Women’s Oral Health at all Life Stages

Blog Summary Women’s oral health changes throughout life due to hormonal shifts during puberty, menstrual cycles, pregnancy, and menopause. This article explains how these changes affect teeth, gums, and overall oral health, and what steps women can take to protect their smiles at each stage.

They are the reason a goofy romantic comedy makes you cry, or sometimes, even just a really good commercial. They are why you have curves, and why those curves sometimes feel squeezed in your jeans, for a couple of days a month, anyway. They are why you can have children and why you really like (need, must have) chocolate, for a couple of days a month anyway.

But did you know they are also the reason that your gums are bleeding when you brush or floss?

We are talking about hormones, and you might be surprised to learn that they have a significant effect on your oral health.

Women's oral health is affected by hormonal changes throughout women's lives. These shifts change women's risk for oral diseases and complications. Let’s take a closer look at what oral health is, how women’s hormones affect it and what women can expect in the different stages of their lives.

If you look at the definition by the CDC, oral health is the condition of the teeth, gums, and the oral-facial system that makes it so you can chew, smile, and speak.

Oral diseases, like tooth decay, gum disease, and oral cancer, threaten your oral health. These conditions are caused by bacteria and infection that gets into the oral cavity.

Oral health was separate from general health for many years. However, research over the past couple of decades has discovered a link between the two. Poor oral health could point to general health problems and systemic conditions, like diabetes, heart disease, and Alzheimer’s among others. It works the other way, too; poor general health could indicate oral health problems, too.

Hormones affect everything about women’s health, including their oral health. Hormonal changes or imbalances during puberty, pregnancy, and menopause influence biological functions like blood circulation to the mouth or how much saliva the body produces. These changes can lead to oral health issues like sensitive or bleeding gums, early-stage gum disease, or other oral problems.

“Our hormonal changes during our menstrual cycle, pregnancy, or even menopause, is causing this increased risk for problems in the mouth, teeth, and gums.” – Dr. Lulu Tang, DMD

For example, as estrogen increases during puberty, so does blood flow to the gums. Upsurges in estrogen and progesterone during pregnancy cause swollen gums and mouth sores. Decreases in estrogen during menopause also reduce saliva production, leading to cavities and gum disease. Moreover, menopausal hormone changes can lead to osteoporosis, which causes bones to weaken or break, increasing the risk for jaw problems or bone loss in the jaw. [i]

Let’s look at the unique challenges women face with changes in hormones and their oral health throughout their lives.

Hormonal changes every month affect what’s happening with your oral health. In particular, the increase in progesterone can make your gums more sensitive. Some women experience bright red swollen gums, swollen salivary glands, canker sores, and gums that bleed around their period. This is sometimes called Menstruation Gingivitis. [i]

It’s not permanent though and usually nothing to worry about. Menstruation Gingivitis starts up right before the first day of a woman’s cycle and ends right after, not even making it to the end of the monthly flow. Maintaining your regular home care during Menstruation gingivitis is all that is necessary in most cases. If your gums are especially sensitive, an over-the-counter topical gel might provide temporary relief.

Birth control is another contributor to changes in women’s oral health. Studies show that taking oral contraceptives increases inflammation in the gum tissues. This inflammation could cause swelling, reddening, and bleeding in the gums. In some cases, it could lead to gum disease. The good news is newer medications have lower doses of hormones, decreasing the risk of this side effect.[ii]

Oral contraceptives can cause other oral health problems, too. For example, the decrease in natural estrogen because of birth control pill use is linked to temporomandibular (TMJ) disorders, which affect the joint that connects your jaw to your head. When you combine this disorder with the lower estrogen levels, some women have increased inflammation, too, which could lead to developing osteoarthritis in their joints.[iii]

Injectable birth control has adverse effects on oral health, too. A study from the Journal of Periodontology suggests that these types of birth control increase inflammation, which contributes to plaque build-up, gum tissue overgrowth, and gum-tissue loss.

When taking birth control, it’s important to pay attention to what’s going on throughout your body, and that includes your mouth. If you are experiencing any unusual discomfort in your gums or jaw, tell your dental team about it, and be sure to tell the team about any medications you are taking, including birth control pills. An exam will be able to reveal if you need any additional treatment or if you should change your pill or birth control prescription.

