Hormonal changes during a woman’s life can affect oral health.
Women are more susceptible to certain oral health problems due to the unique hormonal changes they experience during the different stages of their lives. Hormonal changes can affect the blood supply to the gums and change the way the body responds to plaque buildup. These changes can lead to gingivitis and periodontal disease – which is infection and inflammation of the gums and bone that surround and support the teeth.
“Changes in sex steroid hormones can occur during puberty, pregnancy and menopause,” said Mia Geisinger, DMD, professor at the University of Alabama at Birmingham School of Dentistry. “In severe cases, we may even see a noncancerous tumor of the gum tissue called a pyogenic granuloma, which can be painful and bleed easily.”
There are five different stages in a woman’s life that can affect hormone levels: puberty, menstruation, when using oral contraceptives, pregnancy and menopause.
Research shows that with each of these stages of life, increases in estrogen and progesterone increase the risk of gum inflammation. These elevated levels cause bacteria or plaque to grow, which stimulates the body’s inflammatory response to the plaque. This inflammatory reaction causes the gums to become red and swollen, along with swollen salivary glands, mouth ulcers, or bleeding gums.
“Patients with hormone-modified gingivitis may notice increased bleeding, red gum tissue and painful gums,” Geisinger said. “The best time to see the dentist for these problems is before they become symptomatic to prevent such conditions from occurring.”
Fortunately, says Geisinger, because many of the oral conditions affected by sex steroid hormones are primarily caused by bacterial plaque, so as long as women continue regular dental visits and keep plaque levels low by practicing good oral hygiene – including visiting your dentist twice a year, brushing twice a day, flossing daily, eating a well-balanced diet and avoiding risk factors for poor oral health such as tobacco use – these can minimize the risk from oral health problems.
Oral health and pregnancy
For women who are pregnant or planning to become pregnant and have not visited their dentist in the past six months, the American College of Obstetricians and Gynecologists recommends visiting a dentist for a comprehensive exam and to learn how to establish and maintain good oral health.
“Dental care is safe and effective during pregnancy,” Geisinger said. “Dentists can work with pregnant patients to find the safest course of treatment for them, but the need for dental treatment – especially preventive and/or emergency care – should not be postponed during pregnancy.” There is evidence to suggest that maternal periodontal disease is associated with low birth weight and/or preterm birth. This is likely related to the inflammation and bacteria from periodontitis that can travel around the body in the blood and affect pregnancy outcomes.
Geisinger also notes that research shows that mothers who maintain good oral hygiene are more likely to teach these habits to their children, leading to fewer cavities and better overall oral health outcomes.
“The bottom line here is that it’s always a good time to establish good oral health, but it can be especially important for both mother and baby during pregnancy,” Geisinger said.
For patients who are currently noticing changes in their oral health, Geisinger recommends seeing their dentist regularly to identify oral disease early and determine the best at-home oral health care recommendations for them.
Make an appointment today with the UAB School of Dentistry at uab.edu/dentistry.