Hormonal changes throughout a woman’s life may impact oral health.
Women have increased sensitivity to some oral health problems because of the unique hormonal changes they experience throughout different stages of their lives. Hormonal changes can impact the blood supply to the gums and can modify how 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, DDS, professor in the University of Alabama at Birmingham School of Dentistry. “In severe cases, we may even see a noncancerous tumor of the gum tissues called a pyogenic granuloma, which can be painful and bleed easily.”
Throughout a woman’s life, there are five different stages that may impact hormone levels: puberty, menstruation, during the use of oral contraceptives, pregnancy and menopause.
Research shows that, with each of these stages of life, the rise in estrogen and progesterone increases the risk of inflammation in the gums. These increased levels cause the growth of bacteria, or plaque, which stimulates the body’s inflammatory response to the plaque. This inflammatory response causes the gums to become red and swollen, along with swollen salivary glands, mouth ulcers or bleeding gums.
“Patients with gingivitis modified by hormones may notice an increase in bleeding, red gum tissues and painful gums,” Geisinger said. “The best time to visit the dentist about these issues is before they become symptomatic to prevent onset of such conditions.”
Fortunately, Geisinger says, since many of the oral conditions affected by sex steroid hormones are caused primarily by bacterial plaque, so as long as women continue regular visits with their dentist and maintain low plaque levels by practicing good oral hygiene — including visiting their dentist twice a year, brushing twice a day, flossing each day, eating a well-balanced diet and avoiding risk factors for poor oral health such as tobacco use — they can minimize the risk of problems with their oral health.
Oral health and pregnancy
For women who are pregnant or planning to become pregnant and have not seen their dentist within the last six months, the American College of Obstetrics and Gynecology recommends establishing a dental visit to have a comprehensive exam and learn about establishing and maintaining 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 dental treatment needs —particularly preventive and/or emergent care — should not be delayed during pregnancy. There is evidence to suggest that maternal periodontal disease is associated with low birth weight and/or preterm birth. This likely relates to the inflammation and bacteria from periodontitis that can travel throughout the body in the bloodstream and impact pregnancy outcomes.”
Geisinger also notes that research shows mothers who maintain good oral hygiene are more likely to teach their children these habits, leading to less tooth decay and better oral health outcomes overall.
“The bottom line here is that it is always a good time to establish good oral health, but it may be especially important for both mom and baby during pregnancy,” Geisinger said.
For patients who are currently noticing changes in their oral health, Geisinger recommends visiting their dentist regularly to identify oral disease early and to determine the best home oral health care recommendations for them.
Schedule an appointment today with the UAB School of Dentistry at uab.edu/dentistry.