Women and Periodontal Health
Throughout a woman’s life, hormonal changes affect tissue throughout the body. Fluctuations in hormonal levels occur during puberty, pregnancy and menopause. At these times, the chance of periodontal disease may increase, requiring special care of your oral region.
During puberty, there is increased production of sex hormones. These higher hormone levels increase gum sensitivity and lead to greater irritation from plaque and food particles. The gums can become swollen, turn red, and feel tender.
Similar symptoms occasionally appear several days before menstruation. Bleeding of the gums, bright red swelling between the teeth and gum, or sores on the inside of the cheek may occur. These symptoms generally clear up once the period has started.
Swelling, bleeding, and tenderness of the gums may also occur when you are taking oral contraceptives, which are synthetic hormones.
Patients should always mention any prescriptions being taking, including oral contraceptives, prior to medical or dental treatment. This will help eliminate the risk of drug interactions, such as antibiotics with oral contraceptives, which lessens the effectiveness of the contraceptive.
Changes in the look and feel of the mouth may occur during menopause or post-menopause. They include: feeling pain and burning in the gum tissue and salty, peppery, sour tastes, and “dry mouth.” Careful oral hygiene at home and professional cleaning may relieve these symptoms. There are also saliva substitutes to treat the effects of dry mouth.
The gums and teeth are also affected during pregnancy. Between the second and eighth month, gums may also swell, bleed, and become red or tender. Large lumps may appear as a reaction to local irritants; however, these growths are generally painless and not cancerous. They may require professional removal, but usually disappear sometime after delivery. Periodontal health practices should be part of prenatal care. Any infections during pregnancy, including periodontal infections, can place a baby’s health at risk. For more information, see the section of our website labeled “Pregnancy and Periodontal Disease” under the “Mouth-Body Connection” tab.
Periodontal Disease and Pregnancy
Pregnant women with periodontal disease may expose the fetus to a variety of risks and possible complications. Pregnancy causes many hormonal changes in women, which increase the likelihood of developing periodontal disease such as gingivitis, or gum inflammation. These oral problems have been linked to preeclampsia, or low birth weight of the baby, as well as premature birth. Fortunately, halting the progression of periodontal disease through practicing high standards of oral hygiene and treating existing problems can help reduce the risk of periodontal disease-related complications by up to 50%.
There are several factors that contribute to why periodontal disease may affect the mother and her fetus. One is an increase in prostaglandin in mothers with advanced stages of periodontal disease, particularly periodontitis. Prostaglandin is a labor-inducing compound found in the oral bacteria associated with periodontitis. Because periodontitis increases the levels of prostaglandin, the mother may go into labor prematurely and deliver a baby with a low birth weight.
Another compound that has recently been linked to premature birth and low birth weights is C-reactive protein (CRP). CRP is a protein that has long-been associated with heart disease. Periodontal disease increases CRP levels in the body, which then amplify the body’s natural inflammatory response. Bacteria from periodontal disease may enter the bloodstream, causing the liver to produce extra CRP, which then leads to inflamed arteries and possibly blood clots. Inflamed arteries can lead to blockage, which can cause heart attacks or strokes. Although it is not completely understood why elevated CRP also causes preeclampsia, studies have overwhelmingly proven that an extremely high rate of CRP in early pregnancy definitely increases the risk.
Finally, the bacteria that invades and lives in the gum sockets in a diseased mouth, can travel through the bloodstream and affect other parts of the body. For pregnant women, research has shown that these bacteria may colonize in the internal mammary glands and coronary arteries.
If you are pregnant, it is important to practice effective home care for preventing gum disease.