Pregnancy also has an enormous influence on women's oral health. Teeth sensitivity and pain are common for pregnant women. In addition to the changes in hormones, experts think that disruptions to many women's home care routines (i.e., not wanting to brush teeth in the morning because of morning sickness, for one) might contribute to it. Usually, the sensitivity and pain will go away after the baby is born.

“Any patient that shares with me that they’re trying to conceive, going through IVF, or even have had histories of miscarriage, I always empower them—let’s do the saliva testing. We need to know what’s happening.” – Dr. Bianca Velayo, DMD

There is also an increased risk for bleeding gums in pregnant women, a symptom of gum disease. Studies suggest that as much as 75 percent of pregnant women have some form of gum disease. [i]  Pregnancy Gingivitis is a mild form of gingivitis, the first stage of gum disease. [ii] Women with a history of gingivitis are most likely to have Pregnancy Gingivitis.[iii]

Gum disease has also been associated with adverse pregnancy outcomes. [iv] Studies show a relationship between gum disease in preterm labor and low birth weight. While there is no evidence that gum disease causes these outcomes, research shows that women who experienced preterm labor were 45 percent more likely to have gum disease than women who carried to full term.[v]

Like tooth sensitivity,  Pregnancy Gingivitis goes away once the baby is born. However, if it doesn’t, untreated gum disease has serious consequences, like bone and tooth loss.

Women can do a few things to maintain their oral health and prevent tooth problems during pregnancy. It is essential to maintain a consistent routine of brushing their teeth with fluoride toothpaste for two minutes twice a day and cleaning between teeth daily. In addition, eating well, including foods with a lot of vitamin C, can fight off infection, which will also help reduce the swelling in the gums.[vi]

However, it is essential to note that women should rinse their mouths after morning sickness and wait to brush their teeth. The stomach acids on the teeth can soften the enamel, and brushing them right afterward could be detrimental. Instead, pregnant women should wait at least 30 minutes.[vii]

Dental care does not put a woman's safe pregnancy at risk. Women need to keep up with routine dental care during pregnancy. If there are dental problems during pregnancy, dental professionals know how to treat tooth decay during pregnancy and other issues.

“We print out the results, I review it with their OBGYN… oftentimes that oral health link is one of the missing pieces of the puzzle that’s affecting their overall health.” – Dr. Bianca Velayo, DMD

Dental hygiene in pregnancy is also critical. Also, it is essential for women to talk to their dentist about any problems they are having with the gums to determine if any intervention is necessary to maintain a healthy pregnancy. If would like to read more in depth about how pregnancy causes changes in your oral health, check out "Oral Health During your Pregnancy" blog.

Like pregnancy, the hormone changes women experience during menopause also affect oral health. These menopausal hormonal fluctuations change how foods taste, contribute to feeling burning sensations in the mouth and play a part in bone loss as the decreases in estrogen affect bone density. Some women experiencing menopause also have sensitive teeth, gum problems, and teeth pain.

Menopause hormone changes also cause dry mouth, also called xerostomia. Since saliva helps defend the oral cavity from bacteria, it can lead to more tooth decay and tooth pain for these women.

Some women experience something called Burning Mouth Syndrome (BMS). Women with BMS feel a tingling or burning sensation in their mouths or tongues. However, while BMS is something that women can feel, dental professionals cannot see a cause for it. [i]  The best theory about the cause of BMS is that it is associated with the complex relationship women’s nervous systems have with decreasing estrogen levels. [ii] In addition to dry mouth and BMS, decreasing estrogen levels contribute to gum recession, gum disease, and weakening of the jaw bone due to bone loss.

These changes in oral health are just one of the many things happening to women during menopause. However, consistent home care and regular dentist visits are the best defense against any adverse effects menopause might have on women's oral health. In some cases, your dental team might prescribe something to help counteract the dry mouth symptoms, and toothpaste with more fluoride than usual to protect your teeth. To learn more in-depth about how menopause can change your oral health read our "What to Expect for your Oral Health During Menopause" blog.

“I’ve been able to be part of many people’s pregnancy journeys, positive pregnancy stories… we’re here for education and telling people how we can be healthier.” – Dr. Bianca Velayo, DMD

Women’s oral health at all life stages is affected by what’s going on with their hormones. We realize that you might have more questions. Find a Smile Generation-trusted dentist, well-versed in the Mouth-Body Connection^®, who can assess your oral health, take your health history, and determine if you are at risk for some of these serious and associated health conditions.

For more information or to find a Smile Generation-trusted dentist near you, use our Find a Dentist Tool.