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How Hormones affect Oral Health

Women experience oral health problems due to their unique hormonal changes that they experience at different stages in their life.  Hormones affect the blood supply to the gum tissue. They also affect the body’s response to the toxins that result from plaque buildup. This creates a higher susceptibility to periodontal disease at certain stages in their lives, as well as other health problems. Let’s review some of these vulnerable stages of a woman’s life cycle.

 

Puberty

There is a surge of estrogen and progesterone (the female hormones) that occurs during puberty.  This can increase the blood flow to the gums and change the way gum tissue reacts to toxins in plaque.  This causes the gum tissue to become swollen and red and more likely to bleed and feel tender during home care of brushing and flossing.

Menstruation

Due to the hormonal changes that occur during the menstrual cycle, some women can experience oral changes that include, swollen gums and salivary glands, and an increase propensity to develop canker sores and bleeding gums.  This is a condition called Menstruation gingivitis that usually occurs a day or two before the onset of the monthly cycle, and clears up shortly after the period has begun with proper oral hygiene care of brushing and flossing.  

Oral Contraceptive/Birth Control Pills

If the Birth control pill contains progesterone, it increases the level of that hormone in the body.  This may subsequently have the effect of inflamed gum tissues due to the body’s reaction to toxins produced by oral plaque.  The redness and swelling mimics pregnancy gingivitis which is caused by increased blood flow to the gums. It is most pronounced the first few months of a female going on the pill, and then it usually subsides or is manageable.  If not, discuss this with your dentist. Consider alternative contraception if this is the case.

Pregnancy

Pregnancy can lead to some dental problems in women.  This includes gum disease and increased risk of tooth decay.  An increased level of progesterone in particular can cause a condition called Pregnancy Gingivitis.  It is recommended that pregnant women get more frequent professional dental cleanings. The best times to do so is during the second or early third trimester to help reduce the chances of developing gingivitis and the painful symptoms it produces.

Some women also develop pregnancy tumors due to hormonal changes.  Let this not alarm you, these tumors are not cancerous or malignant.  These growths most often appear during the second trimester and look like little raspberries that form between teeth. In most cases these tumors are limiting and will vanish after the baby is born.  

Morning sickness, vomiting and nauseousness during pregnancy can expose your teeth to stomach acid and weaken the enamel surface of the teeth.  This puts you at higher risk of tooth decay and erosion of your teeth. If you suffer from heartburn or acid reflux this also can weaken and erode your teeth.  Although it may be tempting to brush immediately after vomiting, the best thing to do to protect your enamel, is swish with baking soda and water to neutralize the acids from your stomach.  Mix about a teaspoon of it into a cup of water then use the mixture to rinse out your mouth before brushing.

Always let your dentist know if you are pregnant or think you might be pregnant to limit any xray exposure. Xrays should be taken only as needed for dental emergencies during that time.

Eat healthy choices and limit sugar consumption.  Include foods that have enough protein , calcium, Vitamin A, Vitamin C, Vitamin D and phosphorous.  See Canada’s food guide for guidelines. Calcium is especially important part of your diet for your growing baby, and his or her strong bones and teeth.  If you have low blood calcium you will also have low calcium in your saliva. Calcium in your saliva helps remineralize your tooth enamel when it has been demineralized by acids.  Eat foods high in calcium like dairy and take a calcium supplements as needed so you and your baby do not put your bones and teeth at risk.

If you have good oral health, you can prevent a number of risks to you and your baby.  Pregnant mothers with poor oral health have a risk of delivering a pre-term baby, babies with low birth weight and having pre-eclampsia or pregnancy hypertension.

Menopause

Oral health changes due to age may be the consequence of medications that combat diseases, and hormonal changes due to actual menopause. These include altered taste, burning sensations in the mouth, greater sensitivity to hot and cold foods, decreased saliva flow that can result in dry mouth.  

Dry mouth can in turn result in the development of tooth decay, especially around areas of root exposure due to recession.  Also it can lead to gum disease. Saliva is our natural defense mechanism in our mouths to combat the bacteria that causes a host of dental problems.  It moistens and cleanses the mouth by neutralizing the acids produced by plaque. Dry mouth may be from medications commonly prescribed or taken by older adults.  There are suggestions that your dentist can make to combat dry mouth and appropriate courses of action to treat the symptoms.

The decline of estrogen during menopause also puts women at greater risk of bone density loss.  This loss, specifically in the jaw can lead to tooth loss and receding gums and more tooth surface exposed to potential tooth decay.  

There is a condition called Menopausal gingivostomatitis. It is seen in the mouth as shiny, pale to deep red gums that bleed easily.  Medications may be prescribed by your dentist if this is the case.

 

Hope you liked our article, let us know if you have any personal questions regarding your oral  health.

All the Best,

Dr. Karen.