Female hormones and oral health: from adolescence to menopause

Gum inflammation during pregnancy

Studies show that up to 75% of pregnant women suffer from gum inflammation. Hormonal fluctuations can cause mild gingival inflammation in pregnant women, which can lead to periodontitis. Pregnancy-related gum inflammation affects many pregnant women, especially in the second and third trimesters. Symptoms include gums that become swollen, tender, and bleed easily.

If the inflammation is not treated, bacterial plaque can progress under the gums and damage the tooth's support as it destroys the supporting connective tissue fibers. When bacteria that cause periodontitis accumulate in the gingival margins and periodontal pockets, the inflammation becomes worse. Untreated inflammation can weaken tooth support and eventually lead to tooth loss.^4,5

Poor oral hygiene often causes inflammation of the gums. Regular and thorough brushing and flossing reduces gum inflammation and bleeding in pregnant women by removing plaque from tooth surfaces and the gum line. Research suggests that up to 95% of oral diseases are caused by bacterial plaque.^4,5 Neglecting oral health during pregnancy can lead to premature birth, low birth weight, and the development of preeclampsia during pregnancy.⁶

Good oral hygiene during pregnancy protects the fetus. Oral health is part of general health and impacts the well-being of both the mother and the fetus during pregnancy. Hormonal changes during pregnancy make saliva more acidic and less resistant to plaque, making oral hygiene especially important at this stage of life. Brushing your teeth with strong-flavored fluoride toothpastes can be unpleasant during pregnancy, so you may find it helpful to try a different brand.

Many pregnant women suffer from hormone-induced morning sickness, which can expose tooth enamel to stomach acid and cause erosion. Heartburn, which is common during pregnancy, can also erode tooth enamel. Softening of tooth surfaces due to acid exposure increases the risk of wear, especially if teeth are brushed during chewing or immediately after ingesting acidic foods. To prevent acid erosion, it is recommended to use xylitol regularly. Rinsing your mouth with water after vomiting can also help reduce erosion caused by stomach acid.

Periodontal disease is associated with the risk of preterm birth and low birth weight, highlighting the need for oral health during pregnancy. Antibacterial treatment is highly recommended at this stage as it helps protect the pregnant woman's oral health and the health of the fetus. It may be advisable to visit the dentist frequently during pregnancy to reduce oral health problems caused by hormonal factors.

How does menopause affect a woman's oral health?

Many women experience pain or burning in the mouth during or after menopause. The mouth may become sore, and the mucous membranes may become sensitive and ulcerated. Taste perception may also change.

Estrogen production in the body decreases significantly during menopause, which can affect oral health due to decreased saliva production.⁷ Saliva protects teeth from cavities, so a lack of saliva can make teeth more susceptible to cavities. Hormonal changes reduce the defenses of the gums, making it easier for even small amounts of bacterial plaque to cause gingivitis.^7,8 Xerostomia is much more common in women than men due to hormonal fluctuations. Many of the illnesses and medications prescribed to menopausal women also worsen the feeling of dry mouth.^8,9

After menopause, estrogen hormone levels decrease, increasing the risk of osteoporosis. Periodontal disease can develop more quickly as bones become weaker, and you are more likely to lose teeth if you have low bone density.^Ten

As you age, you are more likely to need dental implant treatment. The durability of implants placed in patients treated for periodontitis can be challenged as they require healthy facial bone and healthy gingiva. Careful dental self-care is essential for successful implant treatment. Implants do not eliminate the risk of periodontal disease. Without proper treatment, inflammation can occur around the implant. Peri-implantitis occurs when plaque bacteria affects the gum tissue and bone around the implant. Regular antimicrobial treatment can help prevent peri-implantitis.

Oral health leads to better results

Good oral hygiene habits, regular dental visits, and special treatment (if needed) can help women maintain oral health through life changes. Oral health promotes overall health and helps prevent potential complications such as premature birth and tooth loss. Educating patients about the relationship between hormones and oral health allows them to take preventive measures at every stage of life and enjoy a lifetime of healthy mouths and smiles.

Editor's note: This article was first published clinical insight Newsletter, a publication of Endeavor Business Media Dental Group. Read more articles and subscribe.

References

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3. Alzoman H, Alssum L, Helmi M, Alsaleh L. Relationship between hormonal changes and self-perceived halitosis in women: a cross-sectional study. Healthcare (Basel). 2022;11(1):43. doi:10.3390/Healthcare11010043
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6. Srinivas SK, Parry S. Periodontal disease and pregnancy outcomes: time to move on? J Womens Health (larch). 2012;21(2):121-125. doi:10.1089/jwh.2011.3023
7. Sri V, Sri V. Menopause and oral health. J Midlife Health. 2014;5(3):115-120. doi:10.4103/0976-7800.141187
8. Dutt P, Chaudhary S, Kumar P. Oral health and menopause: A comprehensive review of current knowledge and related dental management. Ann Med Health Sciences Institute. 2013;3(3):320-323. doi:10.4103/2141-9248.117926
9. Jacob LE, Krishnan M, Mathew A, Mathew AL, Baby TK, Krishnan A. Xerostomia – a comprehensive review focused on midlife health. J Midlife Health. 2022;13(2):100-106. doi:10.4103/jmh.jmh_91_21
10. Grodstein F, Colditz GA, Stampfer MJ. Postmenopausal hormone use and tooth loss: A prospective study. J Am Dent Assoc. 1996;127(3):370-377. doi:10.14219/jada.archive.1996.0208

Nina Garo Mercas, Master's degree student; He is a health science journalist and communications manager at Koite Health Ltd. Koite Health Ltd is a rapidly growing health technology company and an innovator in light-activated antimicrobial solutions for the treatment and prevention of oral diseases.