Women and Gum Disease
As a woman you know that your health needs are unique. You know that brushing and flossing daily, diet, exercise and regular visits to your doctor and dentist are all important to help you stay in good shape. 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 change at these times too?
During these particular times, your body experiences hormonal changes. These changes can affect many of the tissues in your body, including your gums. Your gums can become sensitive, and at times react strongly to the hormonal fluctuations. This may make you more susceptible to gum disease.
What is gum disease?
Gum disease, or periodontal disease, is caused by the bacteria and toxins in dental plaque, a sticky colourless film that constantly forms on the teeth. Gum disease affects the gums and supporting structures of the teeth. The earliest stage of gum disease, gingivitis, usually causes the gum tissue to swell, turn red and bleed easily. There is usually little or no pain at this time.
Sometimes swelling and bleeding can be seen only by the dentist. If left untreated, gum disease can progress to a more serious stage where the bone and tissue surrounding the teeth are damaged or destroyed. If still not treated, teeth eventually become loose and may be lost.
Without careful home oral care, including brushing and flossing and regular visits to the dentist, you put yourself at risk of gum disease. In addition, as mentioned before, hormonal changes at certain stages in life can be a contributing factor in your chances of getting some kinds of gum disease, or can make an existing gum problem worse.
The following will give you an idea of some of the symptoms you might experience with your oral health during puberty, menstruation, pregnancy and menopause and help to answer some of the questions you might have.
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During puberty, an increased level of sex hormones, such as progesterone and possibly estrogen, in a young woman’s maturing system causes increased blood circulation to the gums. This, in turn, may cause an increase in the gums’ sensitivity which leads to a greater susceptibility or reaction to any irritation, including food particles, plaque bacteria and calculus (or tartar).
There is also some evidence that the increased level of sex hormones increases the growth of some bacteria just beneath the gums around the teeth. The gums react to local irritants and swell. Since the cause of the swelling is due to local irritants, these must be removed by a dental professional. Afterwards, careful oral home care (including brushing and flossing) is necessary, or the swelling will return. If not treated, the bone and tissues surrounding the teeth can be damaged.
As a young woman progresses through puberty, the tendency for her gums to swell so much in response to a small amount of irritants will lessen. However, it is important that she remembers to brush and floss daily and seek regular professional dental care.
Gingivitis (red, swollen, tender or bleeding gums) can be much more prevalent during menstruation. Again, this is due to an increased amount of progesterone in your system before your period begins, accompanied by plaque accumulation. Occasionally, some women experience sore or bleeding in the mouth three or four days before their period begins. Another rare occurrence for some women is gingivitis during menstruation, which is marked by reappearing gingival (gum) bleeding, a bright red swelling of the gums between the teeth and sores on the tongue and inside of the cheek.
Menstruation gingivitis occurs right before a woman’s period and clears up once her period has started. As always, good home oral hygiene, including brushing and flossing, is important to maintain oral health, especially during these hormonal fluctuations.
There used to be an old wives tale that said ‘A tooth lost for every child’. While it may be far fetched, it actually was based loosely in fact. Your teeth and gums are affected by your pregnancy, just as other tissues in your body. Most commonly, women experience increased gingivitis, beginning in the second or third month that increases in severity through the eighth month and begins to decrease in the ninth month. This condition, called pregnancy gingivitis, is marked by an increased amount of swelling, bleeding and redness in the gum tissue in response to a very small amount of plaque or calculus. This again is caused by an increased level of progesterone in the system.
If your gums are in good health before you get pregnant, you are less likely to have any problems. Pregnancy gingivitis usually affects areas of previous inflammation, not healthy gum tissue. If you experienced some swelling and bleeding of your gums before pregnancy, you might be at an increased risk for pregnancy gingivitis.
Just like any other type of gingivitis, if left untreated, pregnancy gingivitis can have damaging effects on the gums and bone surrounding your teeth,resulting in tissue (bone and gum) loss. As there will be a great increase of estrogen and progesterone in your system throughout your pregnancy, you may experience more gingival problems at this time. Because your oral tissues are more sensitive due to increased progesterone, they will react strongly to any local irritant present.
In order to reduce the amount of gingival problems, it is important to seek professional cleaning to remove irritants and keep up a diligent daily home oral care routine, including brushing and flossing. Now more than ever, regular examinations by your dentist are very important. If your dental check-up is due, don’t skip it. In fact, you might benefit from more frequent professional cleaning during your second trimester or early third trimester.
Remember, if tenderness, bleeding or gum swelling occurs at any time during your pregnancy, notify your dentist as soon as possible.
Occasionally, the inflamed gum tissue will form a large lump. These gum growths, called pregnancy tumours (or granuloma), usually appear in the third month of pregnancy, but may occur at any time during the course of pregnancy. A pregnancy tumour is a large swelling of gum tissue and is not cancerous in any way. It is an extreme inflammatory response to any local irritant (including food particles, plaque or calculus) that may be present.
