Women have an increased sensitivity to oral health problems
because of the unique hormonal changes they experience. These hormonal changes
not only affect the blood supply to the gum tissue, but also the body’s response
to the toxins (poisons) that result from plaque build up. As a result of these
changes, women are more prone to the development of periodontal disease at
certain stages of their lives, as well as to other oral health problems.
At what stages in a woman’s life is she more susceptible to periodontal disease and other oral health problems?
There are five situations in a women’s life during which hormone
fluctuations make them more susceptible to oral health problems – puberty, the
monthly menstruation cycle, when using oral contraceptives, during pregnancy,
and at menopause.
Puberty — The surge in production of the female hormones
estrogen and progesterone that occurs during puberty can increase the blood flow
to the gums and change the way gum tissue reacts to bacterial plaque. This
causes the gum tissue to become red, tender, and swollen, and more likely to
bleed during brushing and flossing.
The monthly menstruation cycle — Due to the hormonal changes
(particularly the increase in progesterone) that occur during the menstrual
cycle, some women experience oral changes that can include bright red swollen
gums, swollen salivary glands, development of canker sores, or bleeding gums.
Menstruation gingivitis usually occurs a day or two before the start of the
period and clears up shortly after the period has started.
Use of oral contraceptives (birth control pills) — Women who
take certain oral contraceptives that contain progesterone might experience
inflamed gum tissues due to the body’s exaggerated reaction to the toxins
produced from plaque. The most profound changes in the gums are seen in the
first few months after starting the birth control pills. Newer birth control
pills, however, have lower concentrations of the hormones which lessens the
inflammatory response of the gums to dental plaque.
There is another reason for telling your dentist if you are
taking oral contraceptives. Certain medicines, such as antibiotics, that your
dentist might prescribe can lower the effectiveness of oral contraceptives.
Always tell your dentist the names and dosages of all the
medicines you are taking. He or she needs to know this information when planning
your course of treatment, especially if prescribing medicines is a part of your
Pregnancy — Hormone levels change considerably during
pregnancy. An increased level of progesterone in particular can increase your
susceptibility to bacterial plaque causing gingivitis which is most noticeable
during the second to eighth month of pregnancy. This condition is called
pregnancy gingivitis where the gums become swollen and bleed easily. Your
dentist might recommend more frequent professional cleanings during your second
or early third trimester to help reduce the chance of developing gingivitis.
Menopause — Numerous oral changes can occur as a consequence
of advanced age, the medicines taken to combat diseases, and hormonal changes
due to menopause. These oral changes can include altered taste, a burning
sensation in the mouth, and greater sensitivity to hot and cold foods and
beverages, and decreased salivary flow that can result in dry mouth.
Dry mouth, in turn, can result in the development of periodontal
disease because saliva is not available to moisten and cleanse the mouth by
neutralizing acids produced by plaque. Dry mouth can also result from many
prescription and over-the-counter medicines that are commonly prescribed to
The decline in estrogen that occurs with menopause also puts
women at greater risk for bone loss or osteoporosis and inflammation of the
tissues surrounding the teeth (called periodontitis). Loss of bone, specifically
in the jaw, can lead to tooth loss. Receding gums can be a sign of bone loss in
the jawbone and also expose more of the tooth surface to potential tooth decay.
Hormone therapy may play a role in preserving dental health in
postmenopausal women. Estrogen therapy prevents bone loss in both the skeletal
bones and the jawbones. This suggests that hormone therapy protects against
tooth loss in postmenopausal women.
What can I do to prevent the development of periodontal disease?
Following these tips will help:
- Brush your teeth at least twice a day with a toothpaste containing
fluoride. Floss at least once a day.
- Visit your dentist twice a year for a professional oral examination and cleaning.
- Eat a well balanced diet.
- Avoid sugary or starchy snacks.
- Ask your dentist if he or she thinks you should use an antimicrobial mouth rinse.
- If you have dry mouth, ask your dentist about treatments for this
condition, such as artificial saliva.
Because more women than men experience temporomandibular
disorders (TMDs) which occur as a result of problems with the jaw, jaw joint,
and surrounding muscles that control chewing and moving the jaw, is there a
hormonal connection to this problem?
According to research published in The Journal of the American Dental
Association, the answer is no. Researchers of one study did not find any
connection between women on birth control pills or older women taking estrogen
replacement and the risk of developing temporomandibular disorders. Any link is
merely coincidental, the researchers stated, adding that the demographic
information was the only common factor – in other words, women who aggressively
sought treatment for TMDs were also the same type of women who requested birth
control pills and estrogen replacement therapy.
© Copyright 1995-2009 The Cleveland Clinic Foundation. All rights reserved.
Can't find the health information you’re looking for?
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/29/2009...#11192