Women's and Men's Oral Health
IN THIS ARTICLE

Men and women have many similarities when it comes to their oral health. For example, they have the same anatomy, gum tissue, and number of teeth. 

However, there are also some differences in oral health between men and women, resulting from biological and social influences. For example, men are more likely than women to develop gum disease and oral cancer, and women are more likely than men to go to the dentist. 

Of course, there are many things that are different between what men experience and what women experience when it comes to their oral health. Let's take a closer look at the factors that make up the differences between men's oral health and women's oral health. 

Physical Differences Between Men's and Women's Oral Health

Few discernable physical differences exist in the mouth when it comes to gender. Research indicates that men and women have anatomical and functional differences. Many men have larger oral facial features, meaning the mouth, pharynx, upper esophageal sphincter, and esophagus, than women.[i]

These physical differences do not pose any changes to the risks of developing gum disease. The most significant differences between men's and women's oral health are the risks for oral disease and complications related to hormone changes, participation in risky behaviors, and social norms. 

Hormones' Impact on Men's and Women's Oral Health

Hormones send chemical messages that initiate various body systems and functions. Their effect on the body is a complicated science. These messages, like biological texts, control different systems like blood pressure regulation, blood sugar, emotional health, growth and development systems, metabolism, reproductive systems, sex drives and function, and sleep regulation, among others.[ii]

How Do Hormones Impact Your Oral Health?

These hormonal effects drive oral health systems also. Hormone changes, in particular, change how the bodily systems receive these messages and respond to the information. These changes are primarily in the oral tissues. Specifically, hormonal changes affect the blood supply to the gum tissue. 

In addition to the blood supply to the gums, hormones also affect infection response to oral health toxins. For example, changes in sex hormones can accelerate the progression of gum disease and bone loss. As the sex hormones decrease, the sensitivity of interacting cells and growth regulators increases, which disrupts the typical reaction to infection and inflammation. The responsive changes then speed up the bone mass and density loss in the jaw and bone. [iii]

Women flow with hormonal changes as their bodies go through life changes

Men's Oral Health vs. Women's Oral Health

Regarding hormonal levels affecting oral health, men have fewer than women. Women's oral health is directly affected by their sex hormones at every age and every stage, whereas men's oral health effects tend to be indirect.

Potential Risk for Men Vs. Women from Sex Hormones

Men can develop osteoporosis during hormone changes (as can women). Research shows osteoporosis affects the jaw and supporting bone of the oral facial structures as men’s testosterone decreases. [i]

Women, who experience hormonal changes regularly throughout their life stages, have more acute reactions to hormone changes. For example, the estrogen receptors in women's oral cavity react to changes with estrogen, leading to oral health problems such as bleeding or sensitive gums, development of early-stage gum disease (called gingivitis) with increases in estrogen, and dry mouth, among other symptoms, with decreases in estrogen. [ii]

Risk Factors for Men's Oral Health

Men have an increased risk for dental problems because they are likely to avoid the dentist and, consequently, miss opportunities to treat gum disease and tooth decay before they worsen. [iii] Studies show that men are more likely than women to develop periodontal disease, at 56.4 percent vs. 38.4 percent. [iv]

However, social norms drive these behaviors rather than biology. For example, men are less likely to brush and floss daily than women. Research from the ADA says that 8 percent fewer men than women brush their teeth twice a day, and are 40 percent less likely to brush after every meal. Regarding flossing, men are 26 percent less likely to floss daily than women. Also. when men do brush, they often choose harder toothbrushes and have a vigorous approach to the activity, which can have detrimental effects on the natural tissues. [v]

Traumatic injuries to the teeth, meaning knocking a tooth out, are more common for men than women, too. Research attributes it to the fact that more men than women participate in contact sports and other activities that can cause an injury like this. Moreover, men are less likely than women to wear a mouthguard during these sports or activities. [vi]

Studies show that men are more likely than women to develop periodontal disease

Men are Less Likely to Visit the Dentist

Research also indicates that men are less likely than women to go to the dentist, which directly affects their oral health. They also are less likely to fix an oral healthcare problem than women if there is an issue. [vii]

Men are also less aware than women of the oral health connection to overall health, which has indirect effects on their oral health. The lack of awareness means men do not only skip going to the dentist, but, they are also likely to ignore their overall health by skipping the doctor's office as well. By ignoring the state of their overall health, men are also more likely to develop conditions like heart disease, which requires medications that can have adverse effects on the oral cavity.[viii]

Men's Risks

Not all men's risks for oral health problems are behavioral. In addition to the development of osteoporosis, studies suggest that low testosterone levels are an excellent predictor of tooth loss. [ix] Low testosterone is linked with chronic gum disease. However, the researchers indicated more research was necessary to explain the relationship between the two. [x]

That said, behavioral issues do play a role here. In addition to avoiding care and a lack of awareness about oral health and overall health connections, men have habits that contribute to increased risk for oral cancers, tooth loss, and other dental problems. For example, men use tobacco products and marijuana more and have more heavy alcohol consumption than women, which leads to poor oral health outcomes (not to mention overall health). [xi]

Risk Factors for Women's Oral Health

Compared to men, women are more likely to have better oral health. However, that does not mean they have fewer risks. On the contrary, women tend to have a higher risk for things like cavities.

