Oral Health for Women

Hormonal fluctuations affect more than a woman's reproductive system. They have a surprisingly strong influence on the oral cavity. Recognition that women have different oral health needs and issues is an essential component in treatment planning. Female hormone variations can alter women's gums, resulting in sensitive, tender, and even bleeding gums, making it even more important to stress an optimal oral hygiene regimen.

Puberty

Gingival tissues may become especially tender and sensitive to the increasing hormone level at the onset of puberty. Oral ulcers can also be the result of the hormone surge.

Menses

Oral changes that may accompany menses include swollen gums, activation of herpes labialis, prolonged bleeding following oral surgery, and swollen salivary glands. These changes usually resolve once menses begin. Herpes labialis lesions in some women occur as a pattern that seems related to their menstrual cycle and heal following menstruation. Sensitivity to pain in the mouth can change during the menstrual cycle, as well as sensitivity to hot and cold.

Pregnancy

" A tooth for every pregnancy" is an old and untrue saying. "Gingivitis, is the most prevalent oral manifestation associated with pregnancy", states Barbara Steinberg, DDS. In her article addressing special dental needs for women patients, Dr. Steinberg explains that 60% to 75% of all pregnant women have gingivitis. Most often it is associated with poor oral hygiene, but hormonal and vascular changes often exaggerate the inflammation. The severity of pregnancy gingivitis increases between the second and third trimesters, often peaking in the eighth month. A recent University of North Carolina study found women with severe gum disease were 7 times more likely to give birth to preterm, low-birth weight babies suggesting that poor oral hygiene affects both mother and baby.

Pregnancy may also cause single tumor-like growths known as a pyogenic granuloma or "pregnancy tumor". This tumor is not a cancerous growth but an inflammatory response to plaque. Prevention is the key to managing both pregnancy gingivitis and pregnancy tumor. Careful oral hygiene including brushing, flossing, and professional cleanings and exams will help avoid pregnancy related gingival changes.

Menopause

The most common oral complaints occurring during and post-menopause are oral discomfort, burning mouth syndrome (BMS), dryness of the mouth, and altered taste perception. Oral discomfort and altered taste perception may be related to hormone withdrawal at menopause and are improved after the administration of estrogens either systemically or topically.

Burning mouth syndrome (BMS) is characterized by a burning tongue and/or other oral tissues without visible changes to these tissues. Contributing factors include vitamin deficiencies, infections, and hormonal changes. Anxiety and depression are often related. Recent research shows that BMS seems to follow a pattern, with burning pain beginning by late morning and peaking by evening. Studies suggest that low doses of the drug clonazepam might offer relief.

Systemic osteoporosis may contribute to bone loss around the teeth and affect the severity of periodontitis if it is a pre-existing disease. Current research indicates that estrogen therapy may prevent tooth loss by protecting against systemic bone loss from osteoporosis.

Among healthy women, salivary flow is not significantly affected by menopause or hormone replacement therapy. Xerostomia or dry mouth is usually the result of other medications. Sugar-free hard candy and gum, and drinking plenty of water will help, or consult your dentist for medication and dental care products specifically designed to help xerostomia.

Female hormone variations can definitely alter a woman's oral health. It is important for a woman to take special care of her gums and teeth because they are much more sensitive to irritants such as plague and food debris. Talk to your dentist if you are experiencing any oral discomfort and discuss any concerns you might have.

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