If you’ve suddenly noticed sore gums, or a little bleeding when you brush, it could be due to hormonal changes — especially in women. Throughout a woman’s life, hormone fluctuations can lead to inflammation, which can manifest itself through the gums and salivary glands.
A professor at Tufts University School of Dentistry (TUSDM) says that while it’s impossible to completely prevent these oral changes, they are controllable, treatable and predictable.
Throughout life, the types and levels of hormones that regulate certain bodily processes change in both men and women. This can affect susceptibility to gum inflammation, says Natalie Jeong, professor and chair of the Department of Periodontology at the University of Texas Medical School.
For example, boys experience a surge in testosterone levels during puberty, and this hormone declines later in life. “This decline may affect overall immune function, leading to greater susceptibility to inflammatory conditions, including gum disease,” Jeong says.
Typically, men are more susceptible to gum disease than women, but Jeong adds, “The effects of hormonal changes are generally not as pronounced in men as in women.”
This is because women experience more and more dramatic hormonal changes. Puberty, menstruation, pregnancy, perimenopause and menopause run through a woman’s life, with new combinations of hormones working in harmony at each stage.
No single hormone affects oral health; rather, gums, salivary glands and teeth are all affected when hormone levels fluctuate.
“Hormonal changes can alter blood flow to the gums and the body’s immune response, so hormonal changes can make our bodies more susceptible to inflammation. And periodontal disease, or gum disease, is an inflammatory disease,” Zheng explains.
In fact, gum inflammation is common in women at every hormonal stage from puberty to menopause. The first symptom is gingivitis.
“Gingivitis is essentially inflammation of the gums. It’s the mildest form of gum disease,” Zheng says. With gingivitis, “some people have bleeding gums when they brush, others have slightly swollen, painful gums, or bad breath.
Some people may also experience gum recession—where the gums pull away from the teeth.” While hormonal imbalances don’t usually affect tooth structure, “the indirect effects on the gums and oral tissues can increase the risk of tooth decay, so the teeth are indirectly affected,” says Zheng.
In addition to swollen and bleeding gums, women can experience a variety of symptoms as they go through the following reproductive stages:
Puberty: Many girls begin orthodontic treatment during puberty because their gum inflammation is more severe then.
“Whether it’s clear or metal braces, braces can interfere with regular home care,” says Zheng. Food particles stuck in the braces can exacerbate a girl’s pre-existing gum inflammation.
Menstrual cycle: A woman’s mouth may be particularly sensitive during her menstrual period. In addition, hormone fluctuations can make the soft tissues of the mouth more sensitive and slightly suppress the immune system. These changes, combined with stress and fatigue before and during menstruation, can trigger mouth ulcers.
Pregnancy: During pregnancy, people may develop pyogenic granulomas, also called pregnancy tumors, on their gums. While these localized growths are benign, Dr. Cheng recommends consulting your dentist if you notice any unusual changes in your mouth, including pregnancy tumors. If a pregnancy tumor causes pain or interferes with home dental care, your dentist may be able to remove it.
Perimenopause: Fluctuations in estrogen and progesterone in the years before a woman’s last menstrual period can cause a decrease in saliva production, which can lead to dry mouth.
Because saliva helps neutralize acid and flush out bacteria, dry mouth can contribute to tooth decay, gum disease, and oral inflammation.
Menopause: Because hormone levels, especially estrogen, continue to drop during menopause, many women experience persistent dry mouth symptoms that may be more severe than during perimenopause.
Some menopausal women experience burning mouth syndrome, a burning, stinging, or scalding sensation on the tongue and lips.
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