When caring for patients who are going through the menopause, it is important to look out for the associated oral health symptoms, and help your patients manage them. One of these is temporomandibular disorder (TMD). Women are estimated to be around three times more likely to develop a TMD than men.[i] And, this becomes even more likely during periods of hormone imbalance.
It is important that dental professionals can spot the signs of menopause. You should help patients manage the effects on oral health, and support and refer patients should they require any additional advice and care.
Not only can the menopause cause mood swings, hot flushes, and night sweats, which it is commonly known for, but it can also trigger oral health issues.[ii]
Hormonal changes occur around the time of menopause. These changes can make the teeth and gums more susceptible to infections. Patients might experience poor periodontal health, dry mouth and burning mouth, all of which can increase the likelihood of developing disease.[iii] Because of this, patients going through the menopause are likely to require additional support when managing their oral health. It is important that clinicians look out for the signs of gingivitis and caries at this time.
Many people across the country experience TMD.[iv] The relatively common condition causes pain when moving the jaw joint. In more severe cases, it can lock the jaw, preventing it from opening. This can cause patients problems when eating, speaking, and cleaning their teeth, and can be caused or made worse by the menopause.
Research suggests that hormonal changes at any time in life, be it during menopause, menstruation, or pregnancy, could have an impact on the severity of jaw pain. This is due to the hormonal changes which occur. For instance, during pregnancy, pain may be less intense due to higher levels of oestrogen.[v] However, some research suggests that increased levels of oestrogen stimulate some types of TMD, while low levels may cause others.[vi]
Late menopause seems to be the most likely time jaw pain is experienced, with intensity subsiding once hormone levels balance out.[vii]
It is important that patients maintain excellent oral hygiene during this time, to help avoid infection caused by symptoms of the menopause. Make sure that patients understand how to carry out proper oral hygiene routines. This should include interdental cleaning, to help protect their teeth and gums, as well as frequent dental check-ups.
There are a number of exercises and relaxation techniques which patients may find useful for treating TMD. One of these is the use of a passive motion device. For patients with severe TMD, who are struggling to open their mouths properly, it is particularly helpful. The exercise helps to stretch the muscles in the face and jaw and strengthen the jaw joint. After repeated practise, patients will increase their range of motion, and reduce pain felt in the jaw.
The OraStretch Press Rehab System, available from Total TMJ, is a handheld device which uses passive motion. It helps to stretch and strengthen the patient’s jaw. It works by opening the joint and stretching the muscles and facial tissues. This improves the patient’s range of motion and flexibility. The OraStretch Press is an excellent solution for your TMD patients. When used as recommended, exercises using the device can increase range of motion by 1-2 mm per week.[viii]
When treating your patients who are going through the menopause, help them manage all of their oral health related symptoms and provide helpful advice. And, if patients need additional help, refer them to the appropriate professional for extra care and support. TMD can be challenging to overcome by itself, but when other oral health issues are occurring at the same time, this can be overwhelming. Support your patients as much as possible and ensure they are able to get the help they need.
[i] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192637/#:~:text=Fluctuating%20levels%20of%20estrogen%20during,and%20increases%20alveolar%20bone%20loss
[ii] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3793432/#:~:text=The%20teeth%20and%20gums%20are,bacteria%20within%20the%20oral%20environment.
[iii] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3793432/#:~:text=The%20teeth%20and%20gums%20are,bacteria%20within%20the%20oral%20environment.
[iv] https://cks.nice.org.uk/topics/temporomandibular-disorders-tmds/background-information/prevalence/
[v] https://www.everydayhealth.com/menopause/study-finds-jaw-pain-may-worsen-during-menopause/
[vi] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192637/#:~:text=Fluctuating%20levels%20of%20estrogen%20during,and%20increases%20alveolar%20bone%20loss
[vii] https://www.everydayhealth.com/menopause/study-finds-jaw-pain-may-worsen-during-menopause/
[viii] https://www.craniorehab.com/orastretch-press-jaw-motion-rehab.html