Women's hormones and oral health: from puberty to menopause

08 March 2024

Nina Garlo-Melkas explores the issues hormonal changes can cause for patients.

International Women's Day is a good time to consider the impact of hormones on oral health. From adolescence to menopause, a woman's body undergoes hormonal fluctuations that affect oral health and, consequently, overall physical and mental wellbeing.

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 them take proactive measures to maintain oral health.

Establishing good oral hygiene habits from an early age

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 wellbeing.

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 eight and 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.

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.

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.

Gum inflammation during pregnancy

Studies indicate that up to 75 per cent of pregnant women suffer from gum inflammation. Due to hormonal fluctuations, mild gum inflammation in pregnant women can lead to severe gum disease and 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 fibres. 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.

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 per cent of oral diseases are due to bacterial plaque.

Neglecting oral health during pregnancy can lead to premature birth, low birth weight, and the onset of preeclampsia during pregnancy.

During pregnancy, good oral hygiene also protects the unborn child. Oral health is part of general health and affects the wellbeing 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 unborn child's wellbeing. Dental professionals can recommend more frequent dental visits during pregnancy as this 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.

Saliva protects teeth from decay, and if there is a lack of saliva, teeth can decay more easily. As the defence capabilities of the gums weaken due to hormonal changes, even a small amount of bacterial plaque can easily cause gum inflammation.

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.

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.

Aging also increases the likelihood of needing implant treatments. Implants are also placed in patients treated for periodontitis. Durability can also be challenging, as placing implants requires healthy facial bone and healthy gums.

Careful self-care of teeth is essential for successful implant treatment. Patients should be reminded that the risk of gum disease does not disappear with an implant. 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 health pays off

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 wellbeing but also prevent potential complications such as premature birth or tooth loss.

Understanding the connection between hormones and oral health allows us to take the best possible preventive measures at different stages of life. This can promote our overall wellbeing and allow us to 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 wellbeing.

References are available on request.