Relationship between hormonal changes and women’s dental health

Hormones affect the health of the mouth. He discovers how puberty, the menstrual cycle, pregnancy, menopause and even taking contraceptives influence women’s teeth.

Last update: 01 March, 2022

Hormonal changes in women influence their dental health, as well as the health of their bones, muscles and reproductive system. Estrogens and progesterone, both natural and artificial, play a preponderant role in the risk of getting caries or gingivitis, for example.

Perhaps it is something that you have not considered, and although you do not have to be scared, it is preferable to take some precautions. As we will see, each stage of a woman’s life depends largely on the effect that hormones have at that time.

Puberty, pregnancy, menopause and the menstrual cycle are accompanied by hormonal changes in women that modify the parameters of their dental health. Similarly, if the chosen contraceptive method is based on hormones, as is the case with pills, there will also be some influence.

Why do hormonal changes affect women’s dental health?

Estrogens and progesterone they are able to act on various tissues of the woman’s body. They do this through receptors found on cells.

These receptors have been identified in the fibroblasts that are in the periodontal tissue, in the gums and in the osteoblasts of the maxillary bones. Therefore, we can assume that the hormones will generate changes in this entire area. These changes may enhance protection against agents that attack the mouth or, on the contrary, be a risk factor for illness.

We also know that progesterone, for example, has the ability to modulate the activity of the immune system. Namely, modifies the way cells respond to defend the body. In the mouth, it is capable of increasing the inflammation of the gums, by stimulating a greater production of inflammatory mediators. As we will see, in pregnancy this is decisive.

Estrogens, for their part, cause changes in the most superficial cells of the epithelia, which are those tissues that cover the surfaces of the body. In the oral mucosa, these changes reduce the possibility that we have to repel bacteria, so they could multiply more easily in women, increasing the risk of caries. This is especially noticeable in pregnancy.

Ultimately, both estrogen and progesterone They modify the circulation in the small arteries. In certain stages of female life, thrombi are more likely to form and the mucous membranes fill with excess blood, which leads to everything from bleeding when brushing teeth to periodontitis.

Hormonal changes of puberty and oral health

Puberty is a time of hormonal changes that does not go unnoticed by any woman. The physical changes are noticeable and the menstrual cycle may take a few months to acquire its normal rhythm.

Estradiol is the estrogen that increases its concentration the most at puberty. In this hormone we can look for clues about how this stage affects dental health.

A characteristic picture of this time is the gingivitis of puberty. It is characterized by an inflammation of the gums, especially in the interdental area. This is associated with more frequent bleeding when brushing teeth, for example, or eating very hard food.

According to statistics, with the onset of puberty there is an increased risk of gingivitis. Then, over the years, that risk decreases. In females, puberty begins between the ages of 8 and 10.

Age coincides with the time when many adolescents are treated with orthodontics to correct malpositions of their dental arches. And the appliances or braces They also increase the risk of gingivitis.

It means that oral hygiene at this stage must be intensified. Especially since the estrogens that increase their concentration are favoring more bacterial plaque. And it can be removed with the use of a toothbrush.

Therefore, the possibility of having a disease in the mouth at puberty will depend more on good habits than on the hormones themselves. Although estradiol promotes changes that are a risk factor for gingivitis, a correct brushing technique will be the necessary protection for girls.

The use of orthodontics in puberty is added as a risk factor for oral infections.

The menstrual cycle and the mouth

The menstrual cycle occurs regularly throughout the woman’s fertile period. From puberty to menopause, about once a month, there are repeated fluctuations of estrogen and progesterone.

Ovulation occurs in the middle of the menstrual cycle. An egg is released from the ovaries and estrogen increases exponentially in a very short time.

In those precise days around ovulation there is an increase in the amount of liquid exuded by the gums. I mean, there is a kind of inflammation of the soft tissues of the mouth that manifests itself with a fluid that passes through the gingival tissue and adds to the saliva.

This phenomenon is more noticeable in women who already suffer from gingivitis and in those who are younger. This has led to the description of a picture known as menstrual gingivitis or intermenstrual gingivitis.

It’s not entirely clear that fluid in the mouth during ovulation is a cause of gingivitis. In reality, it is more likely to be an added problem for women who already have gum disease beforehand.

Therefore, we can again say that maintaining oral hygiene is an essential habit to avoid gingivitis, without having to pay too much attention to the moment of the menstrual cycle in which we find ourselves. Tooth brushing is necessary every day.

