Receding gums and the menopause

Discover the reasons behind gum changes and how to protect yours

In a survey of more than 1,000 women who had experienced menopausal symptoms, 83% said they did not realise that menopause can increase the risk of receding gumlines [1]. Yet this symptom is not uncommon – the same survey found that one in three of the respondents had noticed their gumline receding.

Dentist Dr Shabnam Zai says: ‘As we get older, everyone’s gums recede, that is where the saying “long in the tooth” comes from. It is a sign of wisdom. It is much more common in patients who have naturally thin gums.’

When bacteria in plaque and tartar build up and irritate the gums, this can cause gum disease, known as gingivitis. Left untreated, your inflamed and sensitive gums, which might also bleed, can lead to gum recession, known as gingival recession.

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Your hormones can have a big influence on your dental health as oestrogen and progesterone alter the blood flow to your gums and regulate gum inflammation. When your level of oestrogen decreases, your risk of gum disease is higher.

What else causes receding gums?

There are numerous factors that can cause receding gums. Genetics can play a part – you may have been born with more sensitive, thin gums that will be prone to recession.  A cross sectional review of a studies into gingival recession found trauma, malpositioned teeth (for instance, teeth that are overcrowded or stick out), inflammation and smoking correlate with receding gums [2]

The surveys they reviewed found that age was also a factor – 88% of people 65 years of age and older had one or more sites of recession, compared to 50% of people 18 to 64 years of age.

It is also something that can occur during orthodontic treatment.

‘Brushing too aggressively and poor teeth brushing technique can also lead to recession, as can smoking,’ says Dr Shabnam.

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How can I treat it?

It’s important to identify the cause of your receding gums and consider treatment as once the root of the tooth is more exposed, it is more prone to sensitivity and decay.

You should also be aware that the prevalence of moderate and major gum recession has been discovered to be higher in postmenopausal women who have osteoporosis [3].

‘Once the gum has gone, it does not grow back, so preventing recession in the first place is always best,’ says Dr Shabnam. ‘Once your dentist has helped to determine the cause of your receding gums, they may suggest improving your brushing technique, using sensitive toothpaste to help desensitise the exposed root, or increasing fluoride to help strengthen the tooth and prevent cavities.

‘If you have a tooth in an overcrowded position and sticking out, sometimes aligning it can put the tooth in a better position and lower the risk of further recession. Normally the gum is not treated unless it is causing an aesthetic issue when smiling. In these cases, once the gum is healthy and the cause has been removed, you can consider a gum graft. This is usually provided by a periodontist (gum specialist), who harvests gum from your palate and places it over the recession.’

Lifestyle tweaks you can make include switching to an electric toothbrush. They have inbuilt pressure sensors to stop you from brushing to aggressively, plus you can buy “sensitive” heads that are much gentler on the gum.

It may also be worth considering hormone replacement therapy. A study that looked at women over the age of 50 who were being treated with oestrogen for osteoporosis found that they were 44% less likely to have severe periodontitis than women who were not taking oestrogen [4].

Resources

Dentist Dr Shabnam Zai is clinical director at West House Dental, westhousedental.com Follow her on Instagram @drshabnamzai

References

1. Delta Dental’s 2023 Senior Oral Health and Menopause Report: Breaking the Stigma

2. MOAWIA M. KASSAB, ROBERT E. COHEN. (2003) ‘The etiology and prevalence of gingival recession’, The Journal of the American Dental Association, Volume 134, Issue 2, pp220-225, doi.org/10.14219/jad,a.archive.2003.0137.

3. Duncea I, Pop D, Georgescu C. (2013), ‘Gingival recession in postmenopausal women with and without osteoporosis’, Clujul Med. 86(1):69-73. Epub 2013 Feb 4. PMID: 26527920; PMCID: PMC4462483.

4. Passos-Soares J, Vianna M, Gomes-Filho I, Cruz S, Barreto M, Adan L, Rösing C, Trindade S, Cerqueira E, Scannapieco F. (2017), ‘Association between osteoporosis treatment and severe periodontitis in postmenopausal women’, Menopause, 24(7):p 789-795. doi: 10.1097/GME.0000000000000830