I’d like to try something different—inspired by my friend Cory Rodriguez’s health newsletter, I’ll share one Q&A at the beginning of each newsletter—scroll to the bottom for the answer!
Q: What’s one change in your mouth that can warn of sleep apnea before you ever snore?
In the last newsletter, we looked at how declining estrogen changes your gums, saliva, and airway. We talked about saliva decline, airway changes, and the inflammation that can ripple through your mouth, brain, heart, and bones.
Today’s follow-up is a distilled list of the advice I’ve repeated to perimenopausal patients for years—each item connects directly to those changes and is something I’ve personally vetted, used, or recommended. You don’t need them all to see results—even one change can help your mouth and your whole body now.
22 must-haves to protect your mouth in perimenopause:
- Oral probiotics (S. salivarius K12 & M18 – like this one)
I recommend these because they restore balance to your oral microbiome, which may help protect gums, throat, and airway from the inflammatory bacteria that can take over during estrogen decline. - Stainless steel tongue scraper
Two quick scrapes each morning can keep your breath fresh and reduce odor-causing bacteria without harming the good bacteria your mouth needs. (Hopefully you’ve ditched the mouthwash by now, which nukes your body’s ability to produce nitric oxide.) - Sonicare electric toothbrush with pressure sensor
A pressure sensor trains you to clean thoroughly without damaging gums or enamel, which are more vulnerable now. - Pentadecanoic acid (this one)
Supports cell membrane health, reduces inflammation, and helps with metabolic and cardiovascular resilience—all important as estrogen drops. The science is newer and less extensive than for some other supplements here, but it’s compelling enough that I take it myself. I see it as an “emerging evidence” tool that may offer extra support for gum tissue repair, bone health, and recovery from daily stressors. - High-quality water filter (removes fluoride & heavy metals)
Cuts down hormone-disrupting contaminants, protecting both your mouth and hormone balance. - Glass water bottle (BPA-free)
Prevents estrogen-mimicking chemicals from plastics from getting into your system. - High-quality magnesium (this one)
Magnesium helps your body use vitamin D effectively, supports bone and gum health, and protects saliva flow. Many women in menopause are low in magnesium without realizing it. - Vitamin K2 + D3 combo
Estrogen helps maintain calcium in bones (including the jawbone), and its decline during perimenopause can reduce that efficiency. This combination helps direct calcium to where you need it most—strengthening teeth, jawbone, and skeletal bone—and away from soft tissues like arteries, where it can cause harm. - Electrolyte powder (this one)
Replenishes essential minerals in your saliva, helping it stay at the right pH to buffer acids and protect your teeth from erosion and decay—especially important since dry mouth is such a persistent issue in perimenopause. - Collagen peptides (grass-fed)
Supports the connective tissue in your gums and the ligaments holding your teeth. Growing evidence and a strong biological rationale suggest they may help keep these structures resilient during perimenopause (though there’s not as much research as we have for vitamin D3 and K2 and magnesium—but enough that it’s certainly worth mentioning.) - Red/near-infrared light therapy device (this one)
Stimulates repair in gums and bone, helping offset slower healing when estrogen is low. - CO₂ monitor (this one)
Lets you see if poor air quality could be making airway collapse and dry mouth worse overnight. - Nasal breathing support (nasal dilator or mouth tape)
Helps you maintain nasal breathing at night to protect saliva flow and airway health. - Oura Ring/sleep tracker
Shows early signs of breathing or sleep disruption so you can address them before they impact your oral health. - CBCT scan baseline (only if you have root canals, implants, airway issues, or unexplained symptoms)
Gives a detailed 3D view to catch bone loss or infection early. - Home saliva pH strips
Helps you monitor acidity so you can make changes before damage starts. - Bone density scan (DEXA)
Checks for bone loss in your jaw and the rest of your body. - Mandibular advancement device
Keeps your airway open at night to protect your heart, sleep, and mouth. - Turmeric
Estrogen helps regulate inflammation, and when levels drop in perimenopause, your body can shift toward a more pro-inflammatory state. Turmeric offers natural anti-inflammatory support that may help keep gums, bones, and overall health protected during this transition. One simple way I like to incorporate it is by adding a teaspoon of turmeric powder to soups or stews—the gentle heat and healthy fats help your body absorb it better. - Digestive enzymes (these ones)
My wife and I both take these because we work hard to eat healthy and want to absorb every bit of the nutrients we’re putting in. The ability to break down and absorb nutrients declines with age—in women during perimenopause and in men too. These enzymes help you get more out of the food you eat, so your teeth and gums receive the minerals they need to stay strong. - Microbiome-friendly toothpaste with nano-hydroxyapatite (this one)
Replenishes minerals in your enamel and supports gum health without disrupting the microbiome. - An enlightened MD for HRT
Find a provider who understands how hormone therapy affects your oral health, bone density, airway, and sleep. Ideally, your menopause doctor is someone who is also collaborating with your functional dentist!
ANSWER: Scalloped tongue edges—those little waves or indentations along the sides of your tongue—can be one of the earliest signs your airway is narrowing at night. Even if you’re not snoring yet, it’s worth getting checked. This can be an early clue to sleep-disordered breathing, which, if ignored, can quietly affect your heart, brain, and overall health.
If you’ve made it this far—wow. Thanks for being here. I’d love to know how else I can help you in your health journey. It’s a privilege to be able to write these newsletters, and I don’t take your time and attention for granted. Please reply with your questions or topics you’d like covered—and consider sharing this newsletter with someone else who’d benefit.
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