Oral Health›Life stages

Menopause and Your Mouth

Around menopause, some people notice a dry mouth, a burning feeling, sore gums or sensitive teeth, and bone loss becomes more likely. Here is what helps, what to tell your dentist, and what osteoporosis medicines mean for dental treatment.

Updated September 2026·By the OHA editorial team·7 min read·How we write
Key takeaways
  • The NHS lists sensitive teeth, painful gums and other mouth problems among the symptoms of perimenopause and menopause.
  • Lower oestrogen can reduce saliva. A dry mouth raises the risk of tooth decay, so sip water, use fluoride toothpaste and tell your dentist.
  • Burning mouth syndrome is more common in women after menopause. See your dentist first, who can check for other causes.
  • Bone loss speeds up after menopause. Osteoporosis medicines such as bisphosphonates very rarely affect the jawbone, so tell your dentist you take them and keep up regular check-ups.
  • Do not stop an osteoporosis medicine because of dental worries without speaking to your doctor.

Menopause is when you have not had a period for 12 months, and perimenopause is the time leading up to it. The NHS lists "sensitive teeth, painful gums or other mouth problems" among possible symptoms, alongside weakening bones. The American Dental Association describes menopause as a big change for the mouth, including altered taste, burning sensations and increased sensitivity, and says the two changes most worth knowing about are dry mouth and bone loss.

Dry mouth

Saliva rinses food and bacteria off your teeth, so when there is less of it, the risk of tooth decay goes up (American Dental Association). The Better Health Channel lists hormone changes from menopause among the causes of a dry mouth, and the US Office on Women's Health says lower oestrogen after menopause reduces the amount of saliva. It says a dry mouth can lead to sore and sensitive gums, ulcers, infections and tooth decay.

The NHS lists many other causes of a dry mouth, including medicines, not drinking enough and anxiety, so it is worth getting checked rather than assuming it is the menopause. Our dry mouth article covers these in detail.

What helps

  • Sip water regularly, and keep some by your bed at night (NHS). The American Dental Association also suggests sucking ice chips or sugar-free sweets and choosing caffeine-free drinks.
  • Chew sugar-free gum to get saliva flowing (NHS, Better Health Channel).
  • Cut down on alcohol, caffeine and smoking, which the American Dental Association says can make a dry mouth worse. The NHS also suggests avoiding acidic, spicy, salty or sugary foods.
  • Brush twice a day with fluoride toothpaste, clean between your teeth, and use an alcohol-free mouthwash (NHS, Better Health Channel).
  • Ask about stronger fluoride. The American Dental Association says your dentist may recommend a prescription-strength fluoride toothpaste, and the Better Health Channel says to ask your dentist which high-fluoride or dry mouth products suit you.
  • Do not stop a prescribed medicine without medical advice, even if you think it is drying your mouth (NHS, Better Health Channel).

Burning mouth

Burning mouth syndrome is a burning, scalding or tingling feeling in the mouth, often on the tongue, lips or roof of the mouth, that can last for months or years even though the mouth looks healthy. The US National Institute of Dental and Craniofacial Research (NIDCR) says it is more common in women, especially after menopause, and the Oral Health Foundation says it is more common in menopausal women.

Sources differ on the role of menopause itself. The American Dental Association says burning sensations and other mouth changes around menopause are related to hormones, and the Oral Health Foundation lists hormonal changes as one possible cause. The NIDCR says experts believe the syndrome is caused by damage to the nerves that control pain and taste, and the US Office on Women's Health says researchers are not sure whether the pain is related to menopause.

What they agree on is that a burning mouth should be checked, because it can have other causes that can be treated, including a dry mouth, oral thrush, acid reflux, low iron or vitamin B levels, diabetes, thyroid problems and some medicines (NIDCR, Oral Health Foundation). Both advise seeing your dentist first, who may refer you to your doctor or a specialist.

To ease symptoms, the NIDCR and the Oral Health Foundation suggest sipping cold water, sucking ice and chewing sugar-free gum, and avoiding tobacco, alcohol, alcohol-based mouthwash, and hot, spicy or acidic foods.

Gums, bone and your teeth

The Better Health Channel says the fall in oestrogen at menopause speeds up bone loss, and that in the first five years after menopause the average woman loses up to 10% of her total body bone mass. The US Office on Women's Health says gum problems and bone loss may happen more quickly after menopause, that gum disease can progress faster when bones are weakened by osteoporosis, and that losing bone in the jaw can lead to tooth loss.

The American Dental Association says receding gums (gums pulling back from the teeth) can be a sign of bone loss in the jaw. Exposed roots are more at risk of decay, and a dry mouth adds to that risk. See receding gums and gum disease.

To help protect your bones, the American Dental Association suggests working with your doctor or dentist to get enough calcium and vitamin D, not smoking and avoiding drinking too much alcohol.

