May 22, 2014

From Pregnancy to Menopause: How Hormones Affect Oral Health

Prego-2From puberty to the first menstruation cycle, and from pregnancy to menopause, women go through significant hormonal changes during their lifetime. While some of these changes are expected and understood, many women may be surprised to learn just how much these same hormonal transitions can impact their gums, teeth, and overall oral health.

Hormonal life stages

Gingivitis is a recurring theme at each milestone during a woman’s life. It is, therefore, important  to have a basic understanding of this condition. Gingivitis is an initial stage of gum disease caused by an over-accumulation of plaque along the gumline and on the teeth. Gingivitis symptoms include inflamed gums (red and swollen in appearance), soreness, and bleeding during brushing and/or flossing. If gingivitis progresses without proper treatment, it can lead to periodontitis – a more serious condition linked to soft tissue and bone damage, and possible tooth loss. Fortunately, gingivitis can be treated effectively with proper dental care in each hormonal life stage.

Puberty

There is a correlation between an increased prevalence of gingivitis and increased levels of sex hormones that occur during puberty. In addition, there may also be a nodular overgrowth reaction of the gingiva (gums) in areas that come into contact with food debris, plaque, and calculus deposits1. With red and swollen gums, bleeding may occur easily during brushing.

In addition to elevated levels of hormones, the lifestyle habits of younger adults increase the risk for gingivitis. Adolescents are more likely to wear braces than older adults (making it harder to floss and thoroughly clean the teeth and gumline), and are more likely to drink and/or eat sugary foods – without follow-up brushing. This extra plaque build-up can be a breeding ground for gingivitis.

Menstruation

Gum sensitivity and changes during menstrual cycles vary, with some women experiencing no gingival changes during this monthly hormonal shift, while other women report swollen and bleeding gums a few days before their period. This gum discomfort typically goes away once the menstrual flow begins2, however, special care can be taken to alleviate oral inflammation during this time. It should also be noted that women taking the contraceptive Pill, an artificial steroid drug, may have decreased immune system functioning3 which in turn may affect one’s oral health.

Pregnancy

Gingivitis occurs in about 60 to 75 percent of all pregnant women. Hormones during pregnancy can exaggerate the inflammatory response to local irritants, like plaque, causing gums to become swollen and bleed more easily during this intense (and prolonged) hormonal surge4.

Some pregnant women state that gingival changes begin around the second month of gestation and peak in the eighth month5. Others report that after gradually building in intensity throughout the pregnancy, gingivitis is at its worst during the third trimester. Gingivitis gains momentum during pregnancy as the plasma level of progesterone and estrogen levels rise6. While these hormones (and the prevalence of gingivitis) decline after childbirth in the postpartum phase, often, the gums will not immediately transition back into their pre-pregnancy state. More significantly, periodontal disease during pregnancy may increase the risk factor for delivering a pre-term low birth weight (PLBW) baby7.

Another rare oral health condition called pregnancy tumors (a.k.a. “epulis gravidarum” or “pregnancy granuloma”) affects up to 10 percent of pregnant women. According to the American Dental Association, “a pregnancy tumor classically starts to develop in an area of an inflammatory process. Poor oral hygiene is invariably present, and often there are deposits of plaque or calculus on the teeth adjacent to the lesion. The gingiva enlarges in a nodular fashion to give rise to the clinical mass8.” While the lesion typically shrinks or goes away in the postpartum phase, women should see their doctor and dentist for diagnosis and treatment.

Menopause

Perimenopause starts on average around the age of 47. Most women in the United States officially enter menopause around age of 51. Women who smoke or are thinner than average, may experience menopause even earlier9.

While hot flashes and night sweats are the most common menopausal symptoms, many women experience oral discomfort with these hormonal changes. Symptoms range from dry mouth and burning sensations, to taste perception. The gums may appear dry and shiny, range in color (from pale to red), and may bleed easily10.  While dry mouth is more common with age, and may occur due to medications prescribed during menopause, dry mouth can lead to tooth decay, gum disease and bad breath.

Naturally occurring hormonal changes that usher aging women into menopause can affect bones and the development of osteoporosis. Loss of bone, specifically in the jaw, can lead to tooth loss. Receding gums can be a sign of bone loss in the jawbone. Receding gums also expose more of the tooth surface to potential tooth decay11.”

Gum disease treatment during hormonal shifts

Hormonal changes can leave gums and teeth vulnerable to infection if the initial problem is left untreated. Preventing gum disease begins with proper oral hygiene. Women should establish a consistent and dedicated routine that includes brushing and flossing after every meal (including snacks), replacing toothbrushes at least every 3-4 months, and visiting the dentist every 6 months. Women should discuss any gum and tooth concerns with their dentists as well as any health changes (like a life phase transition) that may have occurred between visits.

Since gums can be sensitive during peak hormonal times, women can benefit from using natural, alcohol-free oral care products. Professional strength Truly Natural® Dental Herb Company products are made with herbal extracts that provide a gentle and effective treatment for gum disease without harsh chemicals that can further aggravate gum tissue. Dental Herb Company products are completely safe for use during pregnancy, and regular use helps maintain healthy oral tissues long term.

Dental Herb Company products contain five pure essential oils (not derivatives or synthetic equivalents) and two alcohol-free organic herbal extracts, which work synergistically to help rebuild and condition gum tissue, reduce oral bacteria, and soothe oral irritation. When looking for a powerful and effective all-natural way to help prevent gum disease, choose Tooth & Gums Tonic by Dental Herb Company, now available for purchase online.

References:

1 “Oral Health Care Series: Women’s Oral Health Issues.” American Dental Association Council on Access, Prevention and Interprofessional Relations; November 2006.

2 “Oral Health Care Series: Women’s Oral Health Issues.” American Dental Association Council on Access, Prevention and Interprofessional Relations; November 2006.

3 Sellman, Sherrill, Hormone Heresy, Bridger House Publishers, Inc. 2009

4 “Oral Health Care Series: Women’s Oral Health Issues.” American Dental Association Council on Access, Prevention and Interprofessional Relations; November 2006.

5 “Oral Health Care Series: Women’s Oral Health Issues.” American Dental Association Council on Access, Prevention and Interprofessional Relations; November 2006.

6 Nayak R1, Choudhury GK, Prakash S, Deshpande S, Ashok KP, Spoorthi BR. “The role of plasma female sex hormones on gingivitis in pregnancy: a clinicobiochemical study.” J Contemp Dent Pract. 2012 Nov 1;13(6):760-3.

7 “Oral Health Care Series: Women’s Oral Health Issues.” American Dental Association Council on Access, Prevention and Interprofessional Relations; November 2006.

8 “Oral Health Care Series: Women’s Oral Health Issues.” American Dental Association Council on Access, Prevention and Interprofessional Relations; November 2006.

9 “Oral Health Care Series: Women’s Oral Health Issues.” American Dental Association Council on Access, Prevention and Interprofessional Relations; November 2006.

10 “Oral Health Care Series: Women’s Oral Health Issues.” American Dental Association Council on Access, Prevention and Interprofessional Relations; November 2006.

11 “Hormones and Health,” WebMD. http://www.webmd.com/oral-health/hormones-oral-health

 




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