Good oral hygiene is important for dental health. It is especially important for women because of hormonal changes throughout their life which can increase the risk of tooth and gum disease.
Hormones can have fluctuating levels during puberty, menstruation, pregnancy, breast feeding and menopause resulting in swelling and changes to the gums. The pill and hormone replacement therapy can also play a role in the health of a woman’s mouth.
Attention to oral hygiene is very important for women because tender, bleeding gums aggravated by changes in hormone levels are more likely to harbour bacteria. This can contribute to plaque formation (plaque is a common cause of tooth decay and gum disease).
If oral hygiene is poor, plaque can eventually harden into calculus (tartar). If left untreated this can lead to infection and inflammation of the tissues supporting the teeth. This can cause serious damage to gums and the bone that support the teeth. In severe cases teeth may loosen and need to be extracted.
To reduce plaque build-up on teeth:
Brush 2 – 3 times daily and floss once per day.
Choose healthy food. High-sugar foods (especially sticky lollies, dried fruits/sticky muesli bars, cakes and biscuits) promote the growth of plaque-forming bacteria. After eating high-sugar or starchy foods, brush your teeth.
- Avoid snacking, which increases the rate of plaque development. Regular meals are healthier for your teeth.
- Drink mainly water and milk. Avoid adding sugar to coffee and tea; if you do, rinse afterwards with water.
- Chew sugarless gum after eating to help stimulate saliva and reduce the risk of plaque.
- Have regular 6 monthly check-ups by your dentist.
Many women experience bleeding gums during their pregnancy (pregnancy gingivitis). This is due to the surge in female hormones and typically is worse during the first 12 weeks of the pregnancy. Careful attention to dental hygiene is important in this time and more frequent visits to the dentist may be required for professional cleaning.
Most dental treatment can be carried out with safety during pregnancy. In general, elective treatment is best performed in the second trimester (ie the fourth, fifth and sixth months) of pregnancy.
If dental x-rays are necessary for assessment or diagnosis of infection or trauma, or for treatment of these conditions, there is no reason, on radiation protection grounds, to defer them. A lead apron is used during any x-ray procedures.
Puberty and Menstruation
Due to the surge of female hormones at puberty and during menstruation, women may develop swollen, tender gums at different times of the month. The gums become sensitive to irritants, such as toothpastes or cold drinks. Ulcers or cold-sore lesions are more likely to occur.
With the onset of menopause and the gradual decline in female hormone levels, women may notice new dental problems developing. Pain in the mouth and burning sensations, dry mouth, or a bad taste can all occur around this time of a women’s life. Gums may become sore and sensitive. These symptoms can all be relieved by continuing good oral hygiene, including brushing, flossing and regular visits to the dentist.
The Contraceptive Pill
The Pill contains levels of hormones which can lead to swollen and sensitive gums. Symptoms are more likely to occur in women who have been using The Pill for many years. Unlike menstruation gingivitis, the symptoms may not necessarily occur just before a period but may be noticeable during the entire month while The Pill is being taken.
Hormone Replacement Therapy
Women who commence HRT at menopause may notice an increase in bleeding, swelling and redness of the gums. This is due to the hormones in the HRT medication.
Bad breath (called halitosis) can afflict women just before a period. Bad breath may be due to hormonal fluctuations, which lead to changes in the saliva and an increase in bacteria in the mouth. Bad breath can also be due to poor oral hygiene, gum disease, chronic sinus problems, and lung or stomach diseases.
To help alleviate bad breath:
- Brush teeth, gums and tongue regularly
- Floss daily
- Tongue cleaning using your toothbrush or a tongue scraper
- Drink plenty of water
- Limit the intake of coffee and alcohol
- Chew sugar-free gum, especially if your mouth is dry
- Brush after eating or drinking milk products, fish and meat
- Quit smoking
Medical Conditions That Affect Oral Health
Burning Mouth Syndrome affects many women in their postmenopausal years. This syndrome causes chronic pain and a burning sensation in the mouth. It may also lead to a dry mouth, increased thirst, altered taste sensation, changes in eating habits, irritability and depression. Symptoms can be eased by using sugar-free gum and drinking water frequently.
Osteoporosis is common in women, especially in postmenopausal women. Some drug therapies used to improve bone strength such as the bisphosphonates can increase the likelihood of osteonecrosis (a very painful dry socket). All women taking bisphosphonates should inform their dentist and extractions should be avoided. Prior to the commencement of this drug therapy, a dental check-up is advised to eliminate caries and establish healthy gums. After commencing bisphosphonate therapy, regular dental check-ups are advised to maintain oral health, avoid extractions and ensure dentures are fitting well.