Oral Health Across the Menopausal Transition: Biological Pathways, Clinical Implications, and Future Perspectives

Area of Science:

• Oral Health
• Endocrinology
• Periodontology

Background:

• Menopause involves estrogen deficiency, affecting systemic tissues including the oral cavity.
• Hormonal changes during menopause are linked to periodontal health, salivary function, and oral quality of life.

Purpose of the Study:

• To review biological mechanisms and clinical signs of menopause's impact on oral health.
• To focus on periodontal outcomes, salivary changes, oral discomfort, dental status, and hormone replacement therapy (HRT).

Main Methods:

• Narrative review of studies from PubMed/MEDLINE and Scopus (2005-2026).
• Inclusion of relevant human studies based on predefined criteria.
• Synthesis of evidence categorized by oral health domains and menopausal phenotypes.

Main Results:

• Fifty studies indicated menopause is associated with worse periodontal parameters (e.g., increased probing depth, attachment loss).
• Reduced salivary flow, dry mouth, altered saliva composition, burning sensations, and taste disturbances are common.
• Estrogen deficiency influences oral health via immune regulation, bone metabolism, salivary function, and host-microbiome interactions. HRT effects are mixed but may improve salivary function and periodontal health.

Conclusions:

• Menopause acts as a systemic modifier of oral health through multifactorial biological mechanisms.
• Oral manifestations of menopause reflect interactions between hormones, inflammation, bone metabolism, and microbial ecology.
• Multidisciplinary approaches and increased professional awareness are crucial for managing oral health in postmenopausal women.