As International Women’s Day is observed on 8 Mar, Nina Garlo, communications manager at Koite Health considers the impact of hormones on oral health in women. From adolescence to menopause, a woman’s body undergoes hormonal fluctuations that affect oral health and, consequently, overall physical, and mental well-being.
During key hormonal periods such as adolescence, menstruation, pregnancy, and menopause, significant changes occur in women’s hormones, affecting both oral and overall health. Hormonal changes can also impact the oral cavity, leading to various oral health issues such as increased gum sensitivity, gum bleeding, and tooth decay.
Women and healthcare professionals need to understand the connection between hormones and oral health, as this knowledge helps in taking proactive measures to maintain oral health for women.
Establishing good oral hygiene habits begin from an early age as hormonal changes during adolescence significantly affect oral health. Therefore, parents should serve as examples of good oral hygiene and teach children good hygiene practices early on. Emphasising good oral hygiene and establishing routines lay the foundation for a child’s lifelong oral health and well-being.
Adolescence may affect girls’ self-esteem and body image, and healthy oral health can also support confidence. Therefore, it is essential to encourage good oral hygiene practices during this life stage.
During adolescence, dietary habits may change, so adult encouragement towards a balanced diet further supports oral health. Additionally, orthodontic treatments often begin during adolescence, further highlighting the importance of good oral hygiene in preventing decay and gum inflammation.
Puberty puts oral health to the test
Gingivitis associated with adolescence typically begins around the onset of puberty, between the ages of 8-13. Adolescent gingivitis manifests as swollen, red, tender, or sore gums that may bleed when brushing teeth or even with a light touch. Usually, the inflammation is accompanied by bad breath as well as plaque and tartar buildup on teeth.1,2
If adolescent gingivitis is left untreated, it can progress to a more severe gum disease called periodontitis. This can cause gum recession and ultimately lead to tooth loss. Guidance and examples from adults support the health of adolescent gums. Preventive care, including effective oral hygiene routines, is crucial.1,2
Menstruation onset during adolescence increases the impact of hormonal changes on oral health. Many women experience changes in oral health due to their menstrual cycle, including increased gum sensitivity and bleeding tendency. Studies suggest that fluctuations in hormone levels are associated with increased halitosis or bad breath.3
Gum inflammation during pregnancy
Studies indicate that up to 75% of pregnant women suffer from gum inflammation. Due to hormonal fluctuations, mild gum inflammation in pregnant women can lead to severe gum disease, periodontitis.
Pregnancy-related gum inflammation affects many expectant mothers, especially in the second and third trimesters. Symptoms may include swollen, tender gums that bleed easily. Untreated inflammation can damage tooth support as bacterial plaque progresses under the gums and destroys the supporting connective tissue fibers. Accumulation of bacteria causing periodontitis in the gum line and pockets further increases inflammation. Untreated inflammation can lead to weakened tooth support and eventually tooth loss.4,5
Poor oral hygiene often triggers gum inflammation. Regular and thorough brushing and flossing reduce gum irritation and bleeding in pregnant women by removing plaque from tooth surfaces and gum margins. Studies suggest that up to 95% of oral diseases are due to bacterial plaque.4,5
Neglecting oral health during pregnancy can lead to premature birth, low birth weight, and the onset of preeclampsia during pregnancy.6 Oral health is part of general health and affects the well-being of both the expectant mother and the unborn child. Hormonal changes during pregnancy increase saliva acidity and resistance to plaque decreases. Therefore, oral hygiene is particularly important during pregnancy. However, brushing with strongly flavoured and scented fluoride toothpaste may be unpleasant during pregnancy. If the strong odour or taste of toothpaste causes morning sickness, trying a different brand may be helpful.
Many expectant mothers also suffer from hormonal-induced morning sickness, exposing tooth enamel to stomach acids, which can lead to erosion. Heartburn, a common ailment during pregnancy, can also erode tooth enamel. Softening of the tooth surface due to acid exposure increases the risk of wear, especially during chewing or if teeth are brushed shortly after consuming acidic foods.
To prevent erosion, it is advisable to use xylitol regularly. Rinsing the mouth with water after vomiting also helps reduce erosion caused by stomach acids.
During pregnancy, meticulous oral hygiene is crucial for both the expectant mother and the developing child. Studies have shown that gum disease is associated with the risk of premature birth and low birth weight, making maintaining oral health particularly important during pregnancy. Antibacterial Lumoral treatment is highly recommended during pregnancy as it helps expectant mothers take care of their oral health and the well-being of the unborn child. Remember to inform your dentist if you are pregnant. They may recommend more frequent dental visits during pregnancy, which can reduce oral health problems caused by hormonal factors.
How does menopause affect women’s oral health?
Many women experience pain or burning sensations in their mouths during or after menopause. The mouth may be sore, and the mucous membranes may be sensitive and ulcerated. Taste perception may also change. During menopause, estrogen production in the body significantly decreases, which also affects oral health as saliva production decreases.7
Saliva protects teeth from decay, and if there is a lack of saliva, teeth can decay more easily. As the defense capabilities of the gums weaken due to hormonal changes, even a small amount of bacterial plaque can easily cause gum inflammation.7,8
Dry mouth is much more common in women than in men due to hormonal background. Many diseases and medications prescribed to women in menopausal age also increase the feeling of dryness in the mouth.8,9
The low level of estrogen hormone after menopause increases the risk of osteoporosis in every woman. When bones weaken due to osteoporosis, gum diseases can occur more quickly. If bone mineral density is low, you are more likely to lose teeth.10
Ageing also increases the likelihood of needing implant treatments. Implants are also placed in patients treated for periodontitis. This can be challenging for the durability of implants, as placing implants requires healthy facial bone and healthy gums.