A pregnancy tumour usually looks like a large lump on the gum tissue with many deep red pin-point markings on it. The tumour is usually painless, however, it can become painful if it interferes with your bite or if debris collects beneath it. If a pregnancy tumour forms, it may be treated by professional removal of all local irritants and diligent home oral care. Any further treatment or removal would need to be discussed with your dentist and doctor.
Pregnancy gingivitis and pregnancy tumours usually diminish following pregnancy but they do not go away completely. If you experience any gum problems during your pregnancy, it is important on completion of your pregnancy to have your entire mouth examined and your periodontal health checked. Any treatment you might need can be determined at this time.
If you are taking any oral contraceptives (birth control pills), you may be susceptible to the same oral health conditions that affect pregnant women. As the hormones in oral contraceptives will increase the levels of progesterone in your system, any local irritants (food, plaque, etc) may cause your gums to turn red, bleed and swell. There are many medications (for example, antibiotics) that can lessen the effect of an oral contraceptive, so it is important for you to tell your dentist or doctor you are taking oral contraceptives before he or she prescribes anything for you
For the most part, any oral problem you have while you are in menopause probably is not directly related to the changes going on in your body. If you are taking estrogen supplement during this time, these should have little or no effect on your oral health. However, progesterone supplements may increase your gums response to local irritants, causing the gums to bleed, turn red and swell.
On rare occasions, a woman may experience a condition called menopausal gingivostomatitis. This condition is marked by gums which are red and shiny, bleed easily and that range in colour from the normally pale to deep red. Other symptoms include a dry, burning sensation in the mouth, abnormal taste sensations (especially salty, peppery or sour), extreme sensitivity to hot and cold foods or drinks, and finally, difficulty removing any partial dentures. If you are diagnosed with menopause gingivostomatitis, your dentist or periodontist can help you manage your condition with special medications.
If you have any questions about your oral health, talk with your dentist or periodontist. They will be happy to address any concerns you may have. Each phase of a woman’s life brings with it many changes. As always, your oral health at these times continues to be of importance to your overall health and well-being. Nothing helps greet each day and each new change in your life like a bright, healthy smile.Summary
Pregnancy can lead to dental problems in some women, including gum disease and increased risk of tooth decay. Proper hygiene at home and professional help from your dentist will ensure that your teeth remain healthy throughout pregnancy. Premature births may be triggered by periodontal disease, which is a chronic infection of the gums.
Pregnancy can lead to dental problems in some women, including gum disease and increased risk of tooth decay. During pregnancy, your increased hormones can affect your body’s response to plaque (the layer of germs on your teeth).
Pregnancy does not automatically damage your teeth. The old wives’ tale that warns a woman to expect a lost tooth for every baby is false. If the mother’s intake of calcium is inadequate during pregnancy, her bones – not her teeth – will provide the calcium her growing baby needs. This calcium loss is quickly made up after breastfeeding is stopped. However, the demands of pregnancy can lead to particular dental problems in some women.
With proper hygiene at home and professional help from your dentist, your teeth should remain healthy throughout pregnancy.
Research has found a link between gum disease in pregnant and premature birth women with low birth weight. Babies who are born prematurely may risk a range of health conditions including cerebral palsy and problems with eyesight and hearing.
Estimates suggest that about 18 out of every 100 premature births may be triggered by periodontal disease, which is a chronic infection of the gums. Appropriate dental treatment for the expectant mother can reduce the risk of premature birth by more than 80 per cent, according to one study.
You are less likely to have dental problems during pregnancy if you already have good oral hygiene habits. Suggestions include:
- Brush your teeth at least twice daily with fluoridated toothpaste.
- Floss between your teeth.
- Visit your dentist regularly. If you are planning on getting pregnant, see your dentist. It is more convenient to have elective procedures done before you conceive. If you require dental treatment during pregnancy, non-urgent procedures are often performed after the first trimester.
Tell your dentist if you are pregnant
Pregnancy may affect your dental care. For example, the dentist may put off taking x-rays until after the birth of your baby. If dental x-rays are unavoidable, the dentist can take precautions to ensure your baby’s safety. If your dental condition requires general anaesthesia or medications, talk to your dentist, doctor or obstetrician for advice.
Common causes of dental health problems during pregnancy can include:
- Gum problems
- Cravings for sugary foods
- Retching while brushing teeth
The hormones associated with pregnancy can make some women susceptible to gum problems including:
- Gingivitis (gum inflammation) – this is more likely to occur during the second trimester. Symptoms include swelling of the gums and bleeding, particularly during brushing and flossing between teeth
- undiagnosed or untreated periodontal disease – pregnancy may worsen this chronic gum infection, which is caused by untreated gingivitis and can lead to tooth loss. It can show up as gum swellings, know as pregnancy epulis, which may or may not resolve once your baby is born.During pregnancy, the gum problems that occur are not due to increased plaque, but a worse response to plaque as a result of increased hormone levels.
