The hormonal changes that the woman undergoes in certain stages of her life condition extraordinarily the appearance of some oral disorders and these, in turn, become a frequent and worrying health problem for the female sex.
The diseases of the gums, although they are also habitual and transcendental in the men, acquire in the woman a greater dimension, especially in the puberty, the pregnancy and the menopause.
Although periodontal disease affects both men and women, and in similar proportions, it has been shown that female hormones are directly related to the weakness of the gum, so that with the same amount of bacteria the inflammatory response of the organism is greater, producing gingivitis and aggravating periodontitis?, says Dr. Pedro Bullón, Professor of Stomatology at the University of Seville.
And it is that oral health care acquires a special significance in women and, even more so, in certain stages of their lives. There are specific hormonal changes in women that often cause differentiated periodontal disease. During the woman’s life there are periods in which the gums will be more susceptible to inflammation and suffering from diseases, mainly for hormonal reasons.
In puberty, before menstruation, during pregnancy and in menopause periodontal diseases have a special prominence?? In fact, there are periodontal pathologies typical of a specific situation in women, such as gestational gingivitis, which affects the majority of pregnant women and is characterized by hypertrophy of the interdental papillae and a marked increase in vascularization.
There are also tumor forms in the mouth, such as polis or gingival granulomas, which appear in pregnancy and can spontaneously disappear after the same with a correct control of the bacterial plaque, although frequently they need to be eliminated with surgery.
Take care of your gums … during puberty
Unlike what is usually accepted, periodontal disease is not only an adult problem; practically all adolescents suffer from gingivitis due to bacterial plaque, which is the first stage of periodontal disease ??. In adolescence, periodontal diseases can progress and worsen.
At puberty marked signs of inflammation may develop in the gums, without a clear increase in plaque levels. It is called pubertal gingivitis?? And it is associated with increases in sex hormones, estrogen and progesterone, which occur around the age of 12. These hormonal changes produce an increase in blood circulation in the gums, which favors an exaggerated inflammatory response to the action of bacteria, bleeding is common.
It is a generally transient situation, and reversible after puberty, at least partially. The elimination of bacterial plaque through proper hygiene instructions and / or dental prophylaxis (“mouth cleaning”) are the key factors in controlling symptoms. Occasionally, some women have a menstrual gingivitis, presenting bleeding and inflammation of the gums with a bright red tone as well as ulcers on the cheeks. Menstrual gingivitis occurs just before menstruation and disappears once it has started.
Take care of your gums … during pregnancy
Alterations in hormone levels that occur during pregnancy affect the blood vessels of the gums, the functioning of the cells of the periodontium (tissue that surrounds and supports the teeth), the bacteria of the plaque and the local immune system. This explains why the inflammation of the gums increases during pregnancy, and usually disappears after delivery (what is known as gingivitis of pregnancy or gravid arum). Nowadays, the importance of the inflammatory-infectious dental pathology, such as periodontitis, is known in the possibility of triggering threats of preterm delivery (before the 37th week of gestation).
As Professor Joseph Maria Laila explains, this phenomenon is closely linked to the release of prostaglandins, which are oxytocic substances that act first in cervical ripening and, subsequently, as inducing uterine contractions. In addition, changes in salivary pH, increase in saliva, and changes in dental plaque during pregnancy are factors that should be taken into account in these women.
Periodontal disease can affect 36-100% of pregnant women (according to studies), as long as there is previous gingivitis. The gum is intensely red, bleeds easily, is thickened and with a clear increase in size between the teeth, which allows more bacteria to be below the gum.
If the pregnant woman has gingivitis or periodontitis prior to pregnancy, there is an additional risk of adverse pregnancy outcomes, mainly premature delivery or low weight. It is estimated that the risk of premature birth can be tripled if the mother has periodontitis (the risk ranges from 2.30 to 5.28, depending on the studies).
In addition, periodontal disease has been linked to the increase in the time a woman takes to become pregnant; It is suggested that periodontitis could be a factor to consider (similar to the control of obesity) to increase the chances of getting a pregnancy.
The effect of periodontitis in the control of diabetes is also known. The control of gingival health is essential in cases of gestational diabetes, to avoid possible complications in both the mother and the fetus. Pregnancy implies the need to feed the future child and the female organism undergoes a stress that can generate pathologies. The mouth as part of that organism is influenced by all those circumstances, but also the oral pathology can alter the evolution of pregnancy or can worsen certain systemic pathologies?
Therefore, need to resolve the possible periodontal problems of the woman before pregnancy or, at the latest, in the first weeks of the same is stressed.
They perform to strengthen their bones, it is recommended that pregnant women or those who pretend to have a child follow a special care with oral health and prepare orally to be mothers (visits to the dentist, proper oral hygiene, and periodontal treatments if necessary).
An adequate technique of oral hygiene (frequent use of toothbrush, interdental brushes and / or dental floss) is essential, not only to reduce gingivitis to a minimum, but to prevent the appearance of possible adverse effects in pregnancy. The visit to the dentist or periodontics during pregnancy can prevent, as well as identify and treat, the signs and symptoms of gingivitis gravid. Periodontal treatments during pregnancy are beneficial for the health of the mother’s gums and safe for the fetus.
Take care of your gums … during menopause
During menopause, both estrogen levels (reducing the anti-inflammatory effect of these hormones on the gums) and progesterone are reduced (bone density decreases and osteoporosis appears). At this stage of the woman’s life, estrogen deficiency produces significant alterations in the tissues of the mouth, with less secretion and changes in the biochemical composition of saliva, and disorders in the oral flora.
Usually, in menopausal women periodontal disorders such as atrophic gingivitis (with an abnormal pallor), postmenopausal gingivostomatitis (bright and dry gums, easy bleeding and color that varies between pale and reddish) and oral discomfort, with a burning sensation, can be appreciated. Dryness and bad taste (“Burning mouth syndrome”).
In this situation, the maintenance of low levels of bacterial plaque is essential. Visits to the dentist or periodontics should be made periodically, in order to identify any changes at the oral level. In the case of taking oral bisphosphonates (to treat osteoporosis), the specialist should be informed so that he / she takes the appropriate preventive and therapeutic measures.