In commemoration of the upcoming ADA Dental Health Week (1st – 7th August) it is necessary to focus on the significance of oral health of women. Hormonal changes during puberty, menstruation, pregnancy and menopause induce many effects on the body however many forget that they can have a significant impact on the state of oral health.
Puberty
During female puberty the body’s production of sex hormones (estrogen and progesterone) dramatically increases and results in a more than normal amount of blood flow to the gums. As a consequence, the gums become more sensitive to plaque and trapped food particles leaving them red and swollen and possibly bleeding more than usual. This is a common condition referred to as pubertal gingivitis and fortunately is easily managed.
Proper brushing and flossing in conjunction with regular visits to the dentist for a professional clean can help to treat this form of gingivitis or even prevent its development.
Menstruation
There are numerous ways in which your period can affect the state of your oral health and the appearance severity of the symptoms varies greatly between each individual.
About three to four days before the beginning of your period, increased amounts of estrogen and progesterone are released in order to prepare the uterus for implantation of an egg. This peak in hormone levels as well as possible accumulation of plaque may cause the gums to become swollen and more prone to bleeding. This is a temporary form of gingivitis, which may be accompanied by sores appearing on the tongue and on the insides of the cheek.
For this reason, it is necessary to be extra attentive towards your oral hygiene in the week before your period in order to minimise the possible inflammation, bleeding and sensitivity.
Although dental treatment is completely safe to be carried out at any time during your menstrual cycle, there are certain times that are optimal for increased comfort during treatment.
- The best time to schedule a clean is the week after your period. Although there is no ‘bad time’ to have a professional clean, during your period the inflammation of your gums can cause extra sensitivity and the procedure could be more painful than if it were carried out at a later stage.
- The best time to undergo oral surgical procedures is in the days following your period. This is the time when hormone levels lower and the gums are less likely to be inflamed or to react badly to any irritants during treatment.
Pregnancy
For information on this subject see our previous blog post titled ‘Maintaining Your Oral Health During Pregnancy’.
Menopause
During menopause, between the ages of 47 to 55, the body shows a pronounced decline in hormone levels. This can have many adverse effects on the condition of your oral health.
Inflammation of gums
This symptom of menopause is part of a condition known as menopausal gingivostomatitis characterised by shiny, pale to deep red gums that tend to bleed very easily. Fortunately, this condition can be simply treated by good and routinely oral hygiene practice and regular visits to the dentist.
Burning mouth syndrome (BMS)
This is an extremely unpleasant condition that is commonly associated with menopause. Symptoms may include; a burning or scalding sensation of the tongue (which may also be present on the throat, palate, gums or lips), dry mouth with increased sensation of thirst, altered taste (usually bitter or metallic taste) or complete loss of taste.
Unfortunately there is no definitive cause of BMS, however it is most likely brought on by hormonal fluctuations brought on by the onset of menopause. If you think you are experiencing any of these symptoms, let your dentist know so that they can help you determine an appropriate course of action.
Xerostomia (dry mouth syndrome)
This condition is a result of reduced or completely absent saliva flow. Complications include difficulty in eating and swallowing and an increased risk of developing tooth decay. Fortunately, there are a wide range of treatments and medications available to treat this condition.
Osteoporosis
Whilst also affecting the strength of bones in the limbs or of the back, osteoporosis can also have a serious effect on the mouth. The supporting structure of the teeth is known as the alveolar process or alveolar bone that can degrade in the presence of osteoporosis. This makes women with the condition three times as likely to experience tooth loss than women without.
A group of medicines called Bisphosphonates are used widely to treat osteoporosis. This drug comes in various forms (i.e. injections, tablets) and names. This useful medication has a strange side effect in that it will prevent healing of the bone within the jaw, in particular the lower jaw – a condition called Osteonecrosis of the Jaw (ONJ). If you are diagnosed with osteoporosis and are about to take any form of bisphosphonates a visit to the dentist is a must to ensure that all teeth and gums are in good shape and to check that you will not likely to need an extraction in the future.
For more information on Women and Oral Health visit http://www.dentalhealthweek.com.au/
References
- Burning Mouth Syndrome. (2016, February 2). Retrieved July 25, 2016, from Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/burning-mouth-syndrome/symptoms-causes/dxc-20179960
- Greenfield, P. (2012, June 19). How Your Menstrual Cycle Affects Your Mouth. Retrieved July 25, 2016, from Women’s Health: http://www.womenshealthmag.com/health/how-your-menstrual-cycle-affects-your-mouth
- Newman, M., Takei, H., Klokkevold, P., & Carranza, F. (2012). Clinical Periodontology. Missouri: Elsevier.
- Oral Health and Bone Disease. (2016, May). Retrieved July 25, 2016, from National Institute of Arthritis and Musculoskeletal and Skin Diseases: http://www.niams.nih.gov/health_info/bone/bone_health/oral_health/default.asp
- Women and Oral Health. (2016). Retrieved July 25, 2016, from Dental Health Week: www.dentalhealthweek.com.au