Hormonal changes of pregnancy and dental health

Pregnancy is, without a doubt, a stage of great hormonal changes in women, which will cause alterations in dental health. Estrogens and progesterone increase in concentration in the blood, just as they do in saliva.

Pregnant women are prone to infections of the oral cavity. To such an extent that a particular clinical picture of this stage is pregnancy gingivitis. It is very rare that it progresses to periodontal disease, but it can bring problems to the mother at a time when dental treatments are more complicated to perform.

Pregnancy gingivitis has been associated with a increased risk of premature births and the birth of children with low birth weight. Therefore, dental check-ups for pregnant women are the best method to detect problems in the mouth in time and solve them according to the possibilities that can be applied in each trimester.

In the same way, another typical clinical picture is epulis gravidarum. This is a gum growth that is a benign tumor. It is attributed to an exaggerated inflammation of the gingival tissue due to progesterone and bacterial plaque.

Once delivery occurs, with the drop in hormone levels, epulis gravidarum shrinks or even disappears. At its largest, it can bleed easily on contact with a toothbrush or hard food.

Menopause and oral health

Menopause is the stage after the end of a woman’s fertile period. Menstrual cycles disappear and the body can no longer conceive.

The drop in estrogen concentration is the most obvious sign of menopause and a main cause of many of the health problems that will arise. Osteoporosis, hot flashes, increased cardiovascular risk, high blood pressure and various other disorders are explained by hormonal changes.

According to studies, menopausal women most often report the following:

  • Nonspecific oral complaints such as pain or a burning sensation.
  • Dryness of the oral mucosa.

On the other hand, osteoporosis causes loss of bone density in the jaws. This increases the risk of tooth loss. The subsequent problem is that implant treatments to replace losses may not be feasible if the maxillary bone does not have the necessary architecture to support a post, for example.

To deal with all these problems there are several options. Some women receive hormone replacement therapy (HRT), which is the taking of artificial estrogens by mouth to counteract the natural decline of the hormone.

HRT is not without controversy. Although improvements have been recorded in the periodontal health of women who are treated with it, it should only be indicated to those patients who have severe symptoms due to menopause and who present negative bone densitometry reports.

On the other hand, for oral discomfort derived from dry mouth, artificial saliva is an option. This product should be combined with more frequent intake of water and tooth brushing to prevent bacteria from taking advantage of the lack of moisture to settle in the mouth.

The use of artificial estrogens in menopause is controversial and the indication is reserved only for some women. They are not prescribed in a general way to all.

Do contraceptives influence women’s oral health?

Finally, within the hormonal changes that alter the dental health of women, we must mention the artificial hormones that are ingested or injected as a contraceptive method. Most of the commercial presentations are based on a combination of an estrogen with a progestogen.

In the past, oral contraceptives (OCs) had high doses of hormones. Those concentrations seemed to increase women’s risk of periodontal disease.

But today, the concentrations are much lower. For this reason, it is considered that there is relative safety for oral health and that women who could have problems are those with poorer dental hygiene.

It is likely that at the beginning of the use of an OC there is an increased possibility of suffering from an oral infection. In any case, this risk decreases as the consumption of the contraceptive is sustained.

Women who are undergoing dental treatments that involve the extraction of a dental element should be especially careful if they take COCs. After removing the tooth, a dry socket could occur, which is a very painful situation and It is considered a complication of dental extractions. more common among contraceptive users.

In short, the dentist will be the best advisor in any of these circumstances. That is why it is important that the woman mentions in dental consultations which contraceptive method she uses.

Most likely, the professional will suggest further care measures and not suspend contraception. With good habits it is possible to reduce the risks that we mention.

And in cases where the dentist prescribes certain antibiotics, he may suggest complementing the care with other methods to avoid unwanted pregnancies. Well some drugs inhibit contraceptive action.

Oral hygiene is key at any stage

No matter what stage a woman is going through, It is essential to maintain good habits to take care of the mouth. Correct and frequent brushing, a diet low in simple sugars and scheduled dental visits are capable of reducing the risk of cavities, gingivitis and periodontal disease.

If you have doubts because you notice changes in your mouth that are not normal and that seem to be related to some stage of hormonal change that you are going through, ask a trusted professional. A dentist will be able to advise you on possible treatments and will clarify whether estrogen or progesterone is really to blame for your disorder.

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