Osteoporosis medicines and dental treatment

Bisphosphonates (such as alendronic acid, ibandronic acid, risedronate and zoledronic acid) and denosumab are medicines that slow down the breakdown of bone (NHS). Both are rarely linked to osteonecrosis of the jaw (NHS, American Dental Association): the NHS explains that cells in the jawbone die, which can lead to problems with healing.

How likely is it?

  • The NHS says it is a rare side effect, seen most often with high-dose bisphosphonates given into a vein for cancer, not for osteoporosis. healthdirect says it happens very rarely.
  • The American Dental Association says the risk is low for people taking these medicines for osteoporosis, and that the benefit of preventing fractures outweighs it. It says the risk is higher with cancer doses, with use for more than 2 years, and in people with gum disease (periodontitis) or dentures, and that it usually follows a tooth extraction or other surgery but can happen without any dental treatment.

What to do

  • Before you start, the NHS says to check with your doctor or pharmacist if you have problems with your teeth, are waiting for dental treatment such as an extraction, or smoke. You may need a dental check-up first.
  • While you take it, the NHS advises keeping your teeth clean and having a check-up every 6 months. healthdirect says to keep up regular dental check-ups and cleaning, and the American Dental Association says good oral hygiene and regular dental care may be the best way to lower the risk.
  • Tell your dentist you are taking the medicine. The NHS says that with an extraction or dental implants there is a very small chance of jawbone damage, and your dentist may suggest a different treatment. Australia's medicines regulator, the TGA, gives the same advice.
  • Do not stop the medicine yourself. The NHS says to speak to a doctor first, because stopping makes a broken bone more likely. The American Dental Association says stopping may not remove the jaw risk and can harm your bone treatment.

In a 2007 safety advisory, the TGA listed symptoms to report, such as toothache, pain, swelling or numbness in the jaw, or discharge around a dental implant.

When to see a dentist
  • Your mouth feels dry most of the time, or dryness has not improved after a few weeks of home or pharmacy remedies (the NHS says to see a GP).
  • You have a burning, scalding or tingling feeling in your mouth.
  • Your gums are sore, bleeding or seem to be receding, or your teeth have become sensitive.
  • You are about to start, or already take, an osteoporosis medicine and have not had a recent check-up.
Get help urgently
  • If you take alendronic acid and get a loose tooth, mouth sores, or swelling or pain in your mouth or jaw, the NHS says to call a doctor or NHS 111 straight away and contact your dentist, as this could be a sign of jawbone damage.
  • Swelling of the face or jaw, a high temperature, or intense tooth or gum pain may be a dental abscess, which the NHS says needs an urgent dental appointment or a call to NHS 111 (or your local equivalent).
  • Call 999 (or your local emergency number) if you are finding it hard to breathe, speak or swallow, or have a lot of swelling in your mouth.

Frequently asked questions

Is burning mouth syndrome caused by menopause?

It is more common in women after menopause (NIDCR), but the cause is not fully understood. The NIDCR points to nerve damage, and the US Office on Women's Health says researchers are not sure it is linked to menopause. See your dentist to rule out other causes.

Can I have a tooth out if I take a bisphosphonate?

Talk to your dentist first. The NHS says there is a very small chance of jawbone damage after an extraction or implant, and your dentist may suggest another option. The American Dental Association's guidance says routine dental treatment should not be changed solely because someone takes these medicines for osteoporosis. Keep taking your medicine unless your doctor advises otherwise.

Does HRT affect my teeth?

The sources we used do not give specific advice on hormone replacement therapy and the mouth. Tell your dentist about all the medicines you take, including HRT.

Sources

  1. Symptoms of menopause and perimenopause, NHS, accessed September 2026
  2. Dry mouth, NHS, accessed September 2026
  3. Osteoporosis: treatment, NHS, accessed September 2026
  4. Who can and cannot take alendronic acid, NHS, accessed September 2026
  5. Side effects of alendronic acid, NHS, accessed September 2026
  6. Common questions about alendronic acid, NHS, accessed September 2026
  7. Dental abscess, NHS, accessed September 2026
  8. Burning mouth syndrome, Oral Health Foundation, accessed September 2026
  9. Dry mouth, Better Health Channel (Victoria), accessed September 2026
  10. Osteoporosis, Better Health Channel (Victoria), accessed September 2026
  11. Osteoporosis medicines, healthdirect Australia, accessed September 2026
  12. Bisphosphonate drugs and osteonecrosis of the jaw (ONJ), Therapeutic Goods Administration (Australia), accessed September 2026
  13. Burning mouth syndrome, National Institute of Dental and Craniofacial Research, accessed September 2026
  14. Hormones and dental health: what every woman needs to know, American Dental Association (MouthHealthy), accessed September 2026
  15. Osteoporosis medications and medication-related osteonecrosis of the jaw, American Dental Association, accessed September 2026
  16. Oral health, US Office on Women's Health, accessed September 2026

This article is general information about oral health. It is not a diagnosis or a substitute for advice from a dentist or doctor who knows your situation. If you have pain, swelling, bleeding that does not settle, or a problem that is getting worse, see a dental professional. In an emergency, contact your local emergency service.

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