You know that hormones affect your mood, but did you know
they can also impact your mouth? It's true: Hormonal fluctuations associated
with puberty, the menstrual cycle, pregnancy, menopause and use of birth
control medications can cause changes in your dental health. You may not be
able to take control of your hormones, but you can be aware of changes in your
mouth and work with your dentist to protect the health of your gums and teeth.
Puberty
What’s going on?
Girls start making more sex hormones (both estrogen and
progesterone) in puberty. With this increase in sex hormones comes an increased
chance of gingivitis, an early stage of gum disease, in which gums may be red,
swollen or tender, and may bleed easily. Some species of bacteria that
contribute to gum disease use sex hormones in place of vitamin K, which is
essential for their growth.
Fixes
Luckily gingivitis responds well to a professional cleaning
at your dentist's office and good oral hygiene at home including brushing twice
a day and flossing. Because the gum tissue can be more reactive during puberty,
in some cases professional cleanings more than twice a year may be needed.
Menstrual cycle
What’s going on?
During menstruation some women are not aware of any changes
in their gums at all, while others complain of oral bleeding and swollen gums
in the days before their period. These symptoms usually go away once
menstruation begins. Other possible oral changes include cold sores, canker
sores and swollen salivary glands.
Fixes
As in puberty, good oral hygiene is important in reducing
inflammation. More frequent cleanings may make sense in women who experience
severe gum symptoms. Over-the-counter topical (like Anbesol) or systemic pain
relievers (like ibuprofen) may help with symptoms from cold sores or canker
sores, but in some cases women should see their dentist or medical doctor for
prescription medications to help keep these problems in check.
Pregnancy
What’s going on?
Hormonal and circulation changes that are part of pregnancy
often change the body's inflammatory response to plaque and other irritants and
lead to an increased chance of gingivitis. Gingivitis occurs in 60 to 75
percent of all pregnant women. Changes in gum health are most noticeable from
the second month of pregnancy, reaching a maximum in the eighth month, and are
more common in front teeth than back teeth.
Pregnancy may also cause tumor-like growths that form in
areas of frequent irritation, in-between teeth, or in areas of poor oral hygiene
with plaque or tartar buildup. This gum tissue growth is called a pregnancy
tumor or pregnancy granuloma and occurs in up to 10 percent of pregnant women.
These purplish-red to deep blue growths often grow rapidly but usually don't
become larger than one inch across.
Although gum changes are the most common changes with
pregnancy, there are a number of other less common changes that women may deal
with:
Hormones do not contribute directly to cavities, but they do
cause an increase in appetite and often a craving for unusual foods, sometimes
in the middle of the night. At night, saliva production is decreased, and women
are less likely to brush after these "midnight snacks" — this
leads to an increased chance of cavities.
Acid erosion can occur as the result of repeated vomiting
associated with morning sickness or acid reflux.
Some pregnant women complain of dryness of the mouth due to
hormonal changes.
A very small number of pregnant women start making too much
saliva. It usually begins two to three weeks into their pregnancy and may
lessen at the end of the first trimester. In some cases, it continues until the
day of delivery.
Fixes
As with puberty and menstruation, good oral hygiene and
regular professional cleanings (even when pregnant) are important to control
pregnancy gingivitis. If you end up with a pregnancy granuloma, your dentist
will be able to let you know how best to manage or treat this benign condition.
If morning sickness is a problem, women should rinse their mouth with 1⁄4
teaspoon of baking soda mixed into 1 cup of warm water immediately after
vomiting so that stomach acids will not remain in the mouth. Women who
experience dry mouth will find that drinking more water and using sugarless
candy or gum may be helpful.
Birth control
What’s going on?
Birth control pills can increase a woman's inflammatory
response, similar to what is seen in pregnancy, causing gums to be redder and
swollen and to bleed more easily. However, most studies done with birth control
pills were done when the medication had much higher levels of hormones than
most that are available today, so these symptoms may be a thing of the past. A
recent clinical study looking at the effects of birth control medications in
young women found these hormonal agents to have no effect on gum tissues. As
far as their effect on saliva, the reviews are mixed — some studies have
shown an increase and some have shown a decrease in salivary flow. Women taking
birth control may also experience a higher chance of getting dry socket following
extraction of wisdom teeth.
Fixes
As with other hormone related gingivitis, good home
oral hygiene combined with professional cleanings should help manage symptoms.
Menopause
What’s going on?
After a woman's reproductive years, there is a five to 10
year period of menopause-related changes in hormone patterns. These patterns
end in a sharp decline of hormone levels. Thirty to 50 percent of women have no
symptoms as they go through this phase of their life. Oral discomfort including
pain, burning sensations, changes in taste and dryness of the mouth have all
been reported with menopausal hormone changes.
Fixes
For women experiencing dryness, drinking more water and
using sugarless candy or gum will be soothing. Any burning or painful
sensations should be examined by a dentist to rule out other non-hormone
related causes.
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