Careful self-care of teeth is essential for successful implant treatment. If you have an implant in your mouth, the risk of gum disease does not disappear. Without proper treatment, inflammation may develop around the implant. Peri-implantitis occurs when plaque bacteria affect the gum tissue and bone around the dental implant. You can also protect yourself against this with regular antibacterial Lumoral treatment.
Good oral hygiene habits, regular dental visits, and, if necessary, special treatments can help women maintain their oral health throughout life changes. By taking care of their oral health, women can promote not only their own well-being but also prevent potential complications such as premature birth or tooth loss.
Understanding the connection between hormones and oral health allows us to take preventive measures and take care of oral health in the best possible way at different stages of life. This way, we can promote our overall well-being and enjoy healthy mouths and smiles throughout life.
The Lumoral method developed by Finnish researchers cleans teeth even more effectively than traditional brushing. The light activated Lumoral treatment kills both Streptococcus mutans bacteria that cause tooth decay and gum disease-causing bacteria. The device is primarily intended for individuals for whom conventional oral hygiene does not produce the desired results. This is often a problem for people with chronic periodontitis, the elderly, and pregnant women, whose hormonal fluctuations cause trouble for oral and bodily well-being.11,12
Lumoral, recommended by dentists and the Dental Hygienist Association, is a Finnish innovation for maintaining oral health as well as treating and preventing oral diseases at home.13
References
1. Chaitra TR, Manuja N, Sinha AA, Kulkarni AU. Hormonal effect on gingiva: pubertal gingivitis. BMJ Case Rep. 2012 Aug 27;2012:bcr2012006193. doi: 10.1136/bcr.2012.006193. PMID: 22927275; PMCID: PMC3433508.
2. Jafri Z, Bhardwaj A, Sawai M, Sultan N. Influence of female sex hormones on periodontium: A case series. J Nat Sci Biol Med. 2015 Aug;6(Suppl 1):S146-9. doi: 10.4103/0976-9668.166124. PMID: 26604605; PMCID: PMC4630749.
3. Alzoman H, Alssum L, Helmi M, Alsaleh L. Relationship between Hormonal Changes and Self-Perceived Halitosis in Females: A Cross-Sectional Study. Healthcare (Basel). 2022 Dec 23;11(1):43. doi: 10.3390/healthcare11010043. PMID: 36611503; PMCID: PMC9818922.
4. Wu M, Chen SW, Jiang SY. Relationship between gingival inflammation and pregnancy. Mediators Inflamm. 2015;2015:623427. doi: 10.1155/2015/623427. Epub 2015 Mar 22. PMID: 25873767; PMCID: PMC4385665.
5. Yenen Z, Ataçağ T. Oral care in pregnancy. J Turk Ger Gynecol Assoc. 2019 Nov 28;20(4):264-268. doi: 10.4274/jtgga.galenos.2018.2018.0139. Epub 2018 Dec 17. PMID: 30556662; PMCID: PMC6883753.
6. Srinivas SK, Parry S. Periodontal disease and pregnancy outcomes: time to move on? J Womens Health (Larchmt). 2012 Feb;21(2):121-5. doi: 10.1089/jwh.2011.3023. Epub 2011 Oct 12. PMID: 21992584; PMCID: PMC3270055.
7. Suri V, Suri V. Menopause and oral health. J Midlife Health. 2014 Jul;5(3):115-20. doi: 10.4103/0976-7800.141187. PMID: 25316996; PMCID: PMC4195183.
8. Dutt P, Chaudhary S, Kumar P. Oral health and menopause: a comprehensive review on current knowledge and associated dental management. Ann Med Health Sci Res. 2013 Jul;3(3):320-3. doi: 10.4103/2141-9248.117926. PMID: 24116306; PMCID: PMC3793432.
9. Jacob LE, Krishnan M, Mathew A, Mathew AL, Baby TK, Krishnan A. Xerostomia – A Comprehensive Review with a Focus on Mid-Life Health. J Midlife Health. 2022 Apr-Jun;13(2):100-106. doi: 10.4103/jmh.jmh_91_21. Epub 2022 Sep 16. PMID: 36276621; PMCID: PMC9583374
10. Grodstein F, Colditz GA, Stampfer MJ. Post-menopausal hormone use and tooth loss: a prospective study. J Am Dent Assoc. 1996 Mar;127(3):370-7, quiz 392. doi: 10.14219/jada.archive.1996.0208. PMID: 8819784..
11. Pakarinen S, Saarela RKT, Välimaa H, et al. Home-applied dual-light photodynamic therapy in the treatment of stable chronic periodontitis (HOPE-CP)—three-month interim results. Dent J (Basel). 2022;10(11):206. doi:10.3390/dj10110206
12. Trujillo K, Räisänen IT, Sorsa T, Pätilä T. Repeated daily use of dual-light antibacterial photodynamic therapy in periodontal disease—a case report. Dent J (Basel). 2022;10(9):163. doi:10.3390/dj10090163
13. https://www.suuhygienistiliitto.fi/suomen-suuhygienistiliitto-suosittelee-lumoralia/
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