For example, females' teeth tend to erupt sooner, which provides more opportunities to develop cavities. Also, frequent snacking during pregnancy can expose the teeth to more opportunities for decay. [xii] Furthermore, hormonal changes occur regularly throughout their lives, which have acute effects on the female oral cavity. [xiii]

Women Risks

Female hormones change throughout their lifecycle. In addition to the hormonal changes associated with puberty, menstruation, birth control, and menopause, which can affect the gums and oral tissues, pregnancy causes risks to oral health. These hormonal shifts during pregnancy contribute to gingivitis and, if the condition worsens, more advanced forms of gum disease and tooth loss. [xiv]

In addition to changes to the oral cavity by estrogen changes, women also experience changes related to progesterone shifts. Increases in progesterone are associated with an increased risk of plaque that causes gum disease. For pregnant women, high progesterone levels are associated with the middle months of pregnancy, which is why many women develop pregnancy gingivitis. [xv]

Increases in progesterone levels are also part of a woman's monthly cycle. The surge can create menstruation gingivitis, typified by red and swollen gums, canker sores, and swollen salivary glands. [xvi]

Some females have other contributing factors that make them more susceptible to cavities. A deficiency in a gene that is linked to the X-chromosome, amelogenin, can lead to enamel deficiencies, which make the teeth more vulnerable to decay.[xvii]

Oral cancer is a common and deadly disease

Oral Cancer Impact of the Sexes

Oral cancer is a common and deadly disease. The sixth most common cancer in the US is oral cancer. There are as many as 53,000 new cases in the US identified annually, about three percent of all new cancer cases. Worldwide, that number jumps to 275,000. Unfortunately, this cancer has a high morbidity rate; as many as 50 percent of patients with oral cancer succumb to it within five years. [i]

Research indicates that men are more likely to contract oral cancer than women. The ratio is two to one, men vs. women for oral cancer cases. [ii]

Men and Women and Oral Cancer

There are two main reasons men are more likely to have oral cancer than women, and both are behavioral and socially driven more than biological. First, they are more likely to have poor habits, like tobacco product use and heavy alcohol consumption, which is associated with a higher risk for oral cancer. Also, men are more likely than women to experience prolonged sun exposure from outdoor occupations, another risk factor for oral cancer.

These increased risks are profound. Tobacco use alone dramatically increases the risk of developing oral cancer. Smoking increases it from five to nine times, and chewing tobacco increases the risk four times. However, the current ratio of oral cancer disease between the sexes could shift as women's tobacco use increases. [iii]

Positive and Negative Habits Impact on Oral Health

No matter your sex, your home care routine is the best thing you can do to avoid negative impacts on your oral health. Regular brushing twice a day with fluoride toothpaste and daily flossing is essential in providing the best possible environment for proper oral health. In addition, regular visits to your Smile Generation®-trusted office will help you stay on top of oral health changes to your teeth and gums and provide opportunities to catch oral cancer early, reducing the risks of mortality from the disease. 

In addition to excellent and consistent home care habits, nutrition is essential to oral healthcare. Nutrient-dense foods will improve your oral health and overall health. A well-balanced diet with plenty of lean proteins and fruits and vegetables is foundational here. 

Avoiding sugary and starchy snacks and foods is also essential to good oral (and overall) health. This is because the environment these types of food provide is the perfect host for disease-causing bacteria.

Find a Dentist Near You

Do you want to know more about the differences in the sexes regarding oral health, oral cancer risks, or how your hormones could affect oral health? Our Smile Generation team can help with answers and provide care and advice on what you need for optimal oral healthcare. For more information or to find a Smile Generation®- trusted dentist near you, use our Find a Dentist Tool.

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Sources: 

[i] Nascimento WV, Cassiani RA, Dantas RO. Gender effect on oral volume capacity. Dysphagia. 2012;27(3):384-389. doi:10.1007/s00455-011-9379-4

[ii] myclevelandclinic.org. n.d. Hormones: What They Are, Function & Types. [online] Available at: <https://my.clevelandclinic.org/health/articles/22464-hormones> [Accessed 9 August 2022].

[iii] Grover CM, More VP, Singh N, Grover S. Crosstalk between hormones and oral health in the mid-life of women: A comprehensive review. J Int Soc Prev Community Dent. 2014;4(Suppl 1):S5-S10. doi:10.4103/2231-0762.144559

[i] Benscosme, RDH, MA, CHES, J., 2016. Sex-Based Differences in Oral Health - Dimensions of Dental Hygiene | Magazine. [online] dimensionsofdentalhygiene.com. Available at: <https://dimensionsofdentalhygiene.com/article/sex-based-differences-in-oral-health/> [Accessed 9 August 2022].

