Women & Oral Health – Particular Challenges Exist At Many Ages.

Posted on Aug 20, 2018 by William J. Claiborne, DDS MS

The female body is a uniquely complex structure in its ability to produce offspring and feed their young. With this comes the integral interaction of much more than its housing, of course. Females have an intricate system of hormonal components that help to manage these systems in order to maintain their own health as well as that of their young.

As a male who spends the majority of his days surrounded by females – working with a mainly female staff during daytime hours and spending the rest of my hours with my wife – I have an appreciation for women of all ages. From the perspective of a periodontist, I also have an understanding of how our female patients can endure particular challenges as a result of hormonal fluctuations.

Unlike the skin, which may cause an obvious rash after consuming something that causes allergic response, the gum tissues don’t give obvious visual indications when oral health is effected. However, your gum tissues may be more reactive to hormone levels that you realize.

Although gum tissues tend to redden when inflamed, an oft first-noticed symptom is tenderness or swelling. These issues are usually accompanied by redness, which tends to be noticed after other symptoms emerge. And, these other symptoms may be much more attention-getting.

For example, tender gums that bleed when brushing are hard to ignore. While these are symptoms of early periodontal disease (also known as gingivitis), the color of gum tissues can be easily overlooked since they are hidden inside the mouth.

Yet, an imbalance in the body that lies far beyond the mouth can trigger oral symptoms that need prompt attention before worsening. For example, pregnancy gingivitis is not uncommon in women during pregnancy. If not treated and resolved, however, it can develop into full-blown periodontal disease, which is the nation’s leading cause of adult tooth loss.

Below are some of the different phases of life that can be accompanied by various challenges to a female’s oral health:

• Puberty: Estrogen and progesterone hormones produced during puberty increase blood flow to the gums. This changes how the gums respond to plaque, the sticky film of bacteria in the mouth. With this may be gums that bleed when brushing and become red, tender, and swollen.

• Menstruation: The menstrual cycle causes hormonal changes that cause some women to experience symptoms such as swollen gums that turn bright red, canker sores, or gums that bleed easily. Referred to as menstruation gingivitis, this usually occurs just prior to the onset of the period and resolves in a day or so.

• Oral Contraceptives: Taking birth control pills that contain progesterone also causes some women to have gum tissues that become inflamed. This occurs from heightened sensitivity to the toxins produced from the overload of bacteria that form plaque. For many women, the gums become less reactive after the first few months of starting birth control pills. Some medications, such as antibiotics, can lower the effectiveness of oral contraceptives. This is why it is important to keep your dentist updated on all medicines you take.

• Hormone Relationship to the TMJ: It has long been known that more women have TMJ disorders than men. This prompted researchers to look into a possible hormone-related connection. The temporo-mandibular joints (known as TMJ), are the jaw joints. These are located on each side of the head in front of the ears and hinge the lower jaw (the mandible) to the skull. These TMJ are designed to move harmoniously each time you speak, chew, yawn or laugh. Now, research has shown that the use of birth control pills can lead to decreased levels of producing natural estrogen. Studies have found that decreased natural estrogen with the combined effect of the joint compression from TMJ disorders can lead to increased inflammation. In some individuals, this inflammation can result in osteoarthritis in the joint.

• Pregnancy: With each trimester of pregnancy, hormonal levels can change. Pregnancy also causes an increased level of progesterone, which can increase your risk for the formation of plaque. This can lead to pregnancy gingivitis, particularly during the second to eighth month of pregnancy. This condition causes the gum tissues to become swollen and bleed easily. Because gingivitis is the first stage of gum disease, it is important to have it fully resolved so it does not progress further. Because studies have found that gum disease can cause a heightened risk for preterm and low birth weight babies, obstetricians are cautioning their pregnant patients to be particularly diligent in maintaining good oral health..

 • Menopause: As we age, a variety of changes can take place in our mouths, whether male or female. Saliva flow is less plentiful, the mouth is less moist, and side effects of taking medications can pose challenges to keeping the gums healthy. Dry mouth, a particular challenge, is a leading cause of gum disease. Without adequate saliva flow to keep the mouth cleansed and being efficient in neutralizing the acids from plaque, the risk for gum disease is greater for females, especially those in menopausal years. Declining estrogen levels also place women at greater risk for bone loss or osteoporosis as well as inflamed gum tissues around the teeth (called periodontitis). When there is bone loss of the jaw, it can result in tooth loss. Receding gums are a sign of this bone loss since more of the tooth surface is expose to the causes of tooth decay.

Regardless of where you are in your lifespan, if you are a female, it is especially important to be aware of the signs and symptoms associated with these conditions. Having healthy gums is even more important now that science has shown a link between many serious health problems.

If you suspect you have some level of gum disease or have delayed having regular dental check-ups, begin with a consultation appointment. During this time, we’ll discuss your unique needs and how we may be the best fit for your oral health goals. Call 828-274-9440 to schedule.