Inflammation of the gums during pregnancy
Studies show that up to 75% of pregnant women suffer from gum inflammation. Hormonal fluctuations can cause mild gum inflammation in pregnant women and lead to periodontitis. Pregnancy-related gum inflammation affects many mothers-to-be, especially in the second and third trimesters. Symptoms include swollen, tender gums that bleed easily.
Untreated inflammation can damage the tooth support as bacterial plaque grows under the gums and destroys the supporting connective tissue fibers. The buildup of periodontitis-causing bacteria in the gums and pockets further increases inflammation. Untreated inflammation can lead to weakened tooth support and eventually tooth loss.4.5
Poor oral hygiene often causes gum inflammation. Regular and thorough brushing and flossing reduces gum irritation and bleeding in pregnant women by removing plaque from the tooth surfaces and gum margins. Studies show that up to 95% of oral diseases are due to bacterial plaque.4.5 Neglecting oral health during pregnancy can lead to premature birth, low birth weight and the development of pre-eclampsia during pregnancy.6
Good oral hygiene during pregnancy protects the unborn child. Oral health is part of general health and affects the well-being of both the expectant mother and the unborn child. Hormonal changes during pregnancy increase saliva acidity and reduce plaque resistance, making oral hygiene especially important at this stage of life. Brushing with strongly flavored, fluoride-scented toothpaste can be unpleasant during pregnancy, so trying a different brand may be helpful.
Many mothers-to-be suffer from hormone-induced morning sickness, exposing tooth enamel to stomach acids, which can lead to erosion. Heartburn, a common condition during pregnancy, can also erode tooth enamel. Softening of the tooth surface due to acid exposure increases the risk of decay, especially during chewing or if the teeth are brushed shortly after eating acidic foods. To prevent corrosion, regular use of xylitol is recommended. Rinsing the mouth with water after vomiting also helps reduce erosion caused by stomach acids.
Gingivitis has been associated with the risk of preterm birth and low birth weight, underscoring the need for oral health during pregnancy. Antibacterial treatment is highly recommended at this stage, as it helps mothers-to-be take care of their oral health and the well-being of their unborn child. Frequent visits to the dentist may be in order during pregnancy to reduce oral health problems caused by hormonal factors.
How does menopause affect women’s oral health?
Many women experience a sore or burning sensation in the mouth during or after menopause. The mouth may be painful and the mucous membranes may be tender and ulcerated. Taste perception can also change.
Estrogen production in the body drops significantly during menopause and can affect oral health as saliva production decreases.7 Saliva protects teeth from tooth decay, so a lack of saliva can make teeth wear down more easily. Hormonal changes cause the gums’ defense abilities to weaken, so even a small amount of bacterial plaque can easily cause gum inflammation.7,8 Dry mouth is much more common in women than men due to hormonal fluctuations. Many diseases and medications prescribed to menopausal women also increase the feeling of dryness in the mouth.8,9
Low estrogen levels after menopause increase the risk of osteoporosis. As bones weaken, gum disease can occur more quickly, and if bone density is low, tooth loss is more likely.10
Aging increases the likelihood of needing dental implant treatment. The durability of implants placed in patients treated for periodontitis can be questioned as healthy facial bones and healthy gums are required. Careful dental self-care is essential for successful implant treatment. implants do not eliminate the risk of gingivitis. Without proper treatment, inflammation can develop around the implant. Peri-implantitis occurs when plaque bacteria affect the gum tissue and bone around the implant. Regular antibacterial therapy can protect against peri-implantitis.
Good oral health pays off
Good oral hygiene habits, regular visits to the dentist and special treatments (if necessary) can help women maintain their oral health throughout their lives. Oral health promotes overall well-being and helps prevent potential complications such as premature birth or tooth loss. Educating patients about the connection between hormones and oral health can empower them to take preventative measures at every stage of their lives so they can enjoy healthy mouths and smiles for a lifetime.
Editor’s Note: This article first appeared on Clinical Insights newsletter, a publication of Endeavor Business Media Dental Group. Read more articles and Sign up.
bibliographical references
- Chaitra TR, Manuja N, Sinha AA, Kulkarni AU. Hormonal influence on the gums: adolescent gingivitis. BMJ Case Rep. 2012;2012:bcr2012006193. doi:10.1136/bcr.2012.006193
- Jafri Z, Bhardwaj A, Sawai M, Sultan N. Effect of female sex hormones on the periodontium: a case series. J Nat Sci Biol Med. 2015;6(Suppl 1):S146-S149. doi: 10.4103/0976-9668.166124
- Alzoman H, Alssum L, Helmi M, Alsaleh L. Relationship between hormonal changes and self-perceived halitosis in women: a cross-sectional study. Healthcare (Basel). 2022? 11 (1): 43. doi:10.3390/healthcare11010043
- Wu M, Chen SW, Jiang SY. Relationship between gum inflammation and pregnancy. Mediators of Inflammation. 2015? 2015: 623427. doi:10.1155/2015/623427
- Yenen Z, Ataçağ T. Oral care in pregnancy. J Turk Ger Gynecol Assoc. 2019? 20 (4): 264-268. doi:10.4274/jtgga.galenos.2018.2018.0139
- Srinivas SK, Parry S. Periodontal disease and pregnancy outcomes: time to move on? J Womens Health (Larchmt). 2012? 21 (2): 121-125. doi:10.1089/jwh.2011.3023
- Suri V, Suri V. Menopause and oral health. J Midlife Health. 2014? 5 (3): 115-120. doi: 10.4103/0976-7800.141187
- Dutt P, Chaudhary S, Kumar P. Oral health and menopause: a comprehensive review on current knowledge and related dental management. Ann Med Health Sci Res. 2013? 3 (3): 320-323. doi: 10.4103/2141-9248.117926
- Jacob LE, Krishnan M, Mathew A, Mathew AL, Baby TK, Krishnan A. Xerostomia – a comprehensive review with a focus on midlife health. J Midlife Health. 2022? 13 (2): 100-106. doi:10.4103/jmh.jmh_91_21
- Grodstein F, Colditz GA, Stampfer MJ. Postmenopausal hormone use and tooth loss: a prospective study. J Am Dent Assoc. 1996, 127(3):370-377. doi:10.14219/jada.archive.1996.0208
Nina Garlo-Melkas, MSc, is a health and science journalist working as a communications manager at Koite Health Ltd., a fast-growing health technology company and innovator of light-activated antibacterial solutions for the treatment and prevention of oral diseases.
