DURING PUBERTY, sex hormones (estrogen and progesterone) cause rapid changes in the female body. Some of these changes are visible; others are not. In the mouth, this increase in sex hormones changes the way the gums respond to bacteria and make them more susceptible to inflammation and infection leading to periodontal or gum disease.
Everyday, more and more is learned about the connection between oral health and the body. Women experience unique hormonal fluctuations throughout their lives, which affect all parts of their bodies, including the mouth. In the past, no one paid much attention to these changes and it was common for women to loose their teeth as they aged.
Gingival sensitivity and bleeding from oral debris and plaque, occasional discomfort during the course of oral hygiene, tooth decay from dietary changes, periodontitis (gum disease) and bad breath are all influenced by hormonal changes during adolescence, pregnancy, hormonal contraception and menopause. These natural changes compounded by the tendency women have to put the needs of others ahead of their own, as well as the ever-present time consuming demands of children, families, careers, and homemaking, set the stage for dental problems.
During puberty, sex hormones (estrogen and progesterone) cause rapid changes in the female body. Some of these changes are visible; others are not. In the mouth, this increase in sex hormones changes the way the gums respond to bacteria and make them more susceptible to inflammation and infection leading to periodontal or gum disease. The hormones continue to fluctuate during menstruation and many women are prone to aphthous ulcers (canker sores) and cold sores, which recur on a regular cycle.
Gingivitis (inflammation of the gums) is the most common oral concern during pregnancy. It occurs in 60 to 70 percent of all women who are pregnant. As with puberty and menstruation, the hormonal changes exaggerate the gum tissues response to bacterial plaque. Researchers have found a link between periodontal disease and preterm low birth weight babies.
One recent study suggests that women who have periodontal disease are at a 7.5 times higher risk for delivering preterm low birth weight babies than women who do not have periodontal disease. It is extremely important that expectant mothers have a healthy mouth and see a dentist during their pregnancy. Diet can affect cavity formation, as well as the health of the developing baby. It is important to eat a healthy and well-balanced diet. For dry mouth that is sometimes experienced during pregnancy, frequent sips of water and sucking on Xylitol or sugarless candies may help.
Women who use hormonal contraceptives, such as birth control pills, the ring, or the patch, which mimic the effects of pregnancy on the body, are at risk for the same gum disease and bacterial plaque that can be present with pregnancy.
In addition, women on hormonal contraceptives may be more prone to healing problems after tooth extraction leading to a “dry socket,” which is a painful condition that can increase the likelihood of bone inflammation during the healing process. To help avoid this condition, schedule any extractions during the non-estrogen “sugar pill” days (days 23-28) of the pill cycle or the week you are off the patch or the ring.
Menopause, a normal event in a woman’s life, also brings about certain changes in the mouth. The most common are irritation, changes in taste, and a dry mouth. Post menopause, the decrease in hormones puts women at risk for developing osteopenia and osteoporosis, which are risk factors for bone and tooth loss. Estrogen levels have been associated with bone loss and decreased density. Regardless of age and hormonal conditions, there is no doubt that having a healthy mouth, particularly a healthy periodontal status, is the best medicine to control the negative consequences of hormonal changes and menopause.
There are many things that you can do. It is best to have a team approach between yourself and a dental professional who can monitor your oral situation and prevent problems from escalating. Daily at home oral hygiene to remove the biofilm (plaque) from every surface of every tooth including the surfaces under the gum is the first step. This is accomplished with daily brushing and flossing. Ultrasonic toothbrushes are very effective at removing plaque. Flossing is the most effective way to clean the root under the gum.
Once the biofilm or plaque be-
Dr. Edwards graduated from the United States Merchant Marine Academy and Temple University School of Dentistry. He completed a general practice residency at the Queens Medical Center in Honolulu. To reach Dr. Edwards you may call 321-751-7775 or visit www.SDICFL.com