"Being more open will help make treatment plans more accessible for all people who experience menopause," Sarah Chavarria, president and incoming CEO, Delta Dental says.
As payers operationalize responses to social drivers of health (SDOH)—such as food, housing and income insecurity—there are factors that precede and span these challenges: gender and age.
Ignoring these factors can impact outcomes, including for oral health. A first-of-its-kind study from Delta Dental revealed that 84% of women aged 50 and over are not aware that menopause, oral health, and dental discomfort are connected.
Breaking the stigma
These and other surprising results are included in the dental plan's 2023 Senior Oral Health and Menopause Report: Breaking the Stigma. Delta Dental commissioned Atomik Research to conduct the July 2023 survey and to perform analysis in partnership with The Bliss Group.
In its press release for the study, Delta Dental describes how this lesser-known connection makes dentists "a prime, untapped resource for women navigating it." The release adds that while 70% of women 50 and older have experienced at least one oral health symptom since their menopause symptoms began, few have raised the topic with their dental providers: only 2% with their dentists and only 1% with their dental hygienists.
"With menopause a long-stigmatized topic and symptoms going largely unaddressed or even ignored, these findings are stark but unsurprising," says Sarah Chavarria, president at Delta Dental and its incoming CEO, effective January 2024. "Despite the knowledge gaps revealed in this survey, sentiments about menopause are beginning to shift, and women are eager to break the stigma."
Startling results: Oral health and menopause
The Delta Dental study highlights other "missed connections between menopause and oral health."
Of the 1,000+ women surveyed, 70% have experienced increased oral health symptoms during menopause, including dry mouth (39%) or reduced saliva production (13%), receding (30%) or bleeding gums (16%), tooth sensitivity or pain (28%), decay (20%), and other symptoms.
Most women didn't associate these with hormone shifts, however. Lack of awareness included:
- 90% for reduced saliva production
- 88% for increased tooth decay
- 87% for risk of gum disease
- 85% for tooth loss
- 83% for receding gums
Dry mouth and saliva production impact many of the other oral health symptoms. If a woman is menopausal and taking one of 400+ medications that cause dry mouth, the effects are amplified.
"Saliva is the natural buffer of your mouth, and less saliva means less protection against dry mouth, which is at the crux of all other oral health symptoms related to menopause," says Dr. Jessica Buehler, senior director of Dental Affairs at Delta Dental. This includes increased tooth decay and even altered taste and a burning tongue.
Knowledge means power, resources mean action
The Delta Dental survey found that menopausal women aged 50 and older are either extremely or moderately curious about the menopause-hormone-oral health connection, are motivated to make changes, and believe providers play an important role:
- 77% say they will prioritize scheduling their next exam/cleaning.
- 43% say will spend much more time on their oral health care.
- 39% say healthcare providers can encourage more women to ask questions about the oral health-menopause connection.
In addition, only 26% of women aged 50 and older consult their primary care provider for menopause-related oral health concerns—"the same percentage that look to Google," the Delta Dental press release notes.
"That's a care gap with extensive repercussions," says Buehler.
A patient can't raise a connection she isn't aware of, making the Delta Dental study an important resource for not only prevention and tailored treatment, but provider engagement and downstream benefit design.
The critical role of dental providers
The Delta Dental survey revealed that dentists and dental hygienists are a "prime, untapped resource for women navigating menopause."
"Having open conversations with your dentist about your overall health and potential menopause onset will help your provider make the right treatment recommendations," says Dr. Buehler.
Dr. Daniel Croley, chief dental officer at Delta Dental, recommends that dentists check in with these patients. "As medical professionals, we have a responsibility to ensure our patients are receiving the holistic health care and support they deserve—not only oral health, but whole person health as well.
"We can help ease the burden and break the stigma by creating space for these conversations," adds Croley.
The connection to dental benefit design
Delta Dental provides dental benefits to more than 45 million members in 15 states and the District of Columbia.
The Delta Dental study—and conversations between patients and providers—can influence health plan benefit design. In an exclusive quote for HealthLeaders, Brian Sherman, senior vice president and chief people officer of Delta Dental, notes:
"The results from this survey shed a lot of light on what knowledge gaps exist on the impacts menopause has on oral health. Our findings emphasized the importance of tailoring oral health care to the unique needs of this population. At Delta Dental, a people-first organization, we are using this opportunity to evaluate our benefits for our female employees to ensure they receive support through every stage of their life."
Delta Dental offers plans with graduated benefits that make it possible for changing coverage to align with changing needs—due to aging in general as well as menopause.
Delta Dental's soon-to-be CEO is particularly passionate about this topic. Chavarria shares that she is of menopausal age herself and understands the importance of bringing awareness to the underrepresented: painful symptoms and conversations about menopause and stigma.
Perhaps more women in the top spot—at health plans and across the industry—will lead to more studies like Delta Dental's and benefit decisions based on them.
"At Delta Dental, we are committed to empowering more whole-person care that incorporates oral health into overall physician care and wellbeing, including in menopause," says Chavarria. "Being more open will help make treatment plans more accessible for all people who experience menopause."
Laura Beerman is a contributing writer for HealthLeaders.
In a new Delta Dental study, 84% of women 50 and older say they are not aware of the potential impact of menopause on their oral health.
Of the 1,000+ women surveyed, 70% have experienced increased oral health symptoms during menopause but only one in 10 are aware of their connection.
Delta Dental executives—including current president and incoming CEO Sarah Chavarria—comment on the groundbreaking study and its connection to provider engagement and benefit design.