Women’s Hormones and Oral Health

Women’s Hormones and Oral Health

The hormones that a woman’s body makes are very powerful. Most of us don’t know that these hormones affect the health of your mouth, gums, and teeth.  There are both positive and negative effects depending on which hormone and the relative amounts of those hormones.  

The first situation women can experience this is at puberty.  The surge in the levels of estrogen and progesterone at this time can increase the blood flow to gums which can change the way gum tissue reacts to bacterial plaque. If this occurs, the gum tissue becomes red, swollen, and tender, leading to more bleeding during brushing and flossing.  

Next, during a normal menstrual cycle, the hormonal fluctuations (especially the increase in progesterone during the last half of the cycle) some women experience bright red or bleeding swollen gums, canker sores, and swollen salivary glands.  This is known as Menstruation Gingivitis and occurs 1 or 2 days before the period and clears up shortly after menstruation begins.

For women taking oral contraceptives (birth control pills) which contain progestin (synthetic, non-bioidentical forms of progesterone made by the drug companies) can experience inflammation of gum tissue from the body’s exaggerated reaction to toxins produced by plaque in the mouth. Newer birth control pills have been reformulated to contain less of this progestin, which reduces the inflammatory response.

During pregnancy, hormone levels change greatly from baseline. A major increase in the levels of progesterone will increase the chance of gingivitis from bacterial plaque. This is called “Pregnancy Gingivitis” and gums can become swollen and bleed easily.   Some women need to have more frequent professional cleanings during the second and third trimesters of pregnancy.  

Temporomandibular Joint disease (TMJ) has been associated with the use of synthetic estrogen (either from birth control pills or synthetic forms made for hormone replacement). The synthetic estrogens will cause a decrease in the production of native, bio-identical forms of estrogen, which is associated with changes in the bones of the joint. Additionally, the combined effect of low levels of estrogen and the compression within the joint caused by TMJ can lead to chronic inflammation or even osteoarthritis in the joint.

Lastly, menopause (loss of or decrease in the levels of estrogen and progesterone) can cause decreased salivary flow that can result in dry mouth.  This dry mouth results in more development of periodontal disease, since the saliva is not around to moisten and cleanse the mouth of acids produced by plaque. Also, loss of estrogen can increase the risk of osteoporosis. If this loss of bone occurs in the jaw along with inflammation previously discussed, tooth loss can occur. 

As we see, our hormone status affects many, if not most functions within the body, including our oral health. So we have another reason to consider replacing missing hormones when it is appropriate.