The overlooked connection between menopause, sleep and oral health.
At the start of the 20th century, the average woman’s life expectancy was 49. Today, women can expect to live well into their 80s, meaning over a third of their lives may extend beyond the menopausal transition. Despite this, menopause remains shrouded in stigma and under-researched.
For dental practitioners, understanding the link between perimenopause, sleep disruption, and oral health is vital. Poor sleep not only affects general wellbeing, but also has measurable effects on gum health, plaque build-up, and periodontal disease risk.
Perimenopause and sleep disruption
Perimenopause typically begins between the ages of 40–50 but can start earlier. It is characterised by fluctuating hormone levels, particularly reduced oestrogen. Symptoms include:
- Fatigue and depression
- Vasomotor changes (hot flushes, night sweats)
- Mood swings
- Reduced libido
- Sleep problems (reported in up to 60% of postmenopausal women)
One key driver is the imbalance between oestrogen and cortisol: low oestrogen leads to higher cortisol, elevating stress levels and preventing restful sleep.
Sleep deprivation in turn impacts systemic and oral health, increasing gingival inflammation, reducing immune function, and raising the risk of periodontitis.
Oral health challenges during menopause
Menopausal women often experience xerostomia (dry mouth) due to reduced salivary gland flow, alongside changes in saliva composition such as elevated calcium levels that accelerate plaque mineralisation. These changes increase:
- Plaque accumulation and gingivitis
- Caries risk
- Irritation of gingival tissues
- Periodontal disease progression
Sleep disturbances worsen these outcomes, with research linking inadequate sleep to both higher rates of periodontitis and tooth loss.
Practical guidance for HCPs
Dental professionals can play a key role in supporting patients through this transition. Recommendations include:
- Lifestyle guidance: Encourage balanced diets (milk, fish, fruit, vegetables) and regular exercise to reduce cortisol and improve sleep quality.
- Gentle plaque removal routines: Advise twice-daily brushing with a soft brush and adjunctive interdental cleaning.
- Adjunctive tools: For patients struggling with plaque removal or gingivitis, recommend Waterpik™ water flossers as an easy-to-use solution.
Why recommend Waterpik?
Waterpik™ provides a patient-friendly option that supports plaque control and gum health, even when energy levels and motivation are low:
- Removes up to 99.9% of plaque bacteria from treated areas in just 3 seconds (in vitro).
- Clinically proven to be 50% more effective than string floss at improving gum health.
- Cordless Advanced model offers three adjustable pressure settings - gentle enough for sensitive gingivae.
By recommending Waterpik™, HCPs can help perimenopausal and menopausal women maintain gum health, reduce plaque accumulation, and sleep easier knowing their oral health is protected.
Conclusion
The menopause transition is a time of immense physical and emotional change. Sleep disruption, hormonal imbalance, and oral health complications are interconnected and can significantly impact quality of life. By understanding these links and recommending evidence-based tools such as Waterpik™, dental professionals can make a meaningful difference in supporting women’s health at this critical stage.
About the Author
Annastasia Kellett Wright qualified as a Dental Hygienist and Dental Therapist from the University of Sheffield in 2013 and currently practises her full scope of practice with paediatric and adult patients in London. Annastasia has been a professional educator for Waterpik™ since 2016 and is actively involved with the British Society of Dental Hygiene and Therapists, acting as the trade liaison for their London regional group since 2015.