Can women’s oral health be affected by the changes in hormone levels? We all know that women’s bodies can require special care. Hormone fluctuations not only affect a woman’s overall health, but can also affect oral health, making it more important than ever to pay attention to any changes that occur in the mouth.
Vacillating hormone levels may affect women’s oral health during puberty, pregnancy and menopause, and when taking hormone medications. Changing hormone levels may lead to changes in oral tissues and increase the likelihood of certain oral conditions. Taking charge and taking care of your oral health is always important but is particularly important during certain times when hormone levels are changing.
Hormones – Some young women may occasionally experience swollen, red and tender gums during puberty. This is caused by a rise in the level of sex hormones which leads to increased blood flow to the gums. As young women progress through puberty, this tendency for the gums to be more sensitive to irritants such as dental plaque diminishes. However during puberty, it is especially important for young women to practice good oral hygiene by brushing with a fluoride toothpaste and flossing daily. In addition, some women may experience menstruation gingivitis, characterized by herpes-type lesions, mouth ulcers and sensitive gums. This condition generally occurs right before a period and clears once the period has started.
Eating Disorders – A report of the expert group on Mental Health Policy states that eating disorders are most prevalent in Irish women aged 15 – 40 years with 1 in 200 affected by anorexia and 1 in 50 affected by bulimia with women under 20 years affected the most. Eating disorders rob the body of adequate minerals, vitamins, proteins and other nutrients needed for good health causing potential injury to teeth, muscles and major organs. Eating disorders such as bulimia can negatively affect oral health and may result in tooth erosion. Erosion is the loss of tooth enamel caused by frequent contact with stomach acid.
When tooth enamel is eroded away, the dentine underneath is exposed. This may lead to pain and sensitivity, and may increase the risk of tooth decay. What can you do to neutralize the effects of stomach acid on your teeth? (It is important to recognize that gastroesophageal reflux disorder and even morning sickness in pregnant women also can bring up stomach acid that can harm teeth.) Immediately after purging, regurgitating or vomiting, rinse your mouth with baking soda mixed in water, or with a sugar-free mouth rinse, or with plain water if nothing else is available. Eating disorders can cause very serious harm to your body as well as to your teeth and smile. Oral care instructions from your dentist can help prevent tooth damage from worsening. But most importantly, seek professional help to treat the underlying causes of the eating disorder.
Other risk factors – Young women can also engage in behaviors that may place them at increased risk for periodontal disease and oral cancers. The number of young women who smoke is stabilising. According to the Office of Tobacco Control, 22% of Irish females between the ages of 15 and 24 smoke cigarettes leading to an increase in the risk of oral cancers and periodontal diseases.
Women — Ages 20-45
During their 20s 30s and 40s, women’s bodies continue to be exposed to changing hormone levels both naturally, like in pregnancy, or through certain medications, like in oral contraceptives. Pregnant women and women who take oral contraceptives may be at increased risk for gingivitis if dental plaque is not removed on a daily basis.
Oral Contraceptives – Women taking oral contraceptives may experience gingivitis. In addition, use of certain antibiotics used to help treat gum disease, may decrease the effectiveness of oral contraceptives.
Pregnancy – Pregnant women have an increased risk for inflammation of the gums because increases in hormone levels cause increased gum sensitivity. Gum sensitivity results in an exaggerated response to dental plaque. This situation can cause gingivitis that is characterized by red, swollen and tender gums. Practicing good oral hygiene to adequately remove dental plaque is important to maintaining good oral health. Pregnant women also are at risk of developing pregnancy tumours. These benign inflammatory growths occur when swollen gums become irritated and usually shrink soon after pregnancy is over. If not, these pregnancy tumors can be removed after the baby is delivered. Finally, some studies appear to indicate that women with periodontal disease may be at increased risk for pre-term, low birth weight babies.
Dry Socket – Women who use birth control pills are more likely to develop a dry socket when a tooth is extracted and therefore should consult with their dentist before scheduling an extraction procedure. Dry socket is a common complication of an extraction and occurs when the blood clot is disrupted or dislodged from the surgery site.
Medications and Prescriptions – The use of some prescription and over the counter medications, such as diet pills, may affect your oral health. These medications decrease salivary flow and cause dry mouth. Dry mouth is a condition in which there is insufficient saliva to keep the mouth moist. This condition can place a woman at higher risk for tooth decay, gum disease and gum discomfort.
Hormones – Approximately 720,000 women in Ireland are in the postmenopausal phase of life. Women are generally between the ages of 47 and 55 years when their production of oestrogen decreases. There are several conditions that may affect women’s oral health during this phase of life.
Osteoporosis – Over one third of women over age 65 face the onset of osteoporosis. While osteoporosis affects both men and women, post-menopausal women are particularly susceptible to osteoporosis because diminished estrogen levels may speed up bone loss. Osteoporosis is characterized by decreased bone density and weakened bones. Symptoms of osteoporosis often go unnoticed until a major fracture occurs. Bone loss is associated with both periodontal disease and osteoporosis. Your dentist may be able to detect the early signs of osteoporosis during your regular dental exam.
Periodontal Disease – Because of hormone changes, a mature woman’s gums may also be at risk. Periodontal diseases should be monitored and dental treatment sought if necessary. A small percentage of women will experience gingivostomatitis, a condition in which the gums are dry, shiny and bleed easily. The gums may also be deep red or pale in color. Women who experience these symptoms should see their dentist. Women also may experience dry mouth, pain and an altered sense of taste. Like in younger women, dry mouth can lead to an increased risk of tooth decay, gum disease and gum discomfort. Whether you are one of the 44% of Irish adults who visited a dentist in the last two years or one of the 56% who have not visited a dentist in the last two years or more – your oral health is important. Changes in hormone levels throughout a woman’s life make it vital to establish a pattern of good oral health practices to maintain and improve not only oral health but also overall health and wellbeing. Women with a good oral health maintenance program are more likely to keep their teeth for a lifetime.
Tips for women to maintain good oral health
1. Pay attention to your gums during and following your menstrual periods. If your gums become swollen during your periods, consult your dentist.
2. Be aware of your oral health — make regular dental visits and see your dentist at the first sign of trouble.
3. If you’re pregnant, see your dentist at least once during your pregnancy.
4. Tell your dentist about changes in your medical history and about any medications you are taking, and talk to your dentist or physician if you are having oral or general health problems.
5. Use a fluoride toothpaste and drink fluoridated water.
6. Practice good oral hygiene by brushing and flossing daily.
7. Eat a balanced diet and limit in between meal carbohydrate snacks. Drink water instead of soft drinks or sugary drinks.
8. Do not use tobacco products in any form.
American Dental Association: www.ada.org
Academy of General Dentistry: www.agd.org
American Academy of Periodontology: www.perio.org
Journal of American Dental Association
Department of Health and Children (2006) A Vision for Change. Report of the expert group on Mental Health Policy. Stationary Office Dublin.
The Women’s Health Council Department of Health and Children (2007) Oral Health of Irish Adults. Brunswick Press.
Oral Health Tips
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