Women have special needs at different stages of life. Puberty, menstruation, pregnancy and menopause all can influence your oral health and the need for dental treatment.

During these times, your body experiences hormonal changes that can make your gums sensitive and increase your risk for gum disease. By understanding these changes, you can practice good oral health habits that can keep your teeth and gums healthy.

What Is Gum Disease?

Gum disease (periodontal disease) is an infection of the gums and bone caused by plaque, a sticky film of bacteria that adheres to teeth. Plaque forms consistently on teeth and can build up if it is not removed through daily cleaning. The bacteria in plaque produce toxins, or poisons, that can irritate your gums.

In the early stages of gum disease, called gingivitis, gums swell, turn red and bleed easily. Eventually, the body’s response to these toxins causes the gums to separate from the tooth and form deepened spaces called pockets. In later stages of gum disease, called periodontitis, the bone and soft tissues that support the teeth can be destroyed, which ultimately can cause the teeth to become loose, fall out, or require removal by a dentist.

Periodontal disease can occur at any age, but it is most common among adults. In fact, three out of four adults are affected by it at some point in their lives. Women are especially susceptible to periodontal disease at certain stages of life. Hormonal changes can affect the blood supply to the gums, and response to irritants from plaque may be exaggerated. If you are already prone to periodontal disease, you may find the problem worsening at these times.

The Teenage Years

As females reach puberty, the production of the sex hormones progesterone and estrogen increases. The hormonal increase can exaggerate the way gum tissues react to the irritants in plaque. Gums may become red, tender, swollen and likely to bleed easily when chewing or brushing teeth. After the early teen years, women may notice less inflammation and bleeding.

Your Monthly Cycle

During menstruation, you may notice several changes in your mouth, including swollen gums, lesions, canker sores and swollen salivary glands.

Some women don’t notice any changes at all. For others, particularly those for whom plaque or pockets are a problem, the gums may bleed in the days before the period begins. These symptoms may go away once your period begins. These symptoms may go away once your period starts, but symptoms should not be ignored. Your dentist may prescribe special cleanings, gum treatment or topical anesthetics to ease any discomfort.

Pregnancy And Your Oral Health

During pregnancy, your body’s hormone levels rise considerably. Gingivitis, especially common during the second to eighth months of pregnancy, may cause red, puffy or tender gums that tend to bleed when you brush. This sensitivity is an exaggerated response to plaque and is caused by an increased level of progesterone in your system. Your dentist may recommend more frequent cleanings during your second trimester or early third trimester to help you avoid problems.

Occasionally overgrowths of gum tissue, called “pregnancy tumors,” appear on the gums during the second trimester. These localized growths or swellings are usually found between the teeth are are believed to be related to excess plaque. They bleed easily and are characterized by a red, raw-looking, mulberry-like surface. They are often surgically removed after the baby is born. If you experience pregnancy tumors, see your dentist.

It’s especially important, then, to maintain good oral health during pregnancy. Studies indicate that pregnant women who have severe gum disease may be at increased risk for pre-term delivery, which in turn increases the risk of having a low-birthweight baby. If you notice any changes during pregnancy, see your dentist.

If You Are Taking Oral Contraceptives

One of the most common problems for women who take oral contraceptives, or birth control pills, is inflamed gums. The hormone in oral contraceptives increases the level of progesterone in your system. Prolonged use of birth control pills may cause your gums to turn red, bleed, and swell in response to local irritants in the mouth, such as food or plaque. Good oral hygiene is especially important when taking birth control pills. Tell your dentist if you are taking oral contraceptives, because some medications, such as antibiotics, can lessen the effect of an oral contraceptive.

Reaching Menopause

You may notice a number of physical changes when you reach menopause, including some that occur in the mouth. These may include a burning sensation, altered taste sensations (salty, peppery or sour), a decrease in saliva flow that can result in dry mouth, and greater sensitivity to hot and cold food or drinks.

Talk with your dentist if you experience any oral problems that you think might be related to menopause. Be sure to mention any medications you are taking (both prescription and over-the-counter products), because many drugs can have dental-related side effects, including dry mouth. Saliva substitutes may be prescribed to reduce any mouth dryness. Vitamin C and B complexes may be helpful as well. Some women whose physicians have recommended hormone replacement therapy may notice an improvement in their oral symptoms. For good overall health, eat a balanced diet and discuss with your physician how to get the calcium you need to prevent osteoporosis, the risk of which increases after menopause.

How You Can Prevent Periodontal Disease

Remember that it is Plaque, not fluctuating hormone levels, that is the major cause of periodontal disease. Here are ways that you can help prevent periodontal disease:

• Be sure to brush your teeth thoroughly twice a day and clean between your teeth daily with floss or other interdental cleaners. Choose oral care products that carry the American Dental Association Seal of Acceptance, your assurance that a product has met ADA criteria for safety and effectiveness.
• If you need extra help in controlling plaque and gingivitis, your dentist may recommend that you use an antimicrobial mouthrinse.
  Regular dental visits and professional cleanings are essential. Plaque that is not removed can harden into a rough, porous deposit called calculus, or tartar. Tartar can only be removed when your teeth are cleaned in the dental office.
  Eat a balanced diet for good general health and limit snacks.
• In some cases, even with these measures, patients may experience a more advanced stage of periodontal disease that must be treated by other means. Your general dentist may provide treatment or may refer you to a periodontist, a dentist who specializes in the diagnosis and treatment of periodontal diseases.