The Dental Wellness Institute
Oral Health and Women’s Health
Guest Corner Article #GC100, March, 2005
As a woman, you know that your health needs are unique. You also know that at specific times in your life, you need to take extra care of yourself. Times when you mature and change, for example, puberty or menopause, and times when you have special health needs, such as menstruation or pregnancy. Did you know that your oral health needs also change at these times?
While women tend to take better care of their oral health than men do, women's oral health is not markedly better than men's. This is because hormonal fluctuations throughout a woman's life can affect many tissues, including gum tissue.
A study published in the January 1999 issue of the Journal of Periodontology reports that at least 23 percent of women ages 30 to 54 have periodontitis (an advanced state of periodontal disease in which there is active destruction of the periodontal supporting tissues). And, 44 percent of women ages 55 to 90 who still have their teeth have periodontitis.
Because periodontal disease is often a "silent" disease, many women do not realize they have it until it reaches an advanced state. However, at each stage of your life, you can take steps to protect your oral health.
Gum Disease & Puberty
During puberty, an increased level of sex hormones, such as progesterone and possibly estrogen, causes increased blood circulation to the gums. This may cause an increase in the gum's sensitivity and lead to a greater reaction to any irritation, including food particles and plaque. During this time, the gums may become swollen, turn red and feel tender.
As a young woman progresses through puberty, the tendency for her gums to swell in response to irritants will lessen. However, during puberty, it is important to follow a good at-home oral hygiene regimen, including regular brushing and flossing, and regular dental care. In some cases, a dental professional may recommend periodontal therapy to help prevent damage to the tissues and bone surrounding the teeth.
Gum Disease & Menstruation
Occasionally, some women experience menstruation gingivitis. Women with this condition may experience bleeding gums, bright red and swollen gums and sores on the inside of the cheek. Menstruation gingivitis typically occurs right before a woman's period and clears up once her period has started.
Gum Disease and Pregnancy
Women may experience increased gingivitis or pregnancy gingivitis beginning in the second or third month of pregnancy that increases in severity throughout the eighth month. During this time, some women may notice swelling, bleeding, redness or tenderness in the gum tissue.
In some cases, gums swollen by pregnancy gingivitis can react strongly to irritants and form large lumps. These growths, called pregnancy tumors, are not cancerous and are generally painless. If the tumor persists, it may require removal by a periodontist.
Studies have shown a relationship between periodontal disease and pre-term, low-birth-weight babies. Any infection, including periodontal infection, is cause for concern during pregnancy. In fact, pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small! If you are planning to become pregnant, be sure to include a periodontal evaluation as part of your prenatal care.
Women who use oral contraceptives may be susceptible to the same oral health conditions that affect pregnant women. They may experience red, bleeding and swollen gums. Women who use oral contraceptives should know that taking drugs sometimes used to help treat periodontal disease, such as antibiotics, may lessen the effect of an oral contraceptive.
Oral Health: Menopause and Post-Menopause
Women who are menopausal or post-menopausal may experience changes in their mouths. They may notice discomfort in the mouth, including dry mouth, pain and burning sensations in the gum tissue and altered taste, especially salty, peppery or sour.
In addition, menopausal gingivostomatitis affects a small percentage of women. Gums that look dry or shiny, bleed easily and range from abnormally pale to deep red mark this condition. Most women find that estrogen supplements help to relieve these symptoms.
Bone loss is associated with both periodontal disease and osteoporosis. Research is being done to determine whether the two are related. Women considering Hormone Replacement Therapy (HRT) to help fight osteoporosis should note that this may help protect their teeth as well as other parts of the body.
Dental Disease and Women’s Health
Careful periodontal monitoring and excellent oral hygiene is especially important for women who may be noticing changes in their mouths during times of hormonal fluctuation. To help ensure good oral (and overall) health, be sure to:
• See a dental professional for cleaning at least twice a year.
• See a periodontist in your area if you or your dentist notice problems with your gum tissue.
Problems may include:
• Bleeding gums during brushing
• Red, swollen or tender gums
• Gums that have pulled away from the teeth
• Persistent bad breath
• Pus between the teeth and gums
• Loose or separating teeth
• A change in the way your teeth fit together when you bite
• A change in the fit of your dentures
Keep your dental professionals informed about any medications you are taking and any changes in your health history.
Brush and floss properly every day. Review your techniques with a dental professional or view a free AAP brochure sample on how to brush and floss.
You can find additional information on women’s health, including;
AAP news releases on recent findings related to women and periodontal disease;Journal of Periodontology at the American Academy of Periodontology website: http://www.perio.org/consumer/women.htm
© The American Academy of Periodontology. All rights reserved
Tom McGuire, DDS: Comments
The article makes two very important points. First, there is a relationship between cyclical changes in women’s health and gum (periodontal) disease. Normal hormonal fluctuations can express symptoms in the oral cavity and contribute to gum disease.
Second, not every woman is affected in the same way by puberty, menstruation, pregnancy, menopause, and post-menopause. Not every woman will suffer the same degree of gum disease. But you should know that if you now have gum disease, natural hormonal changes over the course of your life will worsen your gum disease and accelerate the destruction it causes.
But the issues raised in the article are specific to women’s health but do not cover other serious health issues that can be made worse by gum disease. To learn more about them I encourage you to explore Dental Disease & Health Risks.
The lesson from this article is simple; you cannot be healthy without healthy gums and teeth. There is no time like the present to do something about freeing yourself from this “insidious and hidden” disease. If you are concerned, I recommend that you search through my website, paying special attention to Prevention Program and Browse Healthy Teeth - Healthy Body. Maybe you don’t have gum disease, but the only way you will ever know for sure is by undergoing a complete oral health examination. This is especially important if you are one of the millions who don’t see a dentist on a regular basis.
If your dentist determines that you don’t have gum disease, you will gain peace of mind. If it turns out that you do have it, your peace of mind will come from knowing you will soon be free of it. Gum disease is not only preventable, it is 100% treatable. Get involved, improve your health, and stop being a victim of this disease.
Last updated:Wed, Jun 30, 2010