The saying goes that men are from Mars and women are from Venus! And this popular aphorism is no less applicable when it comes to oral health and dental care.
Now let’s delve further into the specific oral health problems faced by many women.
They start where most female problems start: at puberty.
The increase of the sex hormones oestrogen and progesterone at puberty can feed bacteria in the mouth, possibly leading to gingivitis or gingival inflammation. In healthy patients with no previous gum issues this should result in nothing more than a slight increase in bleeding and some tenderness. Removing the bacteria by brushing and interdental cleaning, or by using a mouth rinse such as Savacol or Curasept, should help reduce symptoms until the hormones reduce. If you, or your daughter, are experiencing significantly inflamed gums that are painful to clean as part of your usual home routine, seeing your hygienist will significantly help.
In pregnant women the oestrogen and progesterone levels continue to increase beyond those experienced in puberty. In the final stages of pregnancy these hormone levels are, respectively, 10 times and 30 times the level of a female during puberty. This creates an ideal situation for the bad bacteria that cause the more significant and serious forms of gum disease. Many pregnant women find that their gums bleed or hurt, despite their best efforts at cleaning. Women are advised to have a dental check while they are pregnant; this will help to ensure that bacterial levels are low, home cleaning is effective and there is no dental disease present that could worsen during pregnancy.
Like in puberty and pregnancy, the changes in sex hormone levels that occur during menopause can affect women’s gum health. Menopausal women present with more severe forms of gum disease and do so more frequently.
Also due to the changes in hormones, saliva flows decrease in post-menopausal women. Saliva is the mouth’s natural protector, and a decrease in saliva flow increases the risk of all types of dental disease. In addition, a lack of saliva can cause dry mouth, burning mouth syndrome and diseases of the oral mucosa. For patients going through menopause, regular dental checks are important to maintain healthy tissues and check for any changes.
There is a direct link between the lack of oestrogen during menopause and the development of osteoporosis. Some 30 per cent of pre-menopausal women have osteoporosis, and females with osteoporosis are three times more likely than those without to experience tooth loss from severe gum disease.
One of the treatments for osteoporosis is a class of medications called bisphosphonates. Bisphosphonates can cause osteonecrosis of the jaw (when the jaw bone is exposed and begins to starve from a lack of blood) if a tooth is extracted while a patient is on this medication; therefore tooth extraction is avoided in such patients. All medical professionals highly recommend that patients with osteoporosis have dental screenings, especially before taking bisphosphonate medications. Dentists can also help screen for associated risk factors of osteoporosis like gum disease.
Being a woman is never easy. That’s why I often say to my patients: “The greater the risk, the greater the importance of more protective factors.” If you are worried about one or more of the risks described above, you are urged to visit your dentist to be professionally screened and diagnosed, and to have your hygienist create a personal hygiene plan.
Dental Hygienist and Therapist