Tell your dentist about any gum problems that you might have. Switch to a softer toothbrush and brush your teeth regularly, at least twice every day. Use toothpaste that contains fluoride (if you’re not already) to help strengthen your teeth against decay.
If you had gum problems during pregnancy, it is important to get your gums checked by a dentist after you have given birth. While most types of gum problems caused by pregnancy hormones resolve after birth, a small number of women may have developed a deeper level of gum disease that will need treatment to resolve.
Pregnancy hormones soften the ring of muscle that keeps food inside the stomach. Gastric reflux (regurgitating food or drink) or the vomiting associated with morning sickness can coat your teeth with strong stomach acids. Repeated reflux and vomiting can damage tooth enamel and increase the risk of decay.
- Don’t brush your teeth immediately after vomiting. While the teeth are covered in stomach acids, the vigorous action of the toothbrush may scratch the tooth enamel.
- Rinse your mouth thoroughly with plain tap water.
- Follow up with a fluoridated mouthwash.
- If you don’t have a fluoridated mouthwash, put a dab of fluoridated toothpaste on your finger and smear it over your teeth. Rinse thoroughly with water.
- Brush your teeth at least an hour after vomiting.
Retching while brushing teeth
Some pregnant women find that brushing their teeth, particularly the molars, provokes retching. However, you risk tooth decay if you don’t brush regularly. Suggestions include:
Use a brush with a small head, such as a brush made for toddlers.
- Use a brush with a small head, such as a brush made for toddlers.
- Take your time. Slow down your brushing action.
- It may help to close your eyes and concentrate on your breathing.
- Try other distractions, such as listening to music.
- If the taste of the toothpaste seems to provoke your gag reflex, switch to another brand. Alternatively, brush your teeth with water and follow up with a fluoridated mouthwash. Go back to brushing with fluoridated toothpaste as soon as you can.
Some women experience unusual food cravings (and food avoidance) while they are pregnant. A regular desire for sugary snacks may increase your risk of tooth decay. Try to snack on low-sugar foods instead.
If nothing but sweetness will satisfy your craving, try to sometimes choose healthier options such as fresh fruits. Rinse your mouth with water or milk, or brush your teeth after having sugary snacks.
You need to increase your daily amount of calcium during pregnancy. Sufficient calcium will protect your bone mass and meet the nutritional needs of your developing baby.
Good sources of dietary calcium include low-fat versions of products such as:
- Calcium-fortified soymilk.
Increase your vitamin D during pregnancy
Vitamin D helps the body to utilise calcium. Good sources include:
- Fatty fish, such as salmon
- Eggs.Where to get help
- Your doctor
- ObstetricianThings to remember
- The demands of pregnancy can lead to particular dental problems in some women.
- Estimates suggest that about 18 out of every 100 premature births may be triggered by periodontal disease, which is a chronic infection of the gums.
- You are less likely to have dental problems during pregnancy if you already have good oral hygiene habits.You might also be interested in:
- Three of four adults are affected by periodontal disease — commonly known as gum disease — at some point in their lives. But did you know that women are particularly susceptible to this disease at certain stages of life?
Women who are already prone to gum disease may find the problem worsening during some stages of life due to hormonal changes that can affect the blood supply to the gums and exaggerate the body’s response to irritation caused by plaque on the teeth. Specifically:
- During menstruation, some women may experience swollen gums, lesions, canker sores, swollen salivary glands or bleeding gums. Your dentist may prescribe special cleanings, gum treatment or topical anesthetics to ease any discomfort.
- A common problem for women who take oral contraceptives is inflamed gums. Tell your dentist if you are taking birth control pills because some medications the dentist might give you, such as antibiotics, can lessen the effect of an oral contraceptive.
- Gingivitis may cause red, puffy or tender gums during pregnancy, especially during the second to eighth months, due to elevated hormone levels. Your dentist may recommend more frequent cleanings during your second trimester or early third trimester to help avoid these problems.
- Physical changes that can occur in the mouth after reaching menopause include a burning sensation, altered taste sensations (salty, peppery or sour), dry mouth from decreased saliva flow and greater sensitivity to hot and cold foods and drinks. Saliva substitutes may be prescribed to combat dry mouth.Our Practice is open seven days a week from 8am till 10pm. You can book a free consultation with one of our experienced dentists by calling +91-8801627272or emailing;-email@example.com us for further information or to arrange a consultation.
Our Practice is open seven days a week from 8am till 10pm. You can book a free consultation with one of our experienced dentists by calling +91-8801627272or emailing;-firstname.lastname@example.org us for further information or to arrange a consultation.