[ii] perio.org. n.d. Gum Disease and Women - American Academy of Periodontology. [online] Available at: <https://www.perio.org/for-patients/gum-disease-information/gum-disease-and-women/> [Accessed 10 Aug 2022].

[iii] Men's vs. women's oral health. Grin.deltadentalins.com. https://grin.deltadentalins.com/archive/2018/fall/men-vs-women-oral-health/. Published 2018. Accessed August 10, 2022.

[iv] Benscosme, RDH, MA, CHES, J., 2016. Sex-Based Differences in Oral Health - Dimensions of Dental Hygiene | Magazine. [online] dimensionsofdentalhygiene.com. Available at: <https://dimensionsofdentalhygiene.com/article/sex-based-differences-in-oral-health/> [Accessed 9 August 2022].

[v] Lipsky MS, Su S, Crespo CJ, Hung M. Men and Oral Health: A Review of Sex and Gender Differences. Am J Men's Health. 2021;15(3):15579883211016361. doi:10.1177/15579883211016361

[vi] Lipsky MS, Su S, Crespo CJ, Hung M. Men and Oral Health: A Review of Sex and Gender Differences. Am J Men's Health. 2021;15(3):15579883211016361. doi:10.1177/15579883211016361

[vii] Lipsky MS, Su S, Crespo CJ, Hung M. Men and Oral Health: A Review of Sex and Gender Differences. Am J Men's Health. 2021;15(3):15579883211016361. doi:10.1177/15579883211016361

[viii] Lipsky MS, Su S, Crespo CJ, Hung M. Men and Oral Health: A Review of Sex and Gender Differences. Am J Men's Health. 2021;15(3):15579883211016361. doi:10.1177/15579883211016361

[ix]  Singh BP, Makker A, Tripathi A, Singh MM, Gupta V. Association of testosterone and bone mineral density with tooth loss in men with chronic periodontitis. J Oral Sci. 2011;53(3):333-339. doi:10.2334/josnusd.53.333

[x] Kellesarian SV, Malmstrom H, Abduljabbar T, et al. "Low Testosterone Levels in Body Fluids Are Associated With Chronic Periodontitis". Am J Men's Health. 2017;11(2):443-453. doi:10.1177/1557988316667692

[xi] Lipsky MS, Su S, Crespo CJ, Hung M. Men and Oral Health: A Review of Sex and Gender Differences. Am J Men's Health. 2021 May-Jun;15(3):15579883211016361. DOI: 10.1177/15579883211016361. PMID: 33993787; PMCID: PMC8127762.

[xii] Benscosme, RDH, MA, CHES, J., 2016. Sex-Based Differences in Oral Health - Dimensions of Dental Hygiene | Magazine. [online] dimensionsofdentalhygiene.com. Available at: <https://dimensionsofdentalhygiene.com/article/sex-based-differences-in-oral-health/> [Accessed 9 August 2022].

[xiii] my.clevelandclinic.org. 2022. Hormones and Oral Health. [online] Available at: <https://my.clevelandclinic.org/health/articles/11192-hormones-and-oral-health> [Accessed 9 August 2022].

[xiv] Benscosme, RDH, MA, CHES, J., 2016. Sex-Based Differences in Oral Health - Dimensions of Dental Hygiene | Magazine. [online] dimensionsofdentalhygiene.com. Available at: <https://dimensionsofdentalhygiene.com/article/sex-based-differences-in-oral-health/> [Accessed 9 August 2022].

[xv] my.clevelandclinic.org. 2022. Hormones and Oral Health. [online] Available at: <https://my.clevelandclinic.org/health/articles/11192-hormones-and-oral-health> [Accessed 9 August 2022].

[xvi] Frisbee, DMD, E., 2021. Women's Hormones and Oral Health. [online] WebMD.com. Available at: <https://www.webmd.com/oral-health/hormones-oral-health> [Accessed 10 August 2022].

[xvii] Lipsky MS, Su S, Crespo CJ, Hung M. Men and Oral Health: A Review of Sex and Gender Differences. Am J Men's Health. 2021;15(3):15579883211016361. doi:10.1177/15579883211016361

[i] Lipsky MS, Su S, Crespo CJ, Hung M. Men and Oral Health: A Review of Sex and Gender Differences. Am J Men's Health. 2021 May-Jun;15(3):15579883211016361. DOI: 10.1177/15579883211016361. PMID: 33993787; PMCID: PMC8127762.

[ii] Lipsky MS, Su S, Crespo CJ, Hung M. Men and Oral Health: A Review of Sex and Gender Differences. Am J Men's Health. 2021 May-Jun;15(3):15579883211016361. DOI: 10.1177/15579883211016361. PMID: 33993787; PMCID: PMC8127762.

[iii] Lipsky MS, Su S, Crespo CJ, Hung M. Men and Oral Health: A Review of Sex and Gender Differences. Am J Men's Health. 2021 May-Jun;15(3):15579883211016361. DOI: 10.1177/15579883211016361. PMID: 33993787; PMCID: PMC8127762.

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