If you’ve noticed your gums feeling tender or bleeding while brushing, hormonal fluctuations might be to blame, especially for women. As women go through life, fluctuating hormones can contribute to inflammation that affects the gums and salivary glands, making oral health more vulnerable.
Hormones can alter the body’s response to inflammation, and this is evident in changes to gum health. According to Natalie Jeong, Professor and Chair of the Department of Periodontology at Tufts University School of Dental Medicine (TUSDM), both men and women experience hormone-related changes, but women experience more dramatic shifts over their lifetimes, from puberty to menopause. These fluctuations can lead to increased susceptibility to gum inflammation and diseases like gingivitis and periodontitis.
How Hormones Affect Oral Health
While men do experience a surge of testosterone during puberty, it declines later in life, potentially leading to a higher risk of gum disease due to decreased immune function. However, women experience more dramatic hormonal changes. Puberty, menstruation, pregnancy, perimenopause, and menopause all present unique hormonal combinations that influence oral health. These fluctuations can disrupt blood flow to the gums and impair immune function, making the body more susceptible to inflammatory diseases such as gum disease.
Common Oral Health Issues During Hormonal Shifts
Puberty: During puberty, girls often experience more inflamed gums due to increased hormone levels. This can be exacerbated by orthodontic care, such as braces, which can trap food and contribute to poor oral hygiene.
Menstrual Cycle: Hormonal fluctuations during menstruation can cause oral tissues to become more sensitive, and may even suppress the immune system slightly. Stress and fatigue prior to and during the period can also trigger canker sores.
Pregnancy: Pregnant women may develop pyogenic granulomas (pregnancy tumors) on their gums. While these benign growths can be uncomfortable or interfere with oral care, they are treatable and should be evaluated by a dentist.
Perimenopause: The years leading up to menopause often involve fluctuations in estrogen and progesterone levels, which can decrease saliva production. This can lead to dry mouth, a condition that increases the risk of tooth decay, gum disease, and oral inflammation.
Menopause: As estrogen levels decline during menopause, dry mouth becomes more pronounced, and many women experience burning mouth syndrome, characterized by a burning or tingling sensation on the tongue and lips.
Medications and Hormone Therapies
Certain medications, such as antihistamines and antidepressants, can cause dry mouth, exacerbating the risk of tooth decay and gum disease, particularly in older women. Bisphosphonates, used to treat osteoporosis, have been linked to osteonecrosis of the jaw, a rare but serious condition where jawbone cells die. Additionally, hormonal contraceptives (birth control pills and IUDs) and hormone replacement therapy (HRT) during menopause can elevate estrogen or progesterone levels, increasing the likelihood of gum inflammation.
Women taking HRT or birth control should inform their healthcare providers, including their dentists, as some antibiotics can interfere with the effectiveness of oral contraceptives.
Hormone Therapy and Transgender People
Though studies on oral health and hormone therapy for transgender people are limited, existing research suggests that transgender individuals may experience poorer oral health compared to non-transgender individuals. For example, estrogen therapy can cause dry mouth, while testosterone therapy may lead to reduced saliva production and an increased risk of gingivitis.
Managing Hormone-Related Oral Health Changes
While you can’t eliminate the risk of hormonal-induced oral inflammation, you can take steps to maintain optimal oral health:
Regular Checkups: Routine dental visits are essential for catching and addressing oral issues early.
Good Oral Hygiene: Brush your teeth twice a day, floss regularly, and use mouthwash. Pay extra attention to oral care during hormonal fluctuations, especially when pregnant or menstruating.
Watch Your Diet: Avoid acidic or sugary foods and drinks, which can exacerbate oral issues. If you do consume them, brush your teeth afterward.
Avoid Smoking: Smoking is a significant risk factor for gum disease and can worsen hormone-induced oral inflammation. If you smoke, consider quitting.
Seek Prompt Treatment: If you notice signs of gum inflammation, such as bleeding or swelling, seek treatment early. Gingivitis is treatable, but if left untreated, it can progress to periodontitis, which requires more extensive treatment.
By being proactive about oral care, especially during times of hormonal change, you can help protect your gums and teeth from inflammation and disease.
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