Girls start making more sex hormones (both estrogen and progesterone) in puberty. With this increase in sex hormones comes an increased chance of gingivitis, an early stage of gum disease, in which gums may be red, swollen or tender, and may bleed easily. Some species of bacteria that contribute to gum disease use sex hormones in place of vitamin K, which is essential for their growth.
Luckily gingivitis responds well to a professional cleaning at your dentist's office and good oral hygiene at home including brushing twice a day and flossing. Because the gum tissue can be more reactive during puberty, in some cases professional cleanings more than twice a year may be needed.
During menstruation some women are not aware of any changes in their gums at all, while others complain of oral bleeding and swollen gums in the days before their period. These symptoms usually go away once menstruation begins. Other possible oral changes include cold sores, canker sores and swollen salivary glands.
As in puberty, good oral hygiene is important in reducing inflammation. More frequent cleanings may make sense in women who experience severe gum symptoms. Over-the-counter topical (like Anbesol) or systemic pain relievers (like ibuprofen) may help with symptoms from cold sores or canker sores, but in some cases women should see their dentist or medical doctor for prescription medications to help keep these problems in check.
Hormonal and circulation changes that are part of pregnancy often change the body's inflammatory response to plaque and other irritants and lead to an increased chance of gingivitis. Gingivitis occurs in 60 to 75 percent of all pregnant women. Changes in gum health are most noticeable from the second month of pregnancy, reaching a maximum in the eighth month, and are more common in front teeth than back teeth.
Pregnancy may also cause tumor-like growths that form in areas of frequent irritation, in-between teeth, or in areas of poor oral hygiene with plaque or tartar buildup. This gum tissue growth is called a pregnancy tumor or pregnancy granuloma and occurs in up to 10 percent of pregnant women. These purplish-red to deep blue growths often grow rapidly but usually don't become larger than one inch across.
Although gum changes are the most common changes with pregnancy, there are a number of other less common changes that women may deal with:
As with puberty and menstruation, good oral hygiene and regular professional cleanings (even when pregnant) are important to control pregnancy gingivitis. If you end up with a pregnancy granuloma, your dentist will be able to let you know how best to manage or treat this benign condition. If morning sickness is a problem, women should rinse their mouth with 1⁄4 teaspoon of baking soda mixed into 1 cup of warm water immediately after vomiting so that stomach acids will not remain in the mouth. Women who experience dry mouth will find that drinking more water and using sugarless candy or gum may be helpful.
Birth control pills can increase a woman's inflammatory response, similar to what is seen in pregnancy, causing gums to be redder and swollen and to bleed more easily. However, most studies done with birth control pills were done when the medication had much higher levels of hormones than most that are available today, so these symptoms may be a thing of the past. A recent clinical study looking at the effects of birth control medications in young women found these hormonal agents to have no effect on gum tissues. As far as their effect on saliva, the reviews are mixed — some studies have shown an increase and some have shown a decrease in salivary flow. Women taking birth control may also experience a higher chance of getting dry socket following extraction of wisdom teeth.
As with other hormone related gingivitis, good home oral hygiene combined with professional cleanings should help manage symptoms.
After a woman's reproductive years, there is a five to 10 year period of menopause-related changes in hormone patterns. These patterns end in a sharp decline of hormone levels. Thirty to 50 percent of women have no symptoms as they go through this phase of their life. Oral discomfort including pain, burning sensations, changes in taste and dryness of the mouth have all been reported with menopausal hormone changes.
For women experiencing dryness, drinking more water and using sugarless candy or gum will be soothing. Any burning or painful sensations should be examined by a dentist to rule out other non-hormone related causes.
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