Women have special needs at different stages of life. Puberty, menstruation, pregnancy, and menopause can all influence your oral health and the need for dental treatment. During these times, your body experiences hormonal changes. By understanding these changes, you can practice good oral health habits that can keep your teeth and gums healthy.

As a woman, you know that your health needs are unique. You also know that at specific times in your life, you need to take extra care of yourself. Times when you mature and change, for example, puberty or menopause, and times when you have special health needs, such as menstruation or pregnancy. Did you know that your oral health needs also change at these times?

While women tend to take better care of their oral health than men do, women's oral health is not markedly better than men's. This is because hormonal fluctuations throughout a woman's life can affect many tissues, including gum tissue.

A study published in the January 1999 issue of the Journal of Periodontology reports that at least 23 percent of women ages 30 to 54 have periodontitis (an advanced state of periodontal disease in which there is active destruction of the periodontal supporting tissues). And, 44 percent of women ages 55 to 90 who still have their teeth have periodontitis.

Because periodontal disease is often a "silent" disease, many women do not realize they have it until it reaches an advanced state. However, at each stage of your life, you can take steps to protect your oral health.

Puberty

During puberty, an increased level of sex hormones, such as progesterone and possibly estrogen, causes increased blood circulation to the gums. This may cause an increase in the gum's sensitivity and lead to a greater reaction to any irritation, including food particles and plaque. During this time, the gums may become swollen, turn red and feel tender.

As a young woman progresses through puberty, the tendency for her gums to swell in response to irritants will lessen. However, during puberty, it is important to follow a good at-home oral hygiene regimen, including regular brushing and flossing, and regular dental care. In some cases, a dental professional may recommend periodontal therapy to help prevent damage to the tissues and bone surrounding the teeth.

Menstruation

Occasionally, some women experience menstruation gingivitis. Women with this condition may experience bleeding gums, bright red and swollen gums and sores on the inside of the cheek. Menstruation gingivitis typically occurs right before a woman's period and clears up once her period has started.

Pregnancy

Women may experience increased gingivitis or pregnancy gingivitis beginning in the second or third month of pregnancy that increases in severity throughout the eighth month. During this time, some women may notice swelling, bleeding, redness or tenderness in the gum tissue.

In some cases, gums swollen by pregnancy gingivitis can react strongly to irritants and form large lumps. These growths, called pregnancy tumors, are not cancerous and are generally painless. If the tumor persists, it may require removal by a periodontist.

Studies have shown a relationship between periodontal disease and pre-term, low-birth-weight babies. Any infection, including periodontal infection, is cause for concern during pregnancy. In fact, pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small! If you are planning to become pregnant, be sure to include a periodontal evaluation as part of your prenatal care.

Women who use oral contraceptives may be susceptible to the same oral health conditions that affect pregnant women. They may experience red, bleeding and swollen gums. Women who use oral contraceptives should know that taking drugs sometimes used to help treat periodontal disease, such as antibiotics, may lessen the effect of an oral contraceptive.

Menopause and Post-Menopause

Women who are menopausal or post-menopausal may experience changes in their mouths. They may notice discomfort in the mouth, including dry mouth, pain and burning sensations in the gum tissue and altered taste, especially salty, peppery or sour.

In addition, menopausal gingivostomatitis affects a small percentage of women. Gums that look dry or shiny, bleed easily and range from abnormally pale to deep red mark this condition. Most women find that estrogen supplements help to relieve these symptoms.

Bone loss is associated with both periodontal disease and osteoporosis. Research is being done to determine whether the two are related. Women considering Hormone Replacement Therapy (HRT) to help fight osteoporosis should note that this may help protect their teeth as well as other parts of the body.

Steps to Protect Oral Health

Careful periodontal monitoring and excellent oral hygiene is especially important for women who may be noticing changes in their mouths during times of hormonal fluctuation. To help ensure good oral (and overall) health, be sure to:

• See a dental professional for cleaning at least twice a year.

• See a periodontist in your area if you or your dentist notice problems with your gum tissue. Problems may include:

  • Bleeding gums during brushing

  • Red, swollen or tender gums

  • Gums that have pulled away from the teeth

  • Persistent bad breath

  • Pus between the teeth and gums

  • Loose or separating teeth

  • A change in the way your teeth fit together when you bite

  • A change in the fit of your dentures

• Keep your dental professionals informed about any medications you are taking and any changes in your health history.

• Brush and floss properly every day. Review your techniques with a dental professional on how to brush and floss.