry mouth can increase the risk of oral infections such as thrush as well as lead to an increased risk of tooth decay, as saliva helps to protect the teeth.

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The condition can be alleviated by frequent sips of water, using over-the-counter dry mouth products and oral lubricant sprays and gels, as well as chewing sugar-free gum to stimulate saliva and avoiding or limiting caffeine intake. There are also specialized dry mouth toothpaste and mouth rinses.

This condition mainly affects women in their forties and fifties. It causes oral discomfort and a burning sensation affecting the inside of the cheeks, tongue, gums, lips, palate and sometimes the throat.

The causes of burning mouth syndrome are not known, though there seems to be a link between symptom severity and hormonal changes during menopause, or possibly triggered by anxiety/depression.

Dentists recommend that haematinic (iron, vitamin B12, folate) deficiencies as a cause should be excluded via blood tests. Sometimes the condition resolves itself without medical intervention and in other cases it can become chronic, and ongoing medication is needed.

Hormonal changes increase the likelihood of developing gum disease, known as gingivitis or in its more severe form, periodontitis. Symptoms include gum bleeding when brushing, redness, puffiness or gums shrinking away from the teeth in places), bad breath or loose teeth.

It's typically managed by oral hygiene including flossing, brushing the teeth for two minutes twice a day and regular dental visits. There are conflicting results regarding the effect HRT has on gum disease - in some women there are improvements and in others, no change.

Women in this age group commonly develop osteoporosis or brittle or porous bones and may be prescribed specific medication. Some of these medications have been implicated in medication-related osteonecrosis of the jaws or MRONJ, with pain in affected areas, gum swelling and pus. In severe cases patients are at risk of jawbone fracture.

MRONJ is a complication that may occur after an oral surgical procedure such as tooth extraction or implant placement, although it can occur after trauma to the oral tissues, or even spontaneously. Usually it presents with an area of exposed, non-healing jawbone, which may become infected.

The key is prevention - comprehensive dental assessment before starting medication for osteoporosis, meticulous oral hygiene and regular dental visits.

Dental Health Week runs